COMMON MALPRACTICES IN THE HOSPITAL

By: AIZA MURILLO TOLEDO, B.S.N, R.N and LORY MAE ESPERA SARMIENTO, B.S.N, R.N

HOSPITAL RULES:
ISSUE NO 1. Nurses & Volunteer Nurses cleaning the hospital. Ex Moping the floor, scrubbing the wall, cleaning the windows and putting curtains. Philippine Nursing Act (R.A 9173) Sec 28: Scope of Nursing.- As member of the health team, nurses shall collaborate with other health care providers for curative, preventive, and rehabilitative aspects of care, restoration of health alleviation of suffering, and when recovery is not possible, towards peaceful death. It shall be the duty of the nurse to: a.) Provide nursing care through the utilization of nursing process. b.) Establish linkage with the community resources and coordination with the health team. c.) Provide health education in individuals, families, and communities. d.) Teach, guide and students in nursing education programs e.) Undertake nursing and health human resource development training and research ISSUE NO. 2 Nurses working for more than 8 hrs. and are paid 200p per day. Republic Act 5901, Nurse working in agencies with 100 bed capacity and/or above and or working in an area of one million population are supposed to work only forty hours per week.

WARD:
ISSUE NO.1 Doctors not doing the daily rounds to check patients. ISSUE NO.2 Nurses prescribing meds with/without the physicians signature Republic Act 6675, Only valid registered medical, dental, and veterinary practitioner, whether in private institution/corporation or in the government, are authorized to prescribed drugs.

ISSUE NO.3 Prescription made by nurses do not contain complete in formations. Republic Act 5921. The pharmacy Act as amended, all prescriptions must contain the following information: Name of the prescriber, office address, professional registration number, professional tax receipt, patients name, age, sex, and date of prescription. ISSUE NO.4 Physicians prefer to order imported brand/type of medicines. Ex. (KEFOX) 750, IVTT, q 8, KEFOX is a brand name for Cefuroxime. Republic Act 6675. Requires that drugs be written in their generic names ISSUE NO.5 Multiple use of disposable syringes. Legal Aspect of a Nurse (Legal Risk for Defective Equipment) One important duty of the nurse is to make sure that the equipment used in the procedures and treatment is not defective. She should document the times she requested these to show that she was able to foresee the improper functioning of the equipment which might cause possible injury to patients. ISSUE NO.6 Keeping of regulated drugs such as: Diazepam (Valuim), Lorazepam (Ativan), Xanor, and etc. Republic Act 6425 Known as Dangerous Drug Act 1972 covers the administration and regulation of the manufacture, distribution, and dispensing of controlled drugs. ISSUE NO. 7 Nurses giving unnecessary meds as prescribed by physician. Ex: Cefuroxime 750mg +Ranitide 1amp to Hypertensive-Diabetic client without any complaints or s/s of infection. Doctor use to do this to reach a desired quota required by a specific company as an exchange of something in return. Republic Act 9173 Art.III Sec. VIII, Registered Nurses are the advocates of the patients; they shall take appropriate steps to safeguard their rights and privileges. ISSUE NO.8 Requesting irrelevant labs Republic Act 9173 Art.III Sec. VIII, Registered Nurses are the advocates of the patients; they shall take appropriate steps to safeguard their rights and privileges.

ISSUE NO.9 Volunteer Nurses Inserting I.V line without IVF training

 Board of Nursing Resolution No.8 states that any registered nurse without such training and who administers intravenous injections to patient shall be held liable, either criminally under Sec 30 (c) Art. VII of said law or administratively under Sec. 21 Art. III or both (whether causing or not an injury or death to the patient). ISSUE NO.10 Volunteer Nurses Giving IVTT med without IVF training. Board of Nursing Resolution No.8 states that any registered nurse without such training and who administers intravenous injections to patient shall be held liable, either criminally under Sec 30 (c) Art. VII of said law or administratively under Sec. 21 Art. III or both (whether causing or not an injury or death to the patient). ISSUE NO. 11 Nurses taking doctors order via text message. TELEPHONE ORDERS, It is in the interest of safety that only those who have more experience and a greater knowledge of drugs should receive the order. In these connection, there should be a clear hospital policy that is within the bounds of the medical and the nursing laws regarding telephone orders to avoid misunderstanding not only for the individuals concerned but also for the hospital as well. ISSUE NO. 12 Restraining patients without consent. ISSUE NO. 13 Raising side rails without consent. ISSUE NO. 14 Nursing Aides inserting a urine catheter LIABILITY OF NURSES FOR THE WORK OF NURSING AIDES, Nurses should not delegate their functions to nursing aides since the Philippine Nursing Act specifies the scope of nursing practice of professional nurse. ISSUE NO. 15 Nursing Aides giving suppository meds. Via vaginal & rectal. LIABILITY OF NURSES FOR THE WORK OF NURSING AIDES, Nurses should not delegate their functions to nursing aides since the Philippine Nursing Act specifies the scope of nursing practice of professional nurse. ISSUE NO. 16 Nurses charting interventions which were not done. MEDICAL RECORD, The value of medical record is both scientific and legal. In the performance of their duties, nurses are expected to record fully, accurately, legibly, and promptly their observation from admission to the time the patients discharge.

EMERGENCY ROOM
ISSUE NO.1 Doctors and Nurses not responding promptly to patients without down payment. CODE OF GOOD GOVERNACE (General Principle). SRVICE TO OTHERS, This implies a commitment to a life sacrifice and genuine selfishness in carrying out their professional duties even at the expense of personal gain. ISSUE NO.2 Referring patients to other hospitals without proper endorsement from the nurse who brought the patient, and the nurse who will received the patient. ISSUE NO.3 Transporting patient via tricycle or taxi, if patient cannot afford to pay the ambulance

DELIVER ROOM and OPERATING ROOM

ISSUE NO.1 Maltreatment of doctors and nurses to the patient Ex. (shouting to patient, hitting the patient) TORT(Defamation) Slander is an oral defamation of a person by speaking unprivileged or false words by which his reputation is damaged. TORT (Battery) is an intentional, unconsented touching of another person. ISSUE NO.2 Not wearing the appropriate uniform at the sterile area. Ex (Doctor, checking the patient at Delivery room without changing uniform)