What are the four elements required to prove nursing negligence or malpractice?

• A. Intent, malice, negligence, damages
• B. Knowledge, skill, effort, outcome
• C. Duty, breach of duty, causation, and damages
• D. Consent, confidentiality, documentation, reporting

Answer: (C)

Proving nursing negligence requires four elements: a duty of care, a breach of that duty, causation linking the breach to harm, and damages.

Duty of care comes from the nurse–patient relationship and the expectation to provide competent, safe care. A breach occurs when the nurse fails to meet the established standard of care, such as missing a required assessment, administering the wrong medication, or not following accepted infection-control practices. Causation means the injury happened because of that breach; there must be a direct link showing the harm would not have occurred but for the nurse’s action or inaction. Damages are the actual losses or injuries suffered by the patient that can be compensated, such as physical harm, added medical costs, or other measurable harm.

Other concepts like intent or malice are not required for negligence—the nurse can be negligent without intending to cause harm. Simply mentioning knowledge, skill, effort, and outcome doesn’t capture the legal standard of care. While consent, confidentiality, documentation, and reporting are important professional responsibilities, they do not establish the four elements needed to prove negligence.