responsibility and accountability for the practice of professional

8/4/2019 Responsibility and Accountability for the Practice of Professional

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“NEGLIGENCE” refers to the commission or omission of an act,pursuant to a duty, that a reasonably prudent person similarcircumstance would or would not do, and acting of which is theproximate cause of injury to another person or his property.

ELEMENTS:

1. Existence of a duty on the part of the person charged to use duecare under circumstances

2. Failure to meet the standard of due care

3. The forseeability of harm resulting from failure to meetstandards and

4. the fact that the breach of this standard resulted in an injury tothe patient.



* Article 19 of the Civil code states that one shall actwith justice, give every man his due, observe honesty

and good faith.

* Article 20 states that those who, in the performance of their obligations through negligence cause any injury

to another, are liable for damages.



Burns resulting from hot water bags

Objects left inside the patient’s body

Falls of the elderly

Failure to observe and take appropriate action asneeded



1. Failure to report observations to attending physicians

2. Failure to exercise the degree of diligence which thecircumstances of the particular case demands

3. Mistaken Identity 4. Wrong medicine, concentration, route and dose

5. Defects in the equipment

6. Errors due to family assistance

7. Administration of medicine without Doctor’s order



“the thing speaks for itself”

is a rebuttable presumption rebutted by showing that

the event was an inevitable accident and had nothingto do with the defendant’s responsibility of control orsupervision.



Improper or unskillful care of a patient by a nurse.

DOCTRINE OF FORCE MAJUERE

- “force majuere” means an irresistible force, one that isunforeseen or inevitable.

- Circumstances such as flood, fire, earhquakes andaccident fall under this doctrine.

* Habitual tardiness due to heavy traffic is notconsidered an excuse for force majuere.



“let the master answer for the acts of the subordinate”

The liability is expanded to include the master as wellas the employee and not a shift of liability from the

subordinate to the master.

Example

- The surgeon will be held responsible in case a

laparatomy pack is left in patients abdomen



Lack of ability, legal qualifications or fitness to dischargethe required duty.

LIABILITY OF NURSES FOR THE WORK OF NURSING AIDES

- RN should not delegate their functions to nursingaides since the Philippine Nursing Act specifies thescope of nursing practice.

- If a nurse delegates her function to a nursing aide andlatter commits mistake then the person responsible isthe nurse.



Under Philippine Nursing Act of 2002 R.A 9173,

NURSING STUDENTS DO NOT PERFORMPROFESSIONAL NURSING DUTIES.

They must be supervised by a clinical instructor.

To minimize the errors of students the following measures

should be taken:1. Should always supervised by a CI

2. Give assignments that are at their level of training,experience and competency

3. Advised to seek guidance performing first time procedures

4. Oriented to policies of the unit/hospital

5. Assessed frequently performance

6. Frequent conferences with the students



DOCUMENTATION of the care they give in a CONCISE and ACCURATE manner (most common)

MEDICAL ORDERS, DRUGS AND MEDICATIONS

R.A 6675 – valid registered medical, dental and veterinary practitioners are authorized to prescribed drugs.

Prescriptions made by unauthorized persons constitute illegalpractice of medicine in punishable under R.A 2832 (Medical

Act of 1959), R.A 4419 (Dental Act), R.A 382 (Veterinary Act)

R.A 5921 (Pharmacy Act) – prescriptions must contain name of the prescriber, address, PRC #, Tax receipt #, clients name,

age and sex and date of prescription



Philippine Nursing Act of 1991 Sec 28

- In the administration of intravenous injections,special training shall be required according to protocolestablished

BON resolution No. 8 states that any RN withoutsuch training and administers IV therapy shall be heldliable, either criminally under Sec 30 Art. VII of said

law or administratively under Sec. 21 Art. III (whethercausing or not an injury or death to the patient).



1. Interpretation of doctor’s orders for IV therapy

2. Performance of insertion of needles, venipuncture except TPNand cutdown

3. Preparation and administration of IV medications

4. Administration of blood/blood products as ordered by

physicians5. Recognition of solution incompatibilities

6. Maintenance and replacement of tubings, dressings inaccordance with established procedures

7. Establishment of f low rates of solutions, medicines, blood8. Use of IV equipment

9. Nursing management of TPN, out-patient IV care

10. Maintenance of aseptic nursing interventions

11.Maintenance of appropriate documentation



The nurse should read back the order to the physicianto make the certain order has been correctly written.

Such order should be sign within 24 hours.

Write the date and time the order was received



Consent define as a “free and rational act that presupposesknowledge of the thing to which consent is being given by aperson who is legally capable to give consent”

TYPES OF CONSENT

1. Nature of consent - usually for diagnostic procedures

2. Informed consent – patient is knowledgeable whatprocedure is to be done

3. Proof of consent – patient understand the nature of theprocedure the risks and consequences



4. Who must consent – consent taken from another who is authorized to give it in his behalf

5. Consent of Minors – parents or someone standing intheir behalf gives the consent to medical or surgicaltreatment of a minor.

6. Consent of Mentally ill

7. Emergency situation8. Refusal to consent

9. Consent for sterilization



Is a legal, wrong, committed against a person or property independent of a contract which renders the person whocommits it liable for damages in civil action.

Examples

1. Assault and Battery – Assault is the imminent threat orharmful or offensive bodily contact. Battery is anintentional unconsented touching of another person.

2. False imprisonment or Illegal Detention – unjustifiabledetention of a person without a legal warrant.



3. Invasion of Right to Privacy and Breach of Confidentiality – is the right to be left alone, right to

be free from unwarranted publicity.

4. Defamation – “character assassination”

Slander – oral defamation

Libel – written defamation



A legal declaration of a person’s intentions upon death. Called “testamentary document”

“decedent” - is a person who’s property is transmittedthrough succession whether he no left a will

“testator” – if he left a will “testatrix” – if a person making a will is a woman

“heir” – succession by the will of the law

“testate” – a person died with a will

“intestate” – a person died without a will

“probate” – validation of a will in the court

“administrator” – one who administer provision of the will



“holographic will” - a written, dated and signed be the testator

“nuncupative or nuncupation will” – oral will

TESTAMENTARY CAPACITY AND INTENT

1. The testator must be at least 18 years old, not blind, deaf and ableto read and write

2. The testator shall name the person who will carry the provision3. Properties must be disposed in accordance with legal

requirements

4. Must be signed by the testator with 3 witnesses

5. Must be acknowledged before a notary public by the testator and witnesses

6. A married woman can make a will even without the consent of her husband



* The nurse should make a notation on the patient’s chartof the apparent mental and physical condition of the

patient while making the will.



Meeting of minds between two parties whereby one bindshimself, with respect to the other to give something or torender service.

KINDS OF CONTRACTS

1. Formal contract2. Informal contract3. Express contract

4. Implied contract5. Void contract6. Illegal contract



1. Two parties must involved

2. Two parties must give consent to the contract

3. Subject matter of the contract must be specified.

4. The time, price and subject matter are expressed5. Contracting parties must be

a. Of legal age

b. Of sound mind

c. Not under the influence of intoxicated drugsd. Not suffering from physical or mental ability



Contracts obtained through use of illegal process.

Examples

1. Those that are made in protection of the law2. Consent obtained by fraud

3. Those obtained under duress

4. Those obtained under undue influence

5. Those obtained through material misrepresentation



Failure to perform an agreement, whether express orimplied without a cause

BREACH OF CONTRACT FOR NURSING SERVICES

1. Prevention of performance2. Failure to perform because of difficulty

3. Failure of cooperation in the performance

4. Abandonment of duty 5. Substitution of performance

6. Failure to use due care



1.Discovery of material misrepresentation made andrelied upon

2. Where performance will be illegal3. Where performance where made impossible by reasonof illness

4. Where performance is made impossible by death of

patient or nurse5. Where performance is made for other reasons

6. Where contract is insufficient

responsibility and accountability for the practice of professional

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