B71P02 - Foundations in EBP
 Introduction to Healthcare Law and EBP
Achievement of practice
outcomes and portfolio work
 Outcome 1.4.1
 Identify key issues in relevant legislation
relating to mental health, children, data
protection, moving and handling, health and
safety etc……
Law and Evidence Based Practice
EBP is about …

...doing the right thing for patients

…using guidelines, information, research, clinical experience, and patient
wishes/ experiences in order to ensure best practice

…making sure practice is up to date

…being able to account for your actions
So how are EBP and the law connected?
Well....in 2 main ways. The first considers the use of law as evidence for practice
whilst the second considers how the absence of evidence may result in an
infringement of the law.
1) The law as ‘evidence’
 There are laws governing specific areas of health care
practice e.g. Manual Handling Regulations (1993), The
Medicines Act (1968), The Mental Capacity Act (2005)
 So doing the ‘right thing’ for patients might mean
following the details of these laws
 You can justify or explain your actions by saying that you
are following the law
 The law is the ‘evidence’
1) The law as ‘evidence’
 ‘’You must always act lawfully, whether those
laws relate to your professional practice or
personal life’’ (NMC Code of Conduct, 2008)
 ‘’You must adhere to the laws of the country in
which you are practising’’ (NMC Code of
Conduct, 2008)
 There is thus a professional obligation to act
lawfully at all times.
2) EBP and ‘breaking the
law’
 If nurses do not use up to date information,
research, evidence to support their practice then
they may be carrying out substandard or
dangerous practice
 Substandard or dangerous practice could have
legal implications – for example the nurse could
be sued by the patient for the damages caused
by negligence
A Claim for Negligence
 For this to be successful the claimant must
establish a number of facts
 1) A duty of care existed
 2) There was a breach in the standard of care
 3) Reasonably foreseeable harm was caused
 4) There was a clear chain of causation between
the negligent act and the harm
Vicarious liability – means your
employer might be sued for your
mistakes
 Employers are responsible for the actions / faults of their
employees
 To be successful claimants have to establish that an
employee had been negligent and;
 that the person was actually employed
 that the employee was acting in the course of their
employment
Law and consent
 See Open Learn – Learning Space at:
http://openlearn.open.ac.uk/mod/resource/view.php?id=189908
 See NMC Guidance at:
http://www.nmc-uk.org/aFrameDisplay.aspx?DocumentID=4710
Law and consent
 The basic rule underpinning law and consent :
 competent adults have a right to determine what is done to their
bodies.
 People who break this rule (for instance by assaulting others) are
sometimes prosecuted under the criminal law.
 Health care professionals are rarely prosecuted under criminal law
but if they ‘touch’ patients without consent they are more likely to
be involved in civil actions.
 Patients may sue them for compensation for either:
 Battery, or:
 negligence.
Law and consent
Battery and Consent
 Battery is any physical contact without
consent. It need not be violent; the wrong lies
not in any injury caused but in the contact
itself.
Law and consent
Negligence and consent
 A patient agrees to care / treatment but has not been given all the
information about the advantages / disadvantages / risks of the care
/ treatment
 The care / treatment was carried out skilfully – there were no errors
or mistakes
…….but the patient is unlucky and suffers from one of the known
side effects / risks.
She may be able to sue for negligence because she was not fully
informed about the risks
 In this case the negligence is in the information giving – not in the
care / treatment itself
Law and consent
 Every adult must be presumed to have mental capacity
to consent or refuse treatment (or care) unless they are:
 Unable to take in or retain information provided about
their treatment or care
 Unable to understand the information provided
 Unable to weigh up the information as part of the
decision making process
The law and consent
To be valid consent must:
 Be given by a competent person
 Be given voluntarily
 Be informed
Another person cannot give consent for an adult patient
who has the capacity to consent.
Health and Safety Law
 HASAW Act 1974
 RIDDOR (1995)
 COSHH (1989, 1996)
 Manual Handling Regulations (1993)
 Puwer (1998)
 Loler (1998)
Medicines
 Medicines Act 1968
 Misuse of Drugs Act 1971
 Misuse of Drugs Regulations 1985
Human Rights Act (1998)
 Article 2(1) - Right to life
 Article 3 - Right not to be subjected to inhuman or
degrading behaviour
 Article 5 - Right to liberty and security
 Article 8 - Right to respect for private and family life
Reference
 Dimond, B. (2008) Legal Aspects of Nursing.
London: Longman.