Professional Regulations and Legal Aspects
Professional Regulations and Legal Aspects covers licensure, scope of practice, documentation and liability. In Iran the licence to practise (پروانه صلاحیت حرفهای) is issued by the Ministry of Health and Medical Education after passing this competency examination, and renewal depends on continuing education and an unblemished practice record.
Negligence and malpractice
Four elements must coexist: a duty of care existed, the duty was breached, the breach caused the injury, and actual damage occurred. Missing any one element defeats the claim. Vicarious liability means the employer may answer for an employee's acts within the scope of employment.
Documentation as legal evidence
The record is presumed to reflect what happened. Chart objectively and contemporaneously, using measured values rather than judgements. Corrections take a single line through the error, the correct entry, signature and date; never erase, overwrite or rewrite a page. Never chart for a colleague.
Patient Rights Charter
The Iranian Patient Rights Charter sets out five axes: receiving optimal service, information and communication, respect for patient autonomy, privacy and confidentiality, and access to a complaint system.
Worked example
A nurse gives penicillin without checking the allergy band and the patient develops anaphylaxis. Reasoning: duty existed through the assignment, the standard of checking allergies was breached, the breach caused the reaction, and harm resulted - all four negligence elements are satisfied. The incident must be reported and documented factually without editorialising.
Traps that cost marks
- Charting a verbal order for a high-alert drug without read-back and physician confirmation.
- Back-dating or altering a record after an incident.
- Delegating assessment, teaching or IV push medication to unlicensed assistive personnel.