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LEGAL ISSUES IN NURSING

Course # 840
5 CE Hours
$XWKRUV: Julie M. Mroczek, BSN. RN-­BC, CLNC
Shelda L. Hudson, RN, BSN, PHN

Course Material valid through 07/2016


Copyright © 2013
W.S. Keefer
All rights reserved
Published by the National Center of Continuing Education, Inc.,
Lakeway, Texas.
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Printed in the United States of America. Enhanced Learning & Skills...
No Exams,
Just Learning!
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A NATIONAL EPIDEMIC
WE ALL KNOW . . .
. . . that U.S. Copyright Law grants to the copyright owner the exclusive right to duplicate copyrighted, printed and
recorded materials. Piracy involves the illegal duplication of copyrighted materials.

YOU MAY NOT KNOW . . .


. . . that every time you use or make an illegal copy of cassettes or printed material in any form or by any method you
may be subject to litigation.

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. . . that the penalty for criminal violation is up to ÀYH\HDUVLQSULVRQDQGRUDÀQHXQGHUDWRXJKQHZODZ


(Title 17, U.S. Code, Section 506, and Title 18, U.S. Code Section 2319).

. . . that civil or criminal litigation may be costly and embarrassing to any organization or individual. We request you
contact us immediately regarding illegal duplication of these copyrighted, printed materials. The National Center of
Continuing Education will pay a VXEVWDQWLDOUHZDUG for information leading to the conviction of any individual or
institution making any unauthorized duplication of material copyrighted by W.S. Keefer or The National Center of
Continuing Education.

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About the Authors… ...........................................................................................................3


Purpose and Goals ..............................................................................................................3
Instructional Objectives......................................................................................................3
Introduction .........................................................................................................................3
Introduction to Law ............................................................................................................3
Sources of Law ............................................................................................................3
Tort Law ......................................................................................................................5
Professional Liability ..........................................................................................................7
Professional Responsibility ................................................................................................7
Your Rights ..........................................................................................................................9
Discovery ........................................................................................................................... 11
Types of Discovery .................................................................................................... 11
Wrapping It Up .................................................................................................................13
References & Suggested Readings ................................................................................... 13
Legal Terminology/Glossary ............................................................................................. 14
Appendix A, American Health Insurance Portability and
Accountability Act (HIPPA) ..............................................................................................16

We Want You To Learn! ©

Cover Art by Eric Smith, BFA

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‹1DWLRQDO&HQWHURI&RQWLQXLQJ(GXFDWLRQ,QF‡ZZZQXUVHFHFRP Legal Issues in Nursing Page 15


American Health Insurance Portability and Accountability Act
(HIPPA)

HIPPA regulations are divided into the following rules:

(aT;b)eaT_>/U*aU\!>;U9aA\;DA>aU\A-T-Ua\DaFTD\/)\a;A-;b;-_>a@/-;)>aT/)DT-UaA-aD\9/TaF/TUDA>a9/>\9a;A3DT@-
tion for any healthcare institution that conducts healthcare transactions electronically. The Privacy Rule requires
appropriate safeguards to protect the privacy of personal health information, which sets limits and conditions on
use and disclosure that may be made available without patient authorization. It also gives patients rights over their
health information, including the ability to examine, review, and obtain a copy of their health records and to request
changes or corrections.

(a/)_T;\eaT_>/U*aU\!>;U9a\9/aFT;b)eaFTD\/)\;DAaD3a/>/)\TDA;)aFTD\/)\/-a9/>\9a;A3DT@\;DAaG HaA-a-/>Uac;\9a
identifiable health information as defined by HIPPA identifiers. The security rule defines standards, methods, and
procedures for protecting electronic PHI with identification of how PHI is stored, accessed, transmitted, and
_-;\/-Ja9/a a/)_T;\eaT_>/a/A3DT)/Ua\9T//aU/)_T;\eaU3/6_T-U*aUU;6A@/A\aD3aa aU/)_T;\ea)D@F>;A)/a
team, protection of electronic systems, equipment and data, and authentication used to control data access.

(aTAU)\;DAaT_>/U*a A)>_-/aaU/\aD3a)D-/Ua_U/-a3DTa/A)D-;A6a-\+aU_)9aUa@/-;)>a\/T@UaA-a)DA)/F\Ua@/-;)>a
diagnosis, and procedure codes. Code sets for medical data are required for administrative transactions for diag-
nosis, procedures, and drugs.

(aA;L_/a;-/A\;3;/TU*aUaFT\aD3a\9/a a-@;A;U\T\;b/a;@F>;3;)\;DAaT/6_>\;DAa\9/T/aT/a)_TT/A\>ea\9T//a;-/A\;3;/TUa
\9\a9/>FaFTD@D\/aU\A-T-;f\;DA+a/33;);/A)e+aA-a)DAU;U\/A)eJa9/eaT/a\9/a\A-T-UaA;L_/a@F>De/Ta -/A\;3;/T+a
the National Provider Identifier, and the National Health Plan Identifier.

(aA3DT)/@/A\aT_>/U*a/U)T;!/a;@FTDb/@/A\Ua\Da/d;U\;A6a a>c+a)Db/T/-a/A\;\;/U+a!_U;A/UUaUUD);\/U+aA-aD\9-
/TUac9DaT/aU_!</)\a\DaT;6DTD_UaU\A-T-UaT/>\/-a\Da Ja9/a aG/>\9a A3DT@\;DAa/)9AD>D6ea3DTa)D-
AD@;)aA-a>;A;)>a/>\9Ha/dFA-Ua\9/aU)DF/aD3a\9/a aT;b)eaA-a/)_T;\ea_>/UaA-a;A)T/U/Ua\9/aF/A>\;/Ua
for HIPPA violations. It also provides Medicare and Medicaid monetary incentives for hospitals and physicians to
-DF\a+aA-a\9/aT_>/Ua>UDaFTDb;-/a6TA\Ua3DTa\9/a-/b/>DF@/A\aD3aa9/>\9a;A3DT@\;DAa/d)9A6/+ac9;)9a9/>FUa\Da
encourage healthcare providers to adopt technology to improve efficiency in healthcare.

With today’s ever-changing and efficient technological environment in relation to healthcare, all documentation
involving patient care is monitored more closely, thoroughly, and efficiently by the federal government and entities
involved in the medical profession. It is extremely important to always care for patients as proficient, educated,
competent professionals and document patient care with honesty, integrity, and accuracy. Protecting patients' rights
to maintain confidentiality in all areas relating to their healthcare is a top priority affecting the current healthcare
system, which is reinforced and maintained by developing stricter HIPPA regulations. Failure to uphold these stan-
dards can result in severe consequences to all healthcare providers involved.

Appendix A Adapted from 86'HSDUWPHQWRI+HDOWKDQG+XPDQ6HUYLFHV

Page 16 Legal Issues in Nursing ‹1DWLRQDO&HQWHURI&RQWLQXLQJ(GXFDWLRQ,QF‡ZZZQXUVHFHFRP


LEGAL ISSUES
IN NURSING

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