DETAILED LEARNING MODULE

Title: Legal Aspects of Nursing Course Code: NCM 119

Module No. 3 Week: 10

I. Introduction
Welcome to Module 3. This module focuses on the application of legal aspects of nursing in the
concepts of caring for the needs of patients. This module provides a framework for discussing legal
issues in nursing practice. As client advocates, nurses have a responsibility to deliver safe care to
their clients. This expectation requires that nurses have professional knowledge at their expected level
of practice and be proficient in technological skills. A working knowledge of the legal system, client
rights, and behaviors that may result in lawsuits helps nurses to act as client advocates. This module
supports students understanding of the legal aspects of nursing practice, including their essential roles
in developing, maintaining, and/or monitoring standards, licensure, and regulation of professional
nursing practice to ensure safe care and quality outcomes. Thus, you will be given preparatory work
to read about the ethical and moral aspects of nursing practice. You should be encouraged to record
information on the accompanying student learning resources and brainstorm to answer the questions
and other learning tasks.
II. Learning Outcomes
After studying this module, you should be able to:
-describe each general area of the law
-identify the legal responsibilities of nurses
-enumerate each salient points of the law
-discuss the interrelationship between the law and the nursing practice

III. Topics
Topic
6.1 Legal Aspects of Nursing
6.6.1. RA 9173 or The Nursing Act of 2002
6.6.2. Legal Responsibilities of Nurses
6.6.3. Other laws Affecting Nursing Profession (Rooming in, Senior Citizens Act, Sexual
Harassment, Clean Air Act, Local Government Code, Dangerous Drug Act, etc.)
6.6.4. Malpractice and Negligence Act
6.6.5. Contracts/Wills/Testament
6.6.6. Legal protections in the nursing service

IV. Teaching and Learning Materials and Resources

-Nursing Leadership and Management Books/E-books -Study Notebook
-Available Open Educational Resources Portal
-Video Clips (e.g. YouTube, Khan Academy, etc.)
-Slides (attached/provided by Instructor)
-Handouts/Notes (attached/provided by Instructor)
 V. Learning Tasks/Activities
1. Read and review your Legal Aspects of Nursing lectures. (see slides attached/provided by
your instructor)
2. For Synchronous activity:
• The instructor will discuss and present the topic in the selected online platform.
Watch lecture related videos if needed.
• YouTube- TORT-Ethical and Legal Issues in Nursing
https://www.youtube.com/watch?v=i5Ncv80X9KY
• YouTube- The Philippine Nursing Law (Part 1-7)
https://www.youtube.com/watch?v=kHdUV1iPegE
3. Read supplementary references for the topic.
4. Do a quick check of your knowledge of the concepts of the legal aspects of nursing. In your
own words, describe the concepts given. Write your own-description down in your Study
Notebook. When you’re done, check the Reading Activity to see how well you did.

READING ACTIVITY:
Overview
Legal Aspects of Nursing Practice
Nurses at all levels must engage in responsible and accountable nursing practice. Further, nurses have
authority, accountability, and responsibility to make decisions that result in safe, quality, and
evidence-based nursing practice (ANA, 2015a, 2015b). Accountability is “to be answerable to oneself
and others for one’s own choices, decisions and actions as measured against a standard” (ANA,
2015a, p. 41), such as those established by the ANA Code of Ethics for Nurses With Interpretive
Standards, the ANA Nursing Scope and Standards of Practice, and state nurse practice acts (ANA,
2015a, 2015b). To be accountable, nurses at all levels must embrace an approach to nursing practice
that includes application of ethical principles; respect for the dignity, worth, and autonomy of
patients; adherence to the scope and standards of nursing practice and legal and regulatory agencies;
and fulfillment of society’s need for conscientious and qualified nurses (ANA, 2010, 2015b). Nurse
leaders and managers must have a complete understanding of the minimum standards of clinical
practice, the requirements of licensure, regulations that impact nursing, federal and/or state legislation
in place to protect both health-care workers and their patients, classifications of law that relate to
nursing practice, and malpractice. Additionally, nurse leaders and managers are responsible and
accountable for ensuring their nursing staff members have the knowledge, skills, and attitudes
necessary to perform their professional responsibilities.
General Principles
Meaning of Law
The word law has several meanings. For the purposes of this chapter, law means those rules that
prescribe and control social conduct in a formal and legally binding manner (Bernzweig, 1996). Laws
are created in one of three ways:
1. Statutory laws are created by various legislative bodies, such as state legislatures or Congress.
Some examples of federal statutes include the Patient Self-Determination Act of 1990 and the
Americans with Disabilities Act. State statutes include the state nurse practice acts, the state boards
of nursing, and the Good Samaritan Act. Laws that govern nursing practice are statutory laws.
2. Common law develops within the court system as judicial decisions are made in various cases and
precedents for future cases are set. In this way, a decision made in one case can affect decisions made
in later cases of a similar nature. This feature of American law is based on the English tradition of
case law: “judge-made law” (Black, 2004). Many times a judge in a subsequent case will follow the
reasoning of a judge in a previous case. Therefore, one case sets a precedent for another.
3. Administrative law is established through the authority given to government agencies, such as state
boards of nursing, by a legislative body. These governing boards have the duty to meet the intent of
laws or statutes.

Types of Laws
Another way to look at the legal system is to divide it into two categories: criminal law and civil law.
Criminal Law
Criminal laws were developed to protect society from actions that threaten its existence. Criminal
acts, although directed toward individuals, are considered offenses against the state. The perpetrator
of the act is punished, and the victim receives no compensation for injury or damages. There are three
categories of criminal law:
1. Felony: the most serious category, including such acts as homicide, grand larceny, and nurse
practice act violation
2. Misdemeanor: includes lesser offenses such as traffic violations or shoplifting of a small dollar
amount
3. Juvenile: crimes carried out by individuals younger than 18 years; specific age varies by state and
crime

Civil Law
Civil laws usually involve the violation of one person’s rights by another person. Areas of civil law
that particularly affect nurses are tort law, contract law, antitrust law, employment discrimination,
and labor laws.
Tort
A tort is a legal or civil wrong carried out by one person against the person or property of another
(Black, 2004). Tort law recognizes that individuals in their relationships with each other have a
general duty not to harm each other (Cushing, 1999). For example, as drivers of automobiles,
everyone has a duty to drive safely so that others will not be harmed. A roofer has a duty to install a
roof properly so that it will not collapse and injure individuals inside the structure. Nurses have a
duty to deliver care in such a manner that the consumers of care are not harmed. These legal duties
of care may be violated intentionally or unintentionally. Intentional torts: Willful acts that are
intentional and cause injury. An intentional tort is a direct violation of a person’s legal rights and
includes assault, battery, false imprisonment, and fraud. Unintentional torts: Careless acts or
accidents that cause injury. Negligence and malpractice are examples of unintentional torts.
Quasi-Intentional Tort
A quasi-intentional tort has its basis in speech. These are voluntary acts that directly cause injury or
anguish without meaning to harm or to cause distress. The elements of cause and desire are present,
but the element of intent is missing. Quasi-intentional torts usually involve problems in
communication that result in damage to a person’s reputation, violation of personal privacy, or
infringement of an individual’s civil rights. These include defamation of character, invasion of
privacy, and breach of confidentiality (Aiken, 2004, p. 139).
Negligence
Negligence is the unintentional tort of acting or failing to act as an ordinary, reasonable, prudent
person, resulting in harm to the person to whom the duty of care is owed (Black, 2004). The legal
elements of negligence consist of duty, breach of duty, causation, and harm or injury (Cushing, 1999).
All four elements must be present in the determination.
For example, if a nurse administers the wrong medication to a client, but the client is not injured, then
the element of harm has not been met. However, if a nurse administers appropriate pain medication
but fails to put up the side rails, and the client falls and breaks a hip, all four elements have been
satisfied. The duty of care is the standard of care. The law defines standard of care as that which a
reasonable, prudent practitioner with similar education and experience would do or not do in similar
circumstances (Prosser & Keeton, 1984).

Malpractice
Malpractice is the term used for professional
negligence. When fulfillment of duties requires
specialized education, the term malpractice is used.
In most malpractice suits, the facilities employing
the nurses who cared for a client are named as
defendants in the suit. Vicarious liability is the
legal principle cited in these cases. Respondeat
superior, the borrowed servant doctrine, and the
captain of the ship doctrine fall under vicarious
liability. An important principle in understanding
negligence is respondeat superior (“let the master
answer”) (Aiken, 2004, p. 279). This doctrine holds employers liable for any negligence by their
employees when the employees were acting within the realm of employment and when the alleged
negligent acts happened during employment
(Aiken, 2004).
Major Categories of Malpractice
Malpractice suits against nurses have increased since 2000 (Reisling, 2012). Research indicates that
six common categories of nursing practice have the potential for negligence and possible malpractice
(Croke, 2003):
1. Failure to assess and monitor
2. Failure to follow standards of care
3. Failure to communicate
4. Failure to document
5. Failure to act as a patient advocate
6. Failure to use equipment in a responsible manner
Failing to perform these actions can constitute negligence if the required elements are present.

Administrative Cases
In administrative cases, an individual is sued by a state or federal governmental agency assigned the
responsibility of implementing governmental programs. State Boards of Nursing are one such
governmental agency. When an individual violates the state Nurse Practice Act, the Boards of
Nursing may seek to revoke licensure or institute some form of discipline. The burden of proof in
these cases varies from state to state. When the clear and convincing standard is not used, the
preponderance of the evidence standard may be used. Clear and convincing involves higher burdens
of proof than preponderance of evidence but significantly lower burdens of proof than beyond a
reasonable doubt.

Documentation
Automated medication administration systems and point-of-care clinical documentation systems
have positive results for patient care. These results are made possible because electronic
documentation systems are at the bedside or the nurse has direct access to a computer.
Errors are prevented when handwriting is not misinterpreted. Care is documented at the time of
occurrence. Point-of-service bar coding during medication administration helps nurses ensure that
the “eight rights,” which include right patient, medication, time, dose, route, documentation, reason,
and response, have been followed. A drawback of automated medical records systems is that they are
expensive (Landro, 2002). Changing to a bar code system can cost a healthcare organization an
estimated $1.5 billion, and many organizations cannot afford to initiate fully automated systems.
Therefore, nurses must complete accurate documentation in the medical record in a timely manner,
and their handwriting must be legible. Documentation of care should be done at the time of the
occurrence. If called into a court of law, the medical record is viewed as being more objective than
the nurse’s verbal recall of an incident or work history.

Errors
An error of omission occurs when a nurse or other healthcare provider does not make a notation in
the medical record. Examples include not documenting vital signs, the amount of drainage on a
dressing, or medication administration. An error of commission occurs when a nurse or other
healthcare provider fabricates information and documents it in the medical record. Examples include
charting vital signs, central venous pressure readings, or dressing changes that were not done. These
errors have implications for the patient because the care the patient needs is not being delivered and
a medical or nursing decision could be made based on false data. At a minimum, the offending nurse
or healthcare provider should receive disciplinary action; termination from employment is possible.

Incident Reports
If an untoward event occurs, such as a patient fall or a medication error, the nurse should complete
an incident report, which is sometimes referred to as an unusual occurrence report. Incident reports
are documents that help analyze problems so that solutions can be formulated to prevent the event
from recurring. Depending on the state law, these reports may be recoverable. Some states view
incident reports as business reports, which are not part of the medical record. The nurse should not
refer to the incident report in the patient’s medical record because it then becomes a part of the record,
which means the document can be used in a court of law. By keeping incident reports out of the
medical record, agencies can use the information as a quality improvement tool.

Event Reports
Some states have adopted legislation that requires hospitals, outpatient surgical centers, and treatment
centers to document when certain serious events occur (Minnesota Department of Health,
2008). These serious, untoward occurrences are documented on event report forms. Examples of
serious events that should be documented in this way include performing surgery on the wrong body
part, leaving an operative sponge inside of a surgical site, and a patient with Alzheimer’s disease
suffering serious harm after eloping from a facility.

Informed Consent
Many years ago, physicians provided direct care with a paternalistic, “father knows best” approach
(Ignatavicius & Workman, 2010). They proceeded with the medical plan of care with minimal input
from the patient. In the past, patients typically deferred to their physicians for exclusive expert
judgment. Today, however, more patients exercise decision-making autonomy relative to their
medical care and want to be active participants in their plans of care. The formal concept of informed
consent ensures that patients know all of their options relative to medical treatment and care.

Elements of Informed Consent

Four key elements must be present for informed consent to take place:
• competence
• disclosure of information
• comprehension
• voluntariness.
Competence
Competence requires that the person making decisions be able to make them reasonably. The patient
should understand the treatment being discussed, be able to differentiate the risks and benefits of the
treatment as explained by a physician, and be able to make a decision with the knowledge received.
Disclosure of Information
Disclosure defines the boundaries or amount of knowledge an individual need in order to make a
rational decision. The patient must be apprised of all treatment options.
Comprehension
Comprehension is the ability of the individual to understand what is being explained in order to make
a decision. Medical terminology and specific treatments must be explained by a physician.
Voluntariness
Voluntariness requires that a patient make an informed decision, without coercion from others.
Nurse’s Role in Informed Consent
From a purely legal standpoint, a nurse signs an informed consent form only to witness the patient’s
signature. If the patient has questions about the proposed treatment or surgical intervention, the nurse
should refer the patient to the physician for answers. The physician should disclose all risks associated
with a procedure, including surgery, using terms the patient can understand (LeMone & Burke, 2008).
Typically, the nurse assists the physician in determining the patient’s level of understanding. The
informed consent document protects the patient, nurse, physician, and healthcare institution.
Consent for Mentally Incompetent Persons
A mentally incompetent person cannot provide consent for any treatment. In such cases, healthcare
providers can make limited decisions. A person who is mentally incompetent is not able to carry out
important decisions about his or her affairs.
Consent for Emancipated Minors
An emancipated minor is a person who is younger than the age of majority determined by
state law. These individuals are viewed legally as being old enough, by virtue of marriage or financial
independence, to make adult decisions and have the ability to exercise control over their own lives.
The age for emancipated minors varies by state. The medical situations for which emancipated minors
commonly seek treatment include substance abuse, communicable diseases, and pregnancy.

Confidentiality
It is possible for nurses to be involved in lawsuits other than those involving negligence. For example,
clients have the right to confidentiality, and it is the duty of the professional nurse to ensure this right.
This assures the client that information obtained by a nurse while providing care will not be
communicated to anyone who does not have a need to know. This includes giving information by
telephone to individuals claiming to be related to a client, giving information without a client’s signed
release, or removing documents from a health-care provider with a client’s name or other information.

Slander and Libel

Slander and libel are categorized as quasi-intentional torts. Nurses rarely think of themselves as being
guilty of slander or libel. The term slander refers to the spoken word, and libel refers to the written
word. Making a false statement about a client’s condition that may result in an injury to that client is
considered slander. Making a written false statement is libel. For example, stating that a client who
had blood drawn for drug testing has a substance abuse problem, when in fact the client does not
carry that diagnosis, could be considered a slanderous statement. Slander and libel also refer
to statements made about coworkers or other individuals whom you may encounter in both your
professional and educational life. Think before you speak and write. Sometimes what may appear to
be harmless to you, such as a complaint, may contain statements that damage another person’s
credibility personally and professionally.

False Imprisonment
False imprisonment is confining an individual against his or her will by either physical (restraining)
or verbal (detaining) means. The following are examples:
■ Using restraints on individuals without the appropriate written consent
■ Restraining mentally handicapped individuals who do not represent a threat to themselves or others
■ Detaining unwilling clients in an institution when they desire to leave
■ Keeping persons who are medically cleared for discharge for an unreasonable amount of time
■ Removing the clothing of clients to prevent them from leaving the institution
■ Threatening clients with some form of physical, emotional, or legal action if they insist on leaving

Assault and Battery

Assault is threatening to do harm. Battery is touching another person without his or her consent. The
significance of an assault is in the threat: “If you don’t stop pushing that call bell, I’ll give you this
injection with the biggest needle I can find” is considered an assaultive statement. Battery would
occur if the injection were given when it was refused, even if medical personnel deemed it was for
the “client’s good.” With few exceptions, clients have a right to refuse treatment. Holding down a
violent client against his or her will and injecting a sedative is battery. Most medical treatments,
particularly surgery, would be battery if it were not for informed consent from the client.

Advance Directives
According to ANA Code of Ethics for Nurses, nurses have an obligation to be knowledgeable about
the moral and legal rights of their patients regarding self-determination (ANA, 2015a). The PDSA,
discussed earlier, mandates that all patients have the opportunity to initiate an advance directive,
which is a document that provides information about a person’s desires should he or she become
unable to make health-care decisions. In other words, an advance directive provides directions to
family and health-care professionals by a person in advance of becoming ill and incapacitated. Nurses
and other health-care professionals have an ethical and legal duty to respect a patient’s advance
directive. Nurses can be held liable for violating a patient’s advance directive and could be charged
with battery and malpractice. A nurse’s responsibilities related to advance directives include the
following:
● Initiating discussion with a patient about advance directives
● Providing a patient with written information about advance directives
● Communicating the presence of an advance directive to all members of the health-care team
● Ensuring that advance directives are current and accurately reflect the patient’s wishes

Establishing an advance directive or having discussions with families about life sustaining care can
reduce the burden of decision making for loved ones (Hickman & Pinto, 2013). In addition, advance
directives can assist with the delivery of patient-centered care. There are three types of advance
directives:
● A living will
● A do not resuscitate (DNR) order
● A durable power of attorney for health care

Living Will
A living Will is a legal document that details a person’s wishes regarding healthcare treatments and
procedures in the event the person becomes incapacitated and is facing end of life. Living wills are
legal in all states, but elements or what is allowed may vary. Nurses must be familiar with the statutes
related to living wills in the state and organization in which they practice.

Do Not Resuscitate
A DNR order indicates the life-sustaining measures that should be withheld in the event of impending
death. In some instances, an allow natural death (AND) order is initiated, which means that only
comfort measures will be provided. As patient advocates, nurses play an active role in initiating
discussions about DNR and AND orders with patients, families, and members of the health-care team
(ANA, 2012). Nurses “actively participate in assuring the responsible and appropriate use of
interventions to optimize the health and well-being of those in their care. This includes acting to
minimize unwarranted, unwanted, or unnecessary medical treatment and patient suffering” (ANA,
2015a, p. 2).

Durable Power of Attorney for Health Care

A durable power of attorney for health care is a legal document that identifies a health-care surrogate.
The surrogate is a person designated to make health-care decisions for another person, who is
incapacitated. The health-care surrogate should have a clear understanding of the person’s wishes
regarding health care and be willing to respect those wishes even if he or she does not agree. By
participating in discussions with surrogates, providing guidance and referrals, and identifying
problems in the decision-making process, nurses will support patient self-determination (ANA,
2015a).

Good Samaritan Laws

Fear of being sued has often prevented trained professionals from assisting during an emergency. To
encourage physicians and nurses to respond to emergencies, many states developed what are now
known as the Good Samaritan laws. When administering emergency care, nurses and physicians are
protected from civil liability by Good Samaritan laws as long as they behave in the same manner as
an ordinary, reasonable, and prudent professional in the same or similar circumstances. In other
words, when assisting during an emergency, nurses must still observe professional standards of care.
However, if a payment is received for the care given, the Good Samaritan laws do not hold.

Contract Law
The area of contract law most relevant to nurse managers is employment. Most employment
relationships between nurses and employers are “at will,” which allows the employees to quit “at
will” and the employer to terminate “at will,” for no reason. An actual employment contract between
employee and employer is more binding, however. The nurse promises to provide specific nursing
services in exchange for financial reimbursement. If either side violates its promises under the
contract, the contract has been breached, and the other part may seek damages. Contracts also come
into play in the labor law arena. Many nurses work under the auspices of a union.

5. Now, read, analyze, and answer the learning tasks below.

TASK 1. ASSESSING YOUR UNDERSTANDING

Instructions: Using the table below, provide the salient features of each law. Fill-in reflection and
experience which are necessary to understand many of these laws in the context of health care and
nursing practice. (see rubrics for scoring)
Existing Laws Salient Features Reflection/Inference
The Nursing Practice Act of 2002

NURSING CARE MANAGEMENT 119-1ST SEM 2023-2024. NOT FOR SALE. EXCLUSIVE FOR GORDON COLLEGE ONLY.
 The Rooming-In and
Breastfeeding Act of 1992
Expanded Senior Citizen Act of
2010
Anti-Sexual Harassment
Clean Air Act
Local Government Code
Comprehensive Dangerous Drugs
Act 2002
Universal Health Care Law
Labor Code
The Magna Carta of Public Health
Workers
Republic Act No. 11166
Republic Act No. 11332
The Mental Health Act

TASK 2. APPLYING YOUR KNOWLEDGE

Instructions: Briefly answer the following discussion questions. (see rubrics for scoring)
Scenario: Raffie., a 62-year-old patient, is admitted to a medical rehabilitation unit for gait training
and lower extremity strengthening exercises. She has a history of Parkinson’s disease and is married
to Mikel, a healthy 65-year-old man. At 7:00 p.m., Mrs. R. is assisted to the bathroom by her nurse
because her gait is unsteady. Two hours later, at 9:00 p.m., she is given 30 mg of Dalmane to help
her sleep. Her four side rails are up, as ordered by her physician. At 11:00 p.m., she is assisted to
the bathroom again by her nurse. At 3:45 a.m., Mrs. R. is found on the floor and is complaining of
severe pain in her right hip. Three of the side rails are up at this time. An X-ray confirms that Mrs.
R. has sustained a fractured hip. During surgery to repair the hip fracture, Mrs. R. has a stroke and
suffers brain damage. She was the administrator of a large textile company and can no longer work.
Discussion Questions
Discussion Questions
1. Could a medical malpractice claim be pursued by Mrs. Raffie.?
2. Who may be sued?
3. Who are the potential plaintiffs?
4. Who are the potential defendants?
5. What are the potential damages?
6. Who has a claim for damages?
7. What are the potential defenses to a claim of malpractice?

Rubrics
Features 5 4 3 2 1
Focus/Analysis All key aspects Only modest Some potential Adequate in Weak
The single identified and abstraction connections parts; gaps in progression of
controlling point is related beyond facts; missed the logical ideas
made with an overly development
awareness of the derivative

NURSING CARE MANAGEMENT 119-1ST SEM 2023-2024. NOT FOR SALE. EXCLUSIVE FOR GORDON COLLEGE ONLY.
 task about a specific
topic.
Task achievement Fully addresses Sufficiently Presents a Presents Arranges
Fulfillment of the all parts of the addresses all clear position relevant ideas information and
task being task parts of the task but there may but some may ideas but an
presented by the be a tendency be inadequately unclear
activity. that the developed progression
supporting
ideas may lack
position
Relevance/ The task makes The task makes The task makes The task makes The task makes
Connections appropriate some unclear or undistinguishab no connections
Relation of the task connections appropriate inappropriate le connections between the
to the between the connections connections between the purpose and
concepts/ideas purposes and between the between the purposes and features of the
features of the purposes and purposes and features of the ideas/concepts
ideas/concepts features of the features of the ideas/concepts
ideas/concepts ideas/concepts

Guidelines:
The following instructions shall apply:
1. Free medium to use. You can convert your answer sheet in the following format:

a. Picture/Image b. PDF file c. Microsoft Word

2. Submit your answer to our Google Classroom and use your GC domain google account.

3. You may also use the GC Academic Assistance Desk for the submission of accomplished modules.

4. At a minimum, you must cite the journal, textbook, article, and other reading materials. Make sure
to cite any references you use. Use APA style (7th edition) for proper citation format for your
references.

VI. References (Online Sources/EBooks)

Jones, R. A. P. (2007). Nursing leadership and management: theories, processes, and practice. F A
Davis.

Kelly, P. (2010). Essentials of nursing leadership & management (2nd ed.). Delmar Cengage
Learning.

NURSING CARE MANAGEMENT 119-1ST SEM 2023-2024. NOT FOR SALE. EXCLUSIVE FOR GORDON COLLEGE ONLY.
 Korniewicz, D. M. (2015). Nursing leadership and management: the advanced practice role.
DEStech Publications, Inc.

Marquis, B. L., & Huston, C. J. (2012). Leadership roles and management functions in nursing:
theory and application. Wolters Kluwer Health/Lippincott Williams & Wilkins.

Marquis, B. L., & Huston, C. J. (2015). Leadership roles and management functions in nursing:
theory and application. Wolters Kluwer Health.

Tappen, R. M., Weiss, S. A., & Whitehead, D. K. (2001). Essentials of nursing leadership and
management. F.A. Davis Co.

Weiss, S. A., & Tappen, R. M. (2015). Essentials of nursing leadership and management. F.A.
Davis Company.

Whitehead, D. K., Weiss, S. A., & Tappen, R. M. (2010). Essentials of nursing leadership and
management. F.A. Davis.

Prepared by:

LUCKYHANSEL R. CEREZO
Instructor