1. REGULATORY BODIES AND LEGAL
ASPECTS IN NURSING
JENITA JOYCE JOHN
I YEAR MSc (N)
APOLLO COLLEGE OF
NURSING

2. INTRODUCTION
Regulatory agencies are usually a part of
the executive branch of the government, or
they have statutory authority to perform their
functions with oversight from the legislative
branch. Their actions are generally open
to legal review. Regulatory authorities are
commonly set up to enforce standards and
safety

3. REGULATORY BODIES
A regulatory body
is a public
authority or governm
ent
agency responsible
for exercising
autonomous
authority over some
area of human
activity in
a regulatory or super
visory capacity.

4. INTERNATIONAL AGENCIES
INTERNATIONAL COUNCIL OF NURSES
(ICN)
AMERICAN NURSES ASSOCIATION (ANA)
CANADIAN NURSES ASSOCIATION (CNA)
AUSTRALIAN NURSES AND MIDWIVES
ASSOCIATION
BRITISH NURSES ASSOCIATION

5. INDIAN REGULATORY AGENCIES
INDIAN NURSING COUNCIL
TRAINED NURSING ASSOCIATION OF
INDIA (TNAI)
STATE NURSING COUNCIL
STATE MEDICAL HEALTH UNIVERSITIES

6. INTERNATIONAL COUNCIL OF NURSES
Founded in 1899,
headquartered in Geneva,
Switzerland
World’s first largest
international organization
for health
Represents 16 million
international nurses
130 national nurses
organization

7. The Three goals are:
To bring nursing together worldwide
To advance nurses and nursing worldwide
To influence health policy.
Core Values:
Visionary Leadership
Inclusiveness
Flexibility
Partnership
Achievement

8. OBJECTIVES
QUALITY
NURSING
CARE FOR
ALL
SOUND
HEALTH
POLICIES
COMPETENT &
SATISFIED
WORKFORCE
ADVANCEMENT OF
NURSING
KNOWLEDGE

9. BOARD OF DIRECTORS
ICN governed by 16 member board of
directors
Board meets every year

10. PUBLICATIONS
International Nursing Review
Health and Well being of Women
Incentive for health professionals

11. AMERICAN NURSES ASSOCIATION
Founded in 1896, based in
Silver Spring, Maryland,
USA
Represents RNs of USA
Professional organization
to advance and protect
nursing profession

12. Functions:
• Policy development
• Organizations partnership
• Publications and Newsletters
> The American Nurse
> American Nurse Today

13. INDIAN NURSING COUNCIL (INC)
AIM – To establish a uniform
standard of training for nurses
midwives and health visitors
INC is a regulatory body for
nurses and nursing education
in India
It is an autonomous body
under the Government of
India, Ministry of Health and
Family Affairs

14. ORGANIZATIONAL STRUCTURE

15. COMMITTEES

16. PURPOSES
UNIFORM
STANDARDS OF
EDUCATION
NURSES
REGISTRATION
REGISTRATION
OF FOREIGN
NURSES
INDIAN
NURSING
REGISTER

17. FUNCTIONS

18. TRAINED NURSES ASSOCIATION OF INDIA (TNAI)
Formed in 1908 at
Delhi, India
It is a National body
of practitioners of
nursing at various
levels
It is a professional
association of nurses
Affiliated to
Commonwealth
Nurses Federation

19. AIMS
upgrading
UPGRADING, DEVELOPMENT
AND STANDARDIZATION OF
NURSING EDUCATION
IMPROVEMENT OF LIVING
AND WORKING CONDITIONS
OF NURSES IN INDIA
REGISTRATION FOR
QUALIFIED NURSES

20. ACTIVITIES

21. FUNCTIONS OF THE TNAI
Nurses Charter
Standardization of Nursing Education
Service Condition for Nurses
Continuing Education Programme
Socio – Economic Welfare programmes
Scholarships
Nurse’s welfare Funds
Relationship with the Government
International Affiliations
Projects

22. BOARD OF DIRECTORS
• President – Mr. A.B Kulkarni
• Vice President – Sr. (Prof) Gilbert
• Secretary General – Mrs. Sheila Seda

23. PUBLICATIONS
CHN
MANUAL
NURSING
JOURNAL OF
INDIA
HANDBOOK
OF TNAI

24. MEMBERSHIP
Membership is obtained
by submission of a copy
of own state registration
certificate
Membership can also be
transferred by SNA to
TNAI within 6 months
after course completion

25. STATE NURSING COUNCIL
Maintains register of names of professional
nurses of their state
These names are also maintained in the Indian
Nurses Register by INC

26. FUNCTIONS

27. TAMIL NADU NURSES AND MIDWIVES COUNCIL
Registering body for
nurses, midwives,
ANM, MPHW, health
visitors as per INC
standards
Extends registration to
union territories –
Pondicherry, Andaman
& Nicobar Islands

28. BOARD OF DIRECTORS

29. THE TAMIL NADU DR MGR MEDICAL UNIVERSITY
Known as The Tamil Nadu
Medical University in 1980
1988 – The Tamil Nadu Dr
MGR Medical University
Deals with Medicine,
Dentistry, Indian
Medicine/Homeopathy and
Allied Health Sciences

30. OBJECTIVES

31. BOARD OF DIRECTORS

32. LEGAL ASPECTS IN NURSING

33. INTRODUCTION
It is important for nurses to know the basic legal
concepts because nurses are accountable for their
professional judgments and actions

34. NURSING LAW
Defined as that body of
status, executive orders,
regulations, rule and legal
precedents which have their
objective the promotion and
protection of individual and
community by nursing
service

35. FUNCTIONS
FRAMEWORK FOR NURSING ACTION
DIFFERENTIATES NURSES RESPONSIBILITY
BOUNDARIES INDEPENDENT NURSING ACTIONS
MAINTAIN STANDARD PRACTICE

36. SOURCES OF LAW
CONSTITUTION
AL LAW
COMMON
LAW
ADMINISTRATIV
E LAW

37. TYPES OF LAW

38. VOLENTI – NON – FIT - INJURIA
French, it means Voluntarily –
suffered – injury
It is a law that no man can sue
for a tort to which he had
consented either expressly or
impliedly

39. PATIENT’S RIGHTS

40. LEGAL SAFEGUARDS IN NURSING PRACTICE
Licensure
Good Samaritan Law
Good rapport
Standards of care
Standing orders
Informed consent
Correct identity
Documentation
Reporting

41. LEGAL RESPONSIBILITIES OF A NURSE
Appointing and assigning
Quality control
Equipment
Observation and reporting
Record keeping and recording
Death and dying

42. MEDICO LEGAL ASPECTS OF DEATH
Be with patient during death
Reassure patient’s relatives
Do not whisper
Only doctors declare death
Death records
Respect body and conduct all
last offices
Take signature of party before
releasing the body

43. INDIAN PENAL CODE AND MEDICAL PRACTICE
The patient or guardian can
only claim damages from
doctor and hospitals
Both parties bear their own
legal expenses
Patient or guardian can get the
doctor and hospital authority
fined or jailed by proving
negligence in court of law

44. TORT
Tort is a civil wrong for which remedy is
common law action
To constitute a tort all the following conditions
must be satisfied
 Omission
 Wrongful Act
 Legal Damage
 Legal Remedy

45. CLASSIFICATION OF TORT
• Willful act that violate
another’s rights – Assault
• Includes negligence or
malpractice

46. Types of Law
Private/Civil
Contract
Law Tort
Intentiona
l
Assault/Batte
ry
False
Imprisonment
Invasion of
Privacy
Defamatio
n
Libel Slande
r
Willful
Action
Intended
consequence
s
Causatio
n
Unintention
al
Negligence/Mal
practice
Failure to
meet
standard of
care
Duty,Breach of
duty,Forseeabil
ity,Causation,I
njury/harm,da
mage
Public
Criminal Law
Felon
y
Misdemeano
r

47. Felony – A serious crime
Tort – Civil wrong for which remedy is a
common law action
Assault – Any willful attempt or threat or harm
another with ability to actually harm the person
Battery – Intentional touching of another’s body
or anything without consent
Legal – Connected with the law

48. Plantiff – Person who has lodged the complaint
Malpractice – Professional misconduct
Malice – Desire to harm someone
Slander – Act or crime of making a false
statement damaging to a person’s reputation
Negligence – Carelessness which caused negative
results
Fidelity – Quality of being faithful/loyal
Defendant – A person accused of crime
Breach of duty – There must be a standard of care
but the nurse did not observe

49. Foreseeability- A link must exist between the
nurses’ act and the injury suffered
Causation – It must be proved that the harm
occurred as a direct result of the nurses’ failure to
follow the standard of care the nurse should have
Harm/Injury – The client must demonstrate some
type of harm or injury physical, financial or
emotional) as a result of the breach of duty owed
the client
Damages – If malpractice causes injury the nurse
is liable foe damage

50. Manslaughter – second degree murder
Misdemeanor – Offence of a less serious nature
and usually punishable by fine

51. LEGAL ASPECTS
Informed consent
Delegation
Violence, abuse and neglect
Controlled substances
The impaired nurse
Sexual harassment
Abortions
Death and related issues

52. INFORMED CONSENT
It is an agreement by a client to accept a
course of treatment or a procedure after being
provided complete information including the
benefits and risks of treatment.
TYPES
EXPRESS IMPLIFIED

53. DELEGATION
Transfer of responsibility for the performance
of an activity from one person to another while
retaining accountability for the same

54. VIOLENCE, ABUSE AND NEGLECT
When an identified instance of injury appears
to be present as the result of abuse, neglect
or exploitation the nurse must report it to the
authorities

55. CONTROLLED SUBSTANCES
The laws regulate the distribution of controlled
substances such as narcotics, depressants,
stimulants and hallucinogens

56. THE IMPAIRED NURSE
Refers to a nurse whose ability to perform the
functions of a nurse is diminished by chemical
dependency on drugs, alcohol or mental illness

57. SEXUAL HARASSMENT
Unwelcome sexual advances, request for
favors and other verbal or physical conduct
Nurses must develop skills of assertiveness to
deter harassment in the work place

58. ABORTIONS
The nurses have the right to refuse
participation in abortions
Nurse can assist abortions under MTP act

59. DEATH AND RELATED ISSUES
Autopsy
Certification of death
Do Not Resuscitate orders
Euthanasia
Inquest
Organ donation

60. LEGAL ISSUES IN SPECIALTY PRACTICE AREAS
MEDICAL SURGICAL NURSING
CHILD HEALTH NURSING
MATERNAL AND NEW BORN NURSING
PSYCHIATRY NURSING

61. MEDICAL SURGICAL NURSING
Disoriented adults may require some form of
restraints to prevent accidental self injury
Side rails are available on most hospital beds
Disoriented older patients may require belt
restraints to prevent them falling off the bed
If patient falls off the bed they may sue the
nurse and hospital

62. COMMON ACT OF NEGLIGENCE IN MEDICAL
SURGICAL NURSING
Overlooked sponges, needles and instruments
Burns
Falls
Injury due to use of defective apparatus or
supplies
Loss or damage
Assault and battery
Failure to report accidents
Maintenance of records and reports

63. COMMON ACT OF NEGLIGENCE IN CHILD HEALTH
NURSING
Pediatric nurses are responsible for
preventing children in their care from
accidently harming themselves
Cribs with restraints are designed to keep
infants and toddlers from climbing out of bed
Poisonous substances and sharps should be
kept out of reach of children
Suspected child abuse or neglect must be
reported

64. COMMON ACT OF NEGLIGENCE IN OBG
NURSING
Causes of lawsuit for malpractice in this area
can be divided into 2 – Mother and Child
Lawsuits brought against physicians and
nurses differ

65. LIKELY AGAINST DOCTORS…
Failure to diagnose a high risk pregnancy
Delay in performing a Caesarean section
Improper vaginal delivery or failure to
perform a C section
Improper use of forceps
Delay in arriving to hospital
Non attendance at the delivery

66. LIKELY AGAINST NURSES…
Problems of medication
Failure in adequate client monitoring
Failure to adequately assess the client
Failure to report changes in the client
Abortions
Nursing care of new born

67. COMMON ACT OF NEGLIGENCE IN PSYCHIATRY
NURSING
CRITERIA
Dangerous to others
Dangerous to self
Need for treatment

68. Immediate restraint of the insane
Voluntary admission
Admission through magistrate
Admission through police power
Reception after judicial inquisition
Discharge
Discharge on parole
Abscond of the patient

69. CONCLUSION

70. JOURNAL INFORMATION
Menendez Juliet Battard, “Informed Consent”,
JONA healthcare, Laws, Ethics and
Regulation, Volume 15, Number 4, Oct – Dec
2013

71. THANK YOU