O slideshow foi denunciado.
Seu SlideShare está sendo baixado. ×


Próximos SlideShares
Consumer patient rights
Consumer patient rights
Carregando em…3

Confira estes a seguir

1 de 58 Anúncio

Mais Conteúdo rRelacionado

Semelhante a CONSUMER PROTECTION.ppt (20)

Mais recentes (20)



  2. 2. PATIENTS RIGHTS The health care rights have been the subject of much public debate and legislative action in the later half of the 20th century. The fundamental right to quality medical care and compensation for medical malpractice, the right to informed consent, and the right to health care privacy, are all protected under United States congressional law. While these and other laws ensure many rights for medical patients, the changing nature of medical knowledge and care also ensures the continued need to regulate the relationships among patients, care-givers, and care- giving institutions. The government is concerned about the deteriorating services in medical care both in private nursing homes and public hospitals. Consumer organizations are also pressing for a charter of right of consumers of medical services.
  3. 3. The legislative controls of nursing practice primarily protect the rights of the patients. Until the 1960’s patients had few rights, in fact, patients often were denied basic human rights during a time when were vulnerable. In 1973, however, the American Hospital association published its first patient’s bill of rights.  The patient has the right to considerate and respectful care.  The patient has the right to and is encouraged to obtain from physicians and their direct care givers relevant, current, and understandable information concerning diagnosis, treatment and prognosis.
  4. 4.  The patient has the right to make decisions about the plan of care prior to and during the course of treatment and to refuse a recommended treatment or plan of care to the extent permitted by law and hospital policy and to be informed of the medical consequences of this action. In case of such refusal, the patient is entitled to other appropriate care and notify patients of any policy that might affect choice within the institution.  The patient has the right to have an advance directive (such as living will, health care proxy or durable power of attorney for health care) concerning treatment or designating a surrogate decision maker with the expectation that the hospital will honor the intent of that directive to the extent permitted by law and hospital policy.
  5. 5.  The patient has the right to every consideration of privacy. Case discussion, consultation, examination, and treatment should be conducted so as to protect each patients privacy.  The patient has the right to expect that all communications and records pertaining to his/her care will be treated as confidential by the hospital, except in cases such as suspected abuse and public health hazards when reporting is permitted or required by law. The patient has the right to expect that the hospital will emphasize the confidentiality of this information when it release it to any other patients entitled to review information in these records
  6. 6.  The patients has the right to review the records pertaining to his/her medical care and to have the information explained or interpreted as necessary, except when restricted by law. • The patients has the right to expect that, within its capacity and policies, a hospital will make reasonable response to the request of a patient for appropriate and medically indicated care and services. The hospital must provide evaluation, service, and/or referral as indicated by the urgency of the case. When medically appropriate and legally permissible, or when a patient has so requested, a patient may be transferred to another facility.
  7. 7. • The patient has the right to ask and to be informed of the existence of business relationships among the hospital, educational institutions, other health care providers, or prayers that may influence the patients treatment and care. • The patients has the right to consent to or decline to participate in proposed research studies or human experimentation affecting care and treatment or requiring direct patient involvement, and to have those studies fully explained prior to consent.
  8. 8.  The patient has the right to expect reasonable continuity of care when appropriate and to be informed by physicians and other care givers of available and realistic patient care options when hospital care is no longer appropriate  The patients hast the right to be informed of hospital policies and practices that relate to patient care, treatment and responsibilities. The patient has the right to be informed of available resources for resolving disputes, grievances and conflicts, such as ethics committees, patient representatives, or other mechanisms available in the institution. The patient has the right to be informed of the hospitals charges for services and available payment methods.
  9. 9. PATIENTS RESPONSIBILITIES In order to receive optimal care, patient and his family are responsible for:  Providing accurate information about present illness and past medical history and wishes for your medical care  Seeking clarification when necessary to fully understand health problems and the proposed plan of care  Following through on agreed plan of care  Considering and respecting the rights of others.  Being courteous.  Providing accurate information for insurance claims and working with the Health System to make payment arrangements when necessary so that others can benefit from the services provided here.  Following visitation policies of University Hospital.
  10. 10. ETHICAL RIGHTS OF PATIENTS The following four are the types of patient’s ethical rights are as: Rights of personal Dignity: These are the rights that describe the personal dignity of the patients while caring for them, given as follow:  Where the patients are to be considered as human beings by the following actions/activities:
  11. 11. Fig: Patients’ rights supported by ethics.
  12. 12.  Calling the person by name that he or she chooses to have  Maintaining privacy  Modesty by knocking on closed doors, pulling curtains, providing appropriate garments etc.  Helping a person to have the best possible appearance through careful attention to personal hygiene and personal care.
  13. 13.  The attitudes towards the patients, which can be reflected by the manner the nurse, communicates with them through the following ways:  Listening to the thoughts and concerns of patient  Explaining expectations and new situations  Accepting the individual’s feelings as real without judging them right or wrong.
  14. 14. Right to individualized care: This can be considered by the following ways: • Every patient has right according to his or her needs and life style. • Adapt a method of bathing or other nursing procedure to respect a patient’s attitude about modesty. • Alter if possible, visiting hours to help to maintain an important family bond. • Plan diet modifications to fit the patient’s cultural background.
  15. 15. Right to assistance towards independence: It is ethical right of a patient that he or she should be helped to be independent in carrying out activities of daily living of building their self esteem and encouraging them. Few examples are as follow:  Allow the patient to perform self-care wherever possible.  Take care of interest of the patient.  Take extra time to give instructions or directions carefully to the patient.
  16. 16. Right to complain and obtain changes in care: The patient has right to complain when care has not been of high quality and to obtain changes that are important to improve the quality care. Since the nurses have duties towards patient care, ward management and education of patients, they should also have concerned on the following significant matters:  The right to find dignity in self- expression and self- enhancement through use of our special abilities and educational background.
  17. 17.  The right to recognition for our contribution through the provision of environment for its practice and proper professional economic rewards  The right of work environment, which will minimize physical and emotional stress and health risks.  The right to control what is professional practice within the limits of the law.  The right to set standards for excellence in nursing.  The right to social and political action on behalf of nursing and health care.
  18. 18. In case of unknown patient  Intimate the nursing superintendent thereby RMO for further arrangement and body should be sent to mortuary with proper packing and labelling.  In case of MLC, intimate the police through the proper channel and sent the body to for autopsy. If the individual desired to donate his/her organs, information should be sent to the concerning authority for the removal of organ.
  19. 19. RECORDS AND REPORTS The medicolegal patient clinical record is a brief account of the personal and medical history of the patient, results of diagnostic tests, findings of medical examination, treatment and nursing care, daily progress notes and advice on discharge.  The records are kept under safe custody of the nurse in each ward of department.  No individual sheet is separated from the complete record.  Records are kept in a place, not accessible to the patients and visitors.  No stranger is ever permitted to read the records.
  20. 20.  Records are not handed over to the legal advisors without the written permission of the administration.  All hospital personnel are legally and ethically obligated to keep in confidence all the information’s provided in the records.  All records to be handled since, careless handling can destroy the records.  All records are field according to the hospital custom, so that they can traced easily. Records could be arranged:  Alphabetically
  21. 21.  Numerically  With index cards  Geographically.  All records are identified with the bio-data of the patient’s such as name, age, ward, bed no, Op no., diagnosis, etc.  Medicolegal records are never sent out of the hospital without the doctor’s permission. Reference is made by writing separate sheets and sending to the agency who requests for them, e.g. reference letters, discharge summaries.
  22. 22. REPORTS Oral report should be accompanied by written reports.  Nurse is not only meant for providing care to the patient, she should shoulder some of the responsibilities in respect to the patient’s needs, and nurse should know her limitations, for the knowledge of laws regarding health is essential.  She should adapt some of the legal aspects while discharging her duty in every field.
  23. 23. LEGAL ROLE OF THE NURSE Professional nursing practise is not determined by a simplistic adherence to patients rights. Rather its emerge from an interplay between the rights of patients and the legal role of the nurse, and her concern for quality psychiatric nursing. There are three roles that the psychiatric nurse moves in and out in the process of completing her/his professional and personal responsibilities. These are: The role of provider of services, employer or contractor of service and private citizen. These roles are played simultaneously and each role has attendant rights and responsibility.
  24. 24. Nurse as provider of services: • All psychiatric professional have legally defined duties of care and are responsible for their own work. If duties are violated ‘Malpractise’ exists. • Malpractise involves the failure of a professional person to give the kind of proper and competent care that is given by member of his profession in the community resulting in harm to the patient. • Most malpractise claims are field under the law of negligent tort.
  25. 25. Under the law of negligent tort the plaintiff must prove the following: • A legal duty of care existed. • The nurse performed the duty negligently. • Damages were suffered by the plaintiff as a result. • The damages were substantial.
  26. 26. It would be valuable, for the nurse to practise the following preventive measures to avoid possible lawsuits. • Implement nursing care that meets the standards of psychiatric mental health nursing practise. • Know the laws of the state in which one practises, including the rights and duties of the nurse as well as the patients. • Keep accurate and concise nursing records. • Maintain the confidentiality of patient information. • Consult a lawyer if any question arises.
  27. 27. Nurses as an employee: As an employee, a nurse has the responsibility to provide adequate supervision and evaluation of those under her/his authority for the quality of care given, to observe her /his employers rights and responsibilities to clients and other employees, to fulfil the obligation of the contracted service adequately, to adequately apprise the employer of circumstances and conditions that impair the quality of care given, and to report observations of negligent care by others when and where appropriate.
  28. 28. Nurse as a citizen: This role is particularly significant, because all other roles, responsibilities and privileges are awarded because of the inherent right of citizenship. In our form of democratic Government these rights are inherent, civil rights, property rights, right to protection from harm, right to a good name and right to due process. These rights form the foundations for the extension of other legal relationships of the nurse.
  29. 29. Community health nursing: Community health nursing is the combination of nursing practise and public health practise. The community health nurse is subject to the law relating to nursing practise and public health practise. The duties of all nurses become legally binding responsibilities for which the nurse is accountable. In addition, the community health nurses have many responsibilities that are unique to public health focused practise. Despite the broad nature and varied roles of community health nursing practise, two legal aspects apply to most practise situations, such as:
  30. 30.  Professional negligence or malpractise.  Scope of practise. The issue of scope of practise involves differentiating between the practises of physician, nurses and other health care providers. Scope of practise is assessed by:  Examining the usual and customary practise of profession.  Taking into account how legislation defines the practise of profession in a jurisdiction.
  31. 31. The usual and customary practise of community health nursing can be determined through a variety of sources which include:  Contents of community health nursing education profession, general and special.  Experience of other practising nurses.  Activities and statements, including standards of community health nursing professional organization.  Policies and procedures of agencies employing nurses.  Literature, including books, text and journals.
  32. 32. All these sources can be describe and help determine the scope of the usual practise of community health nursing. Legal aspects of the roles and functions of the community health nursing, especially scope of practise and negligence will prove to be useful information for nurses in community health. Every community health nurse must consider legal implication of practise in each clinical encounter, i.e. health education, Nutrition education, maintaining sanitation and supply of portable water, maternal and child health including family planing, communicable diseases control, school, health, occupational health, mental health and so on.
  33. 33. Because the community health nurse may be agent of the government when implementing a particular health programme, consideration must be given to the power of the state or the relationship of this power to individual right. In each clinical encounter, before treating the client, the community health nurse should know what standards of care apply to the situation. Standards of care can be learned from expert nurse witness and can be found in agency policies and procedures, nursing and health care literature.
  34. 34. POINTS TO BE KEPT IN MIND BY NURSES REGARDING LEGAL ISSUES The hospital as an employer: The controlling authority of a hospital is deemed to be an employer. The employer is legally responsible for the acts committed by all employees in the course of their duty and must ensure:  Employees posses the required qualification, registration and level of competence.  All legal requirements are met, including valid contracts of employment.  Safety standards are observed in relation to buildings, equipments and standard of patient care.
  35. 35. The nurse’s responsibility: The legal liability of an employer does not relieve a nurse from individual responsibility and legal action can be taken against hospital and a nurse or against Nurses are less likely to fail in their responsibilities of the following:  They remember that all patients have the rights and privileges accorded to every citizen and it is the duty of the nurses to protect these, whenever patients are unable to do so for themselves.  They require the knowledge, understanding and level of competence to ensure safe, effective nursing care.  They do not take tasks which are beyond their level of competence.  They maintain a high ethical standard in their professional life.
  36. 36. The poisons Act: This Act control the packing, sale and use of poisonous substances in the community. All poisons are listed on one of the eight schedules, and for each schedule there are specific rules regulating the use of poisons listed. The schedule which are of particular importance to nurses are: Schedule ‘4’ containing drugs called restricted drugs. They can only be obtained on written prescription and they must be kept in a locked cupboard.
  37. 37. Schedule’8’ containing drugs od addiction. The regulations relating to poisonous drugs are:  They must be stored in a separate cupboard, away from all other goods.  The cupboard must be firmly fixed to a wall and must be kept locked. The key must be in possession of an authorized person at all times.  A register must be maintained in which full details are recorded of all drugs received from the pharmacy and drugs disposed off in anyway, e.g. administered to the patients, and returned to the pharmacy.
  38. 38. Care of property: On admission to hospital patients should be advised to send home any personal possession which they will not required during hospitalization. Consent for procedures: Standard forms are provided on which written consent must be obtained before an anaesthetic is given, surgery performed or any procedure carried out which is out of the ordinary or involves risk for the patient.
  39. 39. Safety: The maintenance of safety in a hospital divided into two areas:  Provision of safe environment.  Provision of safe patient care.
  40. 40. Confidentiality: Nurses have an ethical obligation not to disclose confidential information which is required about patients in their care, except when such disclosure occurs during the course of their professional duties. The patient’s right to privacy should be respected and his/her affairs should not be discussed with other patients or with non- professional staff or members of the general public. Trespass: It is a term used to describe a number of unlawful acts, e.g. searching a person or person’s property without authority, entering or remaining in premises without owner’s consent opening letters or parcels addressed to others without their consent.
  41. 41.  Witnessing wills: A patient wishing to make a will should be given all the assistance required, but it is a rule in most hospital that the nurses may not act as witnesses. The law defines the conditions under which a license may be revoked. These conditions include:  Negligence is defined as harm done to a patient as a result of neglecting duties or procedures. Negligence is the omission of ordinary precautions expected of a responsible person.  Malpractice is improper treatment of a patient resulting in illness or injury (where negligence is an error of omission and malpractice is an error of commission).  Assault/ Battery are the threat of physical damage and the carrying of that threat. Assault may be violent act, either physical or verbal. Battery is a physical striking or beating.
  42. 42. Some common types of situation that might cause injury to a person and involve legal liability are the following:  Burns from hot water bags, heating pads, contact with steam pipe or scalding by hot water chemicals either improper mixture or improper application.  Sponges overlooked in surgical wound.  Falls on slippery floors.  Falls from an unprotected bed or rib by unconscious patient.  Injury from wrong blood transfusion- mismatching.  Injury from wrong IV fluid infusions.  Injury from wrong site of injections.  Injury from cross infection or hospital born infection.
  43. 43. Therefore, the only practical way for a nurse to prove that she rendered good nursing care to a patient is to document the care rendered in the patient’s record. If good care was given and documented, the medical record is the nurses evidence in the court room. Even if the nursing care given was excellent, if it is not documented in the medical record, the nurse is at a distinct disadvantage in the law suit. Good documentation of the care giver is vital part of good nursing care as well as good ‘legal nursing’.
  44. 44. ROLES AND FUNCTIONS OF NURSE MANAGER IN LEGAL ISSUES The following are the leadership roles and managerial functions of a nurse in legal and legislative issues, him or her:  Serves as a role model by providing nursing care that meets or exceeds accepted standards of care.  Is current in the field and seeks professional certification to increase expertise in a specific field.  Reports substandard nursing care to appropriate authorities.  Fosters nurse/ patient relationships that are respectful, caring and honest, thus reducing the possibility of future lawsuits.
  45. 45.  Joins and actively supports professional organisations to strengthen the lobbying efforts of nurses in health care legislation.  Practises nursing within the area of individual competence.  Priorities patient’s rights and welfare first in decision-making.  Demonstrates vision, risk taking, and energy in determining appropriate legal boundaries for nursing practises, thus defining what nursing is and should be in the future.
  46. 46.  Is knowledgeable responding sources of law and legal doctrines that affect nursing practise.  Delegates to subordinates wisely, looking at the managers scope of practise and that of those they supervise.  Understands and adheres to institutional policies and procedures.  Practises nursing within the scope of the state nurse practise act.
  47. 47.  Monitors subordinates to ensure that they have a valid, current and appropriate license to practise nursing.  Uses foresee ability of harm in delegation and staffing decisions.  Increases staff awareness of intentional torts and assists them in developing strategies to reduce their liability in these areas.  Provides educational and training opportunities for staff on legal issues affecting nursing practise.
  48. 48. CONSUMER PROTECTION ACT Doctors and other health professionals are liable under the prevailing laws such as Civil Panel code, Indian Panel Code, Law of Contractors, Sale of Goods Act, Law of Torts and other specific legislation. These laws are not free from some drawbacks such as delay in justice, huge legal fees, and limited access to courts, difficulties involved in providing both negligence and cause. The last decade of turning millennium saw enactment of Consumers Protection Act (COPRA) 1986 of India, a very important legal instruction aimed at better social justice. This Act was passed by the Indian Parliament to safeguard and protect the interest of consumers.
  49. 49. CONSUMER Consumer means any person who hires any services for a consideration, and includes any beneficiary of such services other than the person who hires the services, when such services are availed of with the approval of the first mentioned person. A person who avails himself of the facility of a government hospital is not a consumer because the facility offered in government hospitals is not service hired for a consideration. For deficiency of service in government hospitals, the aggrieved person will have to file a claim in civil court.
  50. 50.  RIGHTS-  Right to be informed about the quality, quantity, potency, purity, standard and price of goods or services so as to protect the consumer against unfair trade practices.  Right to be assured, wherever possible, access to a variety of goods and services at competitive prices.  Rights to be heard and to be assured that consumers’ interests will receive due consideration at appropriate forums.  Right to seek redressal against unfair trade practices and unscrupulous exploitation of consumers.  Rights to consumer education.
  51. 51. GRIEVANCE REDRESSAL MECHANISM UNDER CPA An aware consumer can approach Consumers Protection Act at three different levels.  For complaints that involve payment compensation upto Rs. 20 lakh, the consumer can approach District Consumer Court.  For complaints above Rs. 20 lakh but less than 1 crore, consumers can approach State Consumer Commission.  For complaints above one crore, the aggrieved person will need to approach the National Commission for redressal of his grievance.
  52. 52. A complaint can be filed within two years from the date on which the cause of action has arisen. However a complaint can be entertained after the period if the complaint had sufficient cause for not filling the complaint within such period by recording its reason for condoning such delay. Who can file a compliant? A complaint can be filed by  A consumer to whom goods are sold or delivered or agreed to be sold or delivered or such services provided or agreed to be provided.  A voluntary consumer organization.  The central Government
  53. 53.  The State Government, Union Territory Administration  One or more consumers where they are of same interest  In case of death of consumer, his/ her legal heir of representatives. Grounds to file a complaint Any allegation in writing made by the complaint against the service provider should enlist:  Adoption of any unfair trade practice or restrictive trade practice.  The goods bought or agreed to be bought suffer from one or more defects.  Services hired/availed or agreed to be hired /availed, suffer from any deficiency.
  54. 54.  The trader has charged for the goods or services a piece in excess of the stipulated price.  The goods or services being offered to the public are hazardous to life and safety. CATEGORIES OF PATIENTS AS CONSUMERS Patients nursed in different types of hospital are considered as consumers are: Patients of Government Hospitals Patients availing free medical care in general wards are not consumers but patients availing medical care in private wards of these hospitals are consumers as they are hiring services for a consideration.
  55. 55. Patients of Charitable Hospitals The patient of charitable hospitals is a consumer when he pays for the medical treatment either partially or in full, but he is not a consumer when he does not pay at all. Patients of Nursing Homes and Private Practitioners Patients of nursing homes and private practitioners are covered under the act because they satisfy the definition of consumer and services as given under section 2 (1) (d) (ii) and 2 (1) (0). Hence as a consumer the service should have been rendered to him, the service should have been hired by him and for hiring the service, he should have paid a consideration.