Topics

• Professional Practice Standards
• Position Statement
• Nurse Practice Act
• References

NURS 410 - Health Care Delivery Systems & Informatics

Module 12: Professional Practice Standards, Policy, and Liability

Nurse Practice Act

Registered nurses are granted the privilege to practice nursing once they pass the NCLEX examination and secure a license from the state of their primary residence (e.g., live in Maryland and obtain a license in Maryland). The National Council for the State Boards of Nursing (NCSBN) administers the NCLEX examination and develops the testing blueprint from which the test questions are selected.  Passing NCLEX is the first step in setting clear expectations on what constitutes safe and competence nursing practice and reflects a nurses’ competency at a single point in time. Now with license in hand, the RN nurse must begin to practice with the established law defined by the states nurse practice act. Review the explanation of how Nurse Practice Acts Guide and Govern Nursing Practice on https://www.ncsbn.org/nurse-practice-act.htm, and then think about the link between this state law, safe and appropriate care, and competent nursing practice. What sparked your interest as a future practicing RN?

Next click on the link titled, Nurse Practice Act Toolkit, then click on, Find Your Nurse Practice Act, then select the state of Maryland. Click the Nurse Practice Act link and again the Nurse Practice Act link. Skim the information located on the page and then open Code of Maryland and Code of Maryland Regulations (COMAR) and focus on file 10.27.09.01.htm Definitions. Scroll down to section (21) to read how Maryland Nurse Practice Act defines RN and defines expectations of RN practice….. "RN" means a registered nurse as defined in Health Occupations Article, §8-301, Annotated Code of Maryland. See how the ANA Scope & Standards of Practice (2010) are integrated in to the Act and how both establish expectations of nurses practicing under state law.

When think of care that is considered potentially harmful or not reflective of the standards of care, we need to consider a concept called professional negligence. Negligence is the failure to use such care as a reasonably prudent person would use under similar circumstances (Hurley & Berghahn, 2010). The law of negligence is part of what is known as "tort" law and originates from the French word meaning "wrong"(Law.com, n.d.). The law of negligence therefore deals with injuries or a wrong caused by one person towards another. Most negligence lawsuits are civil, not criminal, cases. A person can be found negligent even though they did not actually intend to harm the inured party, because negligent conduct is the behavior which results in unintended harm.

Medical malpractice can occur when a health care professional fails to exercise the degree of care that a reasonable health care professional would exercise under the same or similar circumstances. Malpractice is negligence committed by a health care professional. Professional negligence is related to malpractice where a “healthcare professional acts negligently when they fail to exercise ordinary care, the level of care that a reasonable health-care professional would use in a similar situation” (Hurley & Berghahn, 2010, p. 41). Deviating from the standard of care and scope of practice is, most often, the basis for most malpractice claims (Hurley & Berghahn, 2010, p. 41).

All four elements must be present or satisfied to result in a malpractice lawsuit and the plaintiff must prove each of these four elements:

• the defendant owed the plaintiff a duty of reasonable care;
• the defendant breached her duty;
• the plaintiff incurred an injury, loss or harm and,
• the defendant’s acts or omissions caused the plaintiff’s injury, loss or

harm.
The plaintiff must prove each of these four elements by a preponderance of the evidence. A preponderance of the evidence means that it is more likely that the defendant committed the medical malpractice than not.

End this module by watching how two attorneys discuss the 4 elements of malpractice, Tort Law project: Intro to Negligence on https://www.youtube.com/watch?v=u6ynTbY944Q (5:18 minutes)