Knowledge of Staff nurses regarding Legal aspects of patient care

 

Prof. Dr. Sheela Shenai N A¹*, Jisha Joseph², Anu Jacob Kachappillil³

¹Principal, Malankara Orthodox Syrian Church College of Nursing, Kolenchery, Kerala, India

²Assistant Professor, Dept. OBG nursing, MOSC College of Nursing, Ernakulam, Kerala, India

³Assistant Professor, Dept. Medical Surgical Nursing, MOSC College of Nursing, Ernakulam, Kerala, India

 

ABSTRACT:

Aim: A descriptive study was conducted to assess the knowledge of staff nurses regarding legal aspects of patient care in a selected hospital at Ernakulam district. Background: Nursing practice in virtually all nations is governed by law. Each country may have different act but, they all have common purpose to protect the public¹. Many hospitals are not willing to hire nurses without the legal knowledge now that legal issues are becoming more problematic². In order to avoid liability and guard against negligence or malpractice suits, the nurse must be aware of the legal responsibilities of each aspect of the nursing role³. The purpose of this study was to assess the knowledge of staff nurses regarding legal aspects of patient care. Methods: A Descriptive analytical study was conducted among 70 staff nurses working in critical care units of a Medical College Hospital of South India during the month of December 2018.Convenience sampling technique was adopted for the study. A Structured knowledge questionnaire was used to assess the knowledge on legal aspects of patient care. Data were analyzed using SPSS version 20. Results: The findings of the study revealed that that Mean knowledge score was 14.88 ± 3.43. In this study Majority (84%) of the nurses had average knowledge, 3% had good knowledge and only 13% had poor knowledge on legal aspects of patient care. Conclusion: This study identified that even though majority had average knowledge on legal aspects of patient care, only a small percentage had good knowledge on the same. The nurses need to strengthen their knowledge on legal aspects to have a firm foundation of service. It can be concluded that there is a great need to sensitize nurses on legal issues appropriately.

 

 

INTRODUCTION:

Nursing ethics and law are necessary in nursing because nursing is concerned with providing services that impact on human life and health and some of the situations the nurse encounters in practice pose dilemma that if not well handled, may impact negatively on the client and all who are concerned⁴. The first step in preventing entanglement in legal issues is awareness of the law⁵.

 

 

 

Awareness of legal issues and criminal law and its application at the time of providing service prevent errors in many cases and this will reduce medical errors and complications, as well as patient complaints⁶. Nurses must know their legal obligation as they have to update with the fast changing and advancing professional knowledge to provide safe nursing to their clients on the basis of their necessities⁷. As per above mentioned background the present study was aimed to assess the knowledge of staff nurses in legal suspects of patient care.

 

MATERIAL AND METHODS:

A Descriptive analytical study was conducted among nurses working in the intensive care units of a tertiary care hospital in south India in the year 2018. The study was approved by the institutional ethics committee. A Structured knowledge questionnaire was used to assess the knowledge on legal aspects of patient care. After obtaining informed consent 70 staff nurses working in intensive care units were selected by Convenience sampling. Data were analyzed using SPSS version 20

 

RESULTS:

Section A: distribution of demographic variables:

Table 1 show that among the 70 subjects majority (98.6%) were females. Nearly half of the participants were in the age group of  21 to30 years. Majority (64.3%) had GNM education. More than two quarter of subjects (52.9%) had more than five years of experience. Majority (42.9%) belonged to medical ICU.95.7% did not face any legal problems.

 

Table 1: Frequency and percentage distribution of demographic characteristics of staff nurses n=70

No	Variable	Frequency (f)	Percentage (%)
1	Age a) 21 – 30 b) 31 -40 c) Above 40	36 31 3	51.4 44.3 4.3
2	Sex a) Male b) Female	1 69	1.4 98.6
3	Educational Status a) GNM b) B.Sc Nursing	45 25	64.3 35.7
4	Year of working experience a) 0-1year b) 1-2 year c) 2-5 year d) Above 5 year	11 8 14 37	15.7 11.4 20 52.9
5	Area of work a) Neuro ICU b) Surgical ICU c) Medical ICU d) Trauma ICU e) OBG ICU	9 12 30 9 9	12.9 17.1 42.9 12.9 12.9
6	Legal problems faced as a nurse a) Yes b) No	6 7	4.3 95.7

 

Section B: distribution of knowledge of staff nurses on legal aspects of patient care:

Fig. 1 depicts that Majority (84%) of the nurses had average knowledge, 3% had good knowledge and only 13% had poor knowledge on legal aspects of patient care. Mean knowledge score was 14.88 ± 3.43

 

 

Figure 1: Pie diagram showing knowledge of staff nurses regarding legal aspects of patient care.

 

 

 

Section C: Description of association between knowledge and demographic variables

 

Table 2: Association between knowledge and selected demographic variables                                                                                              n=70

Sl. No	Variables	Above median 15	Below median 15	P value
1	Age a)  21 – 30 b)  31 -40 c)  Above 40	23 14 1	13 17 2	0.24 (Fisher’s test)
2	Sex a)  Male b)  Female	0 38	1 31	0.45 (Fisher’s test)
3	Educational status a)  GNM b)  B.Sc Nursing	26 12	19 13	0.29
4	Year of working experience a)  year b)  1-2 year c)  2-5 year d)  Above 5 year	6 4 7 21	5 4 7 16	0.98 (Fisher’s test)
5	Area of work a)  Neuro ICU b)  Surgical ICU c)  Medical ICU d)  Trauma ICU e)  OBG ICU	4 5 16 6 7	5 7 14 3 3	0.65 (Fisher’s test)
6.	Previous exposure to information on legal aspects of patient care a)  Yes b)  No	21 17	16 16	0.42
7	Source of information a)  Nursing curriculum b)  In service education c)  Nursing practice d)  Mass media e)  None	5 15 14 2 2	6 7 17 2 0	0.32 (Fisher’s test)
8	Legal problems faced as a nurse a)  Yes b)  No	2 36	1 31	0.51 (Fisher’s test)

 

Table 2 shows that there was no significant association between knowledge and selected demographic variables.

 

DISCUSSION:

In the present study majority (84%) of the participants had average knowledge (11-20) but, a smaller group (3%) had good knowledge (21-30) and 13% had poor knowledge (0-10) on legal aspects of patient care. Nevertheless, there was no significant association between the level of knowledge on legal aspects in patient care and selected demographic variables such as age, gender, education, years of experience, area of experience and legal problems faced by self.

 

The results of the present study were also consistent with the findings of a similar study conducted by Della Varghese L T and Jomon C U among 230 staff nurses working in critical care units which reported that 10% of nurses had good knowledge and 77% had average knowledge. There was no significant association between level of knowledge and selected demographic variables. The study also suggested the need to improve the knowledge of staff nurses on legal and ethical aspects in patient care which in turn will help to improve their critical thinking ability and decision making during legal and ethical issue.⁸ Another study conducted on knowledge regarding medico legal aspects in care of road traffic accident patients among the nurses in selected hospitals of Pune city also revealed similar results. That is majority had only average knowledge on these aspect.⁹ This is also supported by a study done in Jaipur in the field of psychiatric nursing revealed that majority (90%) of the nurses' possess moderate level of knowledge on legal aspect of psychiatric nursing¹⁰.

 

In contrary to that another study conducted in Thrissur to determine the level of nurses knowledge regarding medico legal aspects of patient revealed that, majority (91.7%) of study participants had inadequate knowledge while 4.2% each had moderately adequate and adequate knowledge. None of the participants reported to be aware of medico-legal cases against nurses in India and in the working institution. Knowledge regarding medico legal aspects of patient care was found to be associated with total years of experience (p=0.000)¹¹. The variation in the result may be due to difference in sample size and setting. The study highlights on the need to strengthen nurse’s knowledge on medico legal aspects of patient care.

 

CONCLUSION:

The present study identified the knowledge gap on medico legal aspect of patient care among nurses. Nurses are confronted with lot of legal issues during their practice. In order to provide safe and comprehensive care to patients, nurses should possess adequate knowledge on legal aspects. Therefore, the present study recommends that nurses should update their knowledge on legal implications in nursing as well as nursing institution also take necessary steps to improve student nurses awareness on this area.

 

ACKNOWLEDGEMENT:

Here we extend our sincere thanks to all the staff nurses who participated in the study.

 

CONFLICT OF INTEREST:

The authors declare no conflict of interest in the study

 

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Received on 20.10.2018         Modified on 10.11.2018

Accepted on 23.12.2018      ©A&V Publications All right reserved