An Exploratory Study to Assess Staff Nurse Knowledge and Attitude related to Legal Responsibilities in patient care at Y.C.R. Hospital, Latur, Maharashtra
Sarvanan. S. S.1, Santosh Kumar S. K.2
1Principal, Maharashtra Institute of Nursing Sciences, Latur.
2Associate Professor, Maharashtra Institute of Nursing Sciences, Latur.
*Corresponding Author E-mail: santosh.kumar@mitmins.edu.in
ABSTRACT:
Background of The Study: For number of years the legal responsibilities of the practicing professional nurse in our country have been occasionally defined. The leaders in the nursing profession are well aware for what they are legally responsible, but there is a lack of well stated guidelines on legal responsibilities in the nursing profession. This is due to unawareness of citizens about their rights of protection against harmful or negligent professional practice. Hence, nurses are rarely got involved in court action or other legal procedures. As the public and profession become more and more aware of the practicing law, both the patient and nurse are in need to protect themselves from legal actions. Hence, understanding of legal responsibilities has become greater importance. Aim: Aim of study is to assess knowledge and attitude of staff nurses related to legal responsibilities in patient care in Y.C.R. Hospital. Method: In the study 60 sample were chosen using non probability convenient sampling, structured questionnaire administered to assess knowledge and attitude among staff nurses of Y.C.R. Hospital Latur. Result: The findings of the present study, revealed that among 78% staff nurses have average knowledge and 22% staff nurses have good knowledge. The total knowledge score ranged from 0 - 31. The knowledge score was further divided arbitrarily in to, Poor (0 – 10), Average (11 – 21), and good knowledge (22 – 31). A modified Likert type attitude scale was prepared and the total score ranged from 30 to 150. This was further divided arbitrarily as follows; Negative (30 – 70), Slightly Positive (71 – 110), and Strongly Positive attitude (111 – 150). Mean knowledge score among staff nurses was 20.0667 with standard deviation + 2.39962 and Range between 0-31 While the Mean attitude score was 91.4833 with Standard Deviation of +10.27007 and Range between 30-150. Hence Null hypothesis is accepted. To find association of knowledge with their selected personal demographical variables Chi-Square was computed, results reveal that no personal variables of samples were found to be statistically significant at 0.05 level of significance. CONCLUSION: The study revealed knowledge and attitude of staff nurses related to legal responsibilities is having a profound impact on patient care majority staff nurses have average knowledge about legal responsibilities in patient care. The result demonstrated that the Questionnaire was effective to assess knowledge and attitude related to legal responsibilities in patient care among staff nurses of Y.C.R. Hospital Latur.
KEYWORDS: Staff Nurse Knowledge, Attitude, Legal Responsibilities, Patient Care, Y.C.R. Hospital, Latur
INTRODUCTION:
Legal word came from Latin word ‘legalis’1 which mean pertaining to the law. Legal aspects mean the science or philosophy of law Also the application of principles of law and justice to health and medicine2.
Various studies have shown that nurse knowledge related to legal responsibilities in patient care is unsatisfactory which is another reason for increasing ethical and legal issues in health sector.
A higher number of patients experience harm during hospitalization as a result of a range of errors and adverse events. The level of knowledge and attitude of nurses towards patient safety has a great impact on provision of safe patient care3.
In nursing practice, profession legal responsibilities are gaining greater importance as the days are passing. Only few numbers of nursing professionals are having specialized knowledge and skills to tackle legal terms and court procedures4.
In recent days of advanced world, every newspaper gives the information of sensational cases being judged in our courts. In every business, the concern about lawsuits and legal liabilities are increasing in number. Health care profession occupies the first place compared to other professions, where legal issues comprise the major area of concern. Nurses convey concern about their responsibilities and whether they are vulnerable to lawsuits5.
A competent and professional nurse perceives legal issues and problems in daily practice. Some of the most commonly occurring legal issues that impact on nursing and nursing practice are those relating to informed consent and refusing treatment, licensure negligence, medication errors, malpractice, assaults, battery and deals cautiously by utilising the current knowledge of legal responsibilities before the questions of legal problem arise6.
For number of years the legal responsibilities of the practicing professional nurse in our country have been occasionally defined. The leaders in the nursing profession are well aware for what they are legally responsible, but there is a lack of well stated guidelines on legal responsibilities in the nursing profession7.
This is due to unawareness of citizens about their rights of protection against harmful or negligent professional practice. Hence, nurses are rarely got involved in court action or other legal procedures. As the public and profession become more and more aware of the practicing law, both the patient and nurse are in need to protect themselves from legal actions6.
A research study of Manipal University among nurses working in critical care units showed that only 10% had good knowledge and 77% had average knowledge regarding the legal and ethical aspects of nursing. A study of Manipal teaching hospital, Nepal showed that a maximum of nurses (58.4%) had inadequate knowledge regarding laws and ethics. One of the main reasons behind this may be few hours given to this topic in nursing schools9.
Each year, 134million adverse events occurs in hospitals in low- and middle-income countries (LMICs), due to unsafe care, resulting in 2.6 million deaths. Hence, understanding of legal responsibilities has become greater importance. In recent years there has been active and increased consumer movement in the field of health. Increasing knowledge of public related to health issues and rising costs of health services are few factors contributing to the consumer movement. Hence, the patients need to be concerned in the treatment decision10.
1. To assess the knowledge and Attitude of staff nurses towards their selected legal responsibilities in patient care.
2. To determine the relationship between staff nurses’ Knowledge and Attitude towards their selected legal responsibilities in patient care.
3. To determine the association of level of knowledge of staff nurses towards their selected legal responsibilities in patient care and their selected personal variables viz, age, gender, educational qualification, work experience, exposure to in service education programmes, clinical area of work experience.
H1 There will be significant relationship between Staff Nurses, Knowledge and Attitude towards selected legal responsibilities in patient care.
H2 There will be significant association between staff nurses’ levels of knowledge towards their selected legal responsibilities in patient care and their selected personal variables.
Variables of the study were
· Study variables: knowledge and attitude.
· Personal variables: Age, gender, Education, Experience and attended ISE
The study was conducted in Y.C.R Hospital Latur.
In the present study, population comprises of staff nurses who are working in YCR hospital at Latur.
The sample of the present study staff nurses of YCR Hospital at Latur. Sixty (60) Staff nurses were selected.
Sampling technique used in this study was non probability convenience sampling technique.
CRITERIA FOR SAMPLING:
Inclusion Criteria:
Staff nurses who are-
1. Willing to participate in the study
2. Available at the time of data collection
Staff nurses who are-
1. Not willing for data collection.
2. Staff Nurses who were ill at the time of data collection.
RESULTS:
Frequency and percentage distribution of staff nurses according to their selected demographic variables.
Section – 2: Description of knowledge and attitude of staff nurses.
a) Description of Mean, median, range and standard deviation of knowledge and attitude.
b) Findings related to relationship between knowledge and attitude.
Section-3: Association of demographic variables with knowledge in patient care.
· Association of demographic variable with knowledge of staff nurses in patient care.
Table 1- Frequency and distribution of demographic characteristics of YCR Hospital staff nurses, Latur.
|
Sr. No |
Demographic Variable |
Number |
% |
|
1 |
AGE a) 20 – 30 years b) 31 – 40 years c) 41 – 50 years d) 51 years and above |
33 24 03 00 |
55% 40% 5% 0% |
|
2 |
Gender a) Male b) Female |
18 42 |
30% 70% |
|
3 |
Education a) Diploma in Nursing b) Basic B. Sc Nursing c) Post Certificate BSc Nursing |
57 03 00 |
95% 5% 0% |
|
4 |
Experience a) 0-2yrs b) 3 -4yrs c) 5-8yrs d) 9 Year and above |
05 28 17 10 |
8.33% 46% 28.33% 16.66% |
|
5 |
Attended ISE a) One b) Two c) Three and above |
54 06 00 |
90% 10% 0% |
Age:
The data presented in table no. 1, shows that, Majority, 55% (33) of them belonged to age group of 20 -30 years, followed by 40 % (24) belonged to 31 to 40 years, least that is 5% (03) belonged to 41- 50 year.
Gender:
The data presented in table no. 1 shows that, Majority 70% (42) were females and 30% (18) were males.
Education:
The data presented in table no.1 and figure 3 shows that, Majority 95% (57) had their formal e3ducation till Diploma in nursing followed by 5% (03) had B.BSC nursing education.
Experience:
The data presented in table no. 1 and figure 4 shows that, Majority 46% (28) have 3-4 years of experience followed by 28.33% (17) have 5-8years of experience, 16.66% (10) have 8years and above experience, 8.33% (05) have up to 2 years of experience.
Attended in service education:
The data presented in table no.1 and figure 5 shows that, Majority 90% (54) have attended at least one in service education programme followed by 10% (06) have attended at least two in service education programme and No samples had attended more than three in service education programme.
Table-2: Mean, median, range and standard deviation of Knowledge and Attitude among staff nurses. N=60
|
Knowledge |
Attitude |
||||||
|
Mean |
Median |
Range |
Standarddeviation |
Mean |
Median |
Range |
Standarddeviation |
|
20.0667 |
20.0000 |
0-31 |
2.39962 |
91.4833 |
92.0000 |
30-150 |
10.27007 |
SECTION II:
The data presented in Table- 2 shows that the Mean knowledge score was 20.0667 with standard deviation + 2.39962 and Range between 0-31 While the Mean attitude score was 91.4833 with Standard Deviation of + 10.27007 and Range between 30-150.
In order to, find the correlation of Staff Nurses Knowledge and Attitude towards selected legal responsibilities in patient care among staff nurses; a correlation coefficient was computed by using Karl Pearson’s Co efficient of correlation.
|
Score |
Staff nurses |
|
|
Mean score |
Correlation coefficient |
|
|
Knowledge scores |
20.0667 |
.053 |
|
Attitude |
91.4833 |
|
‘r’(59)= 0.250 P<0.05
The data are presented in Table 3.
To test the statistical significance following null hypothesis was stated:
H1-There will be significant relationship between Staff Nurses Knowledge an Attitude towards selected legal responsibilities in patient care.
The data presented in Table 3 shows that there is no correlation between knowledge scores and attitude scores, thus the research hypothesis is rejected and the null hypothesis is support
|
Sr. No |
Sample characteristics |
Knowledge |
Chi square value |
Result |
|
|
1. |
Age |
Average |
Good |
3.825 |
NS |
|
|
a) Less than 20 – 30 years |
27 |
6 |
||
|
b) 31 – 40 years |
19 |
5 |
|||
|
c) 41 – 50 years |
1 |
2 |
|||
|
d)51 year and above |
0 |
0 |
|||
|
2. |
GENDER |
|
|
3.933 |
NS |
|
|
a) Male |
17 |
1 |
||
|
b) Female |
30 |
12 |
|||
|
3. |
EDUCATION |
|
|
0.873 |
NS |
|
|
a) Diploma in Nursing |
44 |
13 |
||
|
b) Basic B.sc Nursing |
3 |
0 |
|||
|
c)P.B.sc nursing |
0 |
0 |
|||
|
4. |
EXPERIENCE |
|
|
1.793 |
NS |
|
|
a) up to 2yrs |
4 |
1 |
||
|
b)3-4yrs |
20 |
8 |
|||
|
c)5-8yrs |
15 |
2 |
|||
|
d)8yrs and above |
8 |
2 |
|||
|
5. |
ATTENDED ISE |
|
|
.098 |
NS |
|
|
a) One |
42 |
12 |
||
|
b) Two |
5 |
1 |
|||
|
c)Three and above |
0 |
0 |
|||
Table 4 - Shows that no selected demographic variables were found to be significant at 0.05 level of significance.
Hence Research hypothesis is rejected and null hypothesis was selected, indicating selected demographic variables has no association on knowledge regarding legal aspects among staff Nurses.
The analysis of the results has brought to fore, a large number of issues that need to be addressed in view of the rapidly changing canvas of modern nursing in India. The increasing role of a nurse as a patient care taker and advocate, on one hand and her requirement of having in depth knowledge of the legality of her actions on the other hand, have raised the bar of nursing. The changes in the health status of a patient can be gradual or sudden and nurses are usually the first to see the changes and to take action. A nurse’s accuracy in assessing, monitoring and reporting of changes in health status in time, to a physician, can often spell the difference between life and death. Having seen the level of legal awareness among nursing staff, it would be reasonably safe to conclude that the knowledge of legal responsibilities is integral to the expanding clinical role, and a logical application of the planned, systematic, and focused care, should be the goal of modern nursing. The present study has substantiated the fact, that nurses need to know the laws that govern their profession, and that in the times to come, it will be increasingly difficult to avoid filing lawsuits against them.
REFERENCE:
1. Histroy of the word Legal (https:/www.etymonline.com/word/legal
2. Meaning of legal available from(http://dictionary.sensagent.com/legal%20aspects/en-en/.)
3. https://www.ejeph.com/article/nursing-associated-medication-errors-are-internationally-educated-nurses-different-from-us-educated)
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6150915/
5. http:/nurses.com/com/courses/92-legal-in-nursing
6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3208929/
7. (PDF) Medication errors: a focus on nursing practice (researchgate.net)
8. Hemant Kumar, Gokhale Kalpana Jain, D.R. Mathur Legal Awareness and Responsibilities of Nursing Staff in Administration of Patient Care in A Trust Hospital, Journal of Clinical and Diagnostic Research. 2013 Dec, Vol-7(12): 2814-2817
9. Sarju Maharjan, Mamta Thapa, Bijay Maharjan “Awareness of Nurses on Legal and Ethical Aspects of Nursing in Selected Hospitals of Lalitpur. International Journal of Health Systems and Implementation Research. 2019, Vol. 3(19): 354-358
10. Jain Kalpana, Kumar Hemant and Mathur D.R. Legal Awareness and Responsibilities of Nursing Staff in Administration of Patient Care in A Trust Hospital. [Internet]. Journal of Clinical & Diagnostic Research.10.7860/JCDR/2013/7737.388 6.
Received on 18.10.2022 Modified on 29.12.2022
Accepted on 20.02.2023 ©A&V Publications All right reserved
Int. J. of Advances in Nur. Management. 2023; 11(2):120-124.
DOI: 10.52711/2454-2652.2023.00029