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NUR1111 > 1113 Exam > Flashcards

1113 Exam Flashcards

1
Q

Explain the relationship between law and ethics

A

Law must be followed by nurses and midwives, with consequences if not. Ethics is what is considered morally right or wrong by an individual or society

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2
Q

Explain the fundamental aspects of the Australian Legal system

A
  • Generated and influenced by the history and values of society
  • Regulates peoples actions and apply sanctions for those who do not
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3
Q

Identify the key features of the Australian Law

A
  • Legalisation (parliamentary law)

- Common Law (Judge made law)

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4
Q

Define legalisation (parliamentary law)

A

Passed at a state and federal level, by parliament as acts or statutes. (Primary source of law) e.g.. Mental Health Act 2014

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5
Q

Define an ACT

A

Elected by the people and passed by parliament e.g.. Mental Health Act 2014

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6
Q

Define common law (judge made law)

A

Judges decide on cases brought to the court and develop common law principles called precedents

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7
Q

Distinguish between where you would use Legalisation over Common Law

A

Common law applies when there is no specific statutory law according to the application of Doctrine of Precedent

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8
Q

Define the Doctrine of Precedent

A

“Like cases are treated similarly” Outcomes from similar cases in the past are applied

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9
Q

Define the Adversarial system

A

Where disputes are resolved in court only. Both parties present their case, and the outcome is decided by the judge/judge and jury purely based on the information provided

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10
Q

Define the Inquisitorial system

A

Where the court is able to gain additional information externally outside of the court as part of coming to a decision. eg. Coroner’s Court

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11
Q

Define bioethics

A

The study of ethical/moral dilemmas in the medical environment eg. organ donation

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12
Q

Define the deontology theory

A

Where ‘duty/obligation’ is the basis of all moral action. Concerned with the rightness/wrongness of all actions e.g.. stealing food

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13
Q

Define the teleology theory

A

Concerned with the rightness/wrongness of the consequences of actions. Actions/motives are not considered wrong. eg. Poor person stealing food for their family would be considered right

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14
Q

Define Virtue Ethics (theory)

A

Concerned with the role of an individual and their specific characteristics which inform their actions e.g.. nurse’s empathy

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15
Q

Identify the 4 ethical principles

A

Autonomy
Beneficence
Non-maleficence
Justice

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16
Q

Define autonomy

A

Autonomy is concerned with the rights of people to have an opinion and a choice with decisions that concern them

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17
Q

Define beneficence

A

“Above all do good” eg. providing appropriate intervention ensuring that it will produce greater benefit than harm

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18
Q

Define non-maleficence

A

“Above all do no harm” eg. Avoiding unnecessary and and unreasonable harm in the process of treatment and management

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19
Q

Define justice

A

Concerned with fair and equitable distribution of resources and access to care

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20
Q

Define natural justice

A

Applies to all courts and tribunals to ensure that proceedings against a person are fair, impartial and without bias

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21
Q

Explain the importance of nursing documentation

A
  • High quality documentation contributes to high quality care
  • Communication of important information to other health professionals for coordinated care
  • Patients can request access to medical records, therefore quality of your care will be provided to them
  • Documentation is your only defence in a claim of negligence against you if things go wrong
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22
Q

Identify the 5 requirements of documentation

A
  • Handwriting must be legible, dated, signed with designation
  • Must contain specific, accurate and objective information
  • Subjective information from family members etc. include statements, feelings expectations
  • Must be contemporaneous (real time) reflecting the patients current state written as closely to occurrence as possible
  • Must include everything done to/with the patient eg. assessments, care provided
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23
Q

Explain the purpose of the mental health legalisation

A

It promotes voluntary treatment over compulsory treatment and establishes robust safeguards and oversight mechanisms. Protects the rights, dignity and autonomy of people living with a mental illness

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24
Q

Outline what information the mental health legalisation includes

A

Outlines the purpose, provides definitions and the requirements under the Act, and stipulates how assessment should occur

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25
Q

Identify the (4) common features of a profession

A
  • requires specific skills and training
  • higher education
  • ongoing education and training
  • scope of practice
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26
Q

Define a regulated HCW

A

They are registered and require a licence/ongoing education to practice

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27
Q

Define a unregulated HCW

A

They are not registered and do not require a practicing licence

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28
Q

Identify the (4) functions of APHRA

A
  • provides professional standards
  • registration of HCW
  • manage notifications (complaints)
  • accreditation of graduating students
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29
Q

Identify the (4) functions of NMBA

A
  • registration of nurses, midwives, N&M students
  • development of standards and codes
  • manage notifications and investigations
  • assessment of internationally trained N & M
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30
Q

Define notifiable conduct

A

Is valid when a HCW has:

  • worked under the influence (alcohol or drugs)
  • engaged in sexual misconduct that is unlawful
  • placed the public at risk of substantial harm
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31
Q

Outline the relationship between NMBA and the Health Complaints Commissioner

A

The relationship that exists is due to when a N or M breaches the code of conduct created by NMBA, this is classified as notifiable conduct and is passed on to the HCC

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32
Q

Identify the national code for nurses/midwives

A

Code of Conduct for Nurses (NMBA, 2018)

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33
Q

Identify the (4) actions that may give rise to disciplinary action of a HCW

A
  • under involvement/negligence
  • bullying/harassment
  • breach of professional boundaries
  • confidentiality/privacy
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34
Q

Explain the concept of mandatory reporting of child abuse

A

Any person who believes a child is in need of protection must report it. Evidence is not required, just reasonable grounds to believe

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35
Q

Identify the (4) types of child abuse that may be reported upon

A
  • Neglect
  • Abuse
  • Emotional maltreatment
  • Exposure to family violence`
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36
Q

Identify the three types of consent relevant for clinical practice

A

Verbal
Implied
Written

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37
Q

Define verbal consent

A

When a patient says yes or no

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38
Q

Define implied consent

A

When a patient holds out their arm when you ask to take their blood pressure

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39
Q

Define written consent

A

When a patient signs a consent form e.g. before surgery

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40
Q

Identify the four elements required for consent to be valid

A
  • Freely and voluntarily given (no misinterpretation/pressure)
  • Must cover procedure (Must gain consent for everything you do)
  • Must be informed (patient must be aware of risks, benefits, side effects)
  • Must have legal capacity (Must be of sounds mind and legally competent)
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41
Q

Identify three exceptions for when consent is not required

A
  • Emergency treatment
  • Parental authority is not absolute
  • In necessity
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42
Q

Define emergency treatment (exception to consent rule)

A

Emergency treatment is conducted in order to save a patients life, prevent a patient from serious damage or prevent a patient from suffering in some way

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43
Q

Define ‘parental authority is not absolute’ (exception to consent rule)

A

When parental consent is not required (e.g. in lifesaving situations such as blood transfusion for a child)

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44
Q

Define necessity (exception to consent rule)

A

(Not in a clinical environment) e.g. touching someone to prevent them from being hit by a car)

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45
Q

Define assault

A

Acting with specific intent to cause harm. Can be as simple as instilling fear in a patient e.g. threatening to/pretending to hit a patient

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46
Q

Define battery

A

Acting upon the intent (Acting upon assault) such as touching/striking someone without their permission e.g. pushing/slapping a patient

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47
Q

Define false imprisonment

A

Unlawful, intentional and complete application of restraint restricting a patients freedom to move

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48
Q

Identify the three elements of false imprisonment

A
  • Can be done without actually touching the patient
  • Must be total (Patient has no means to move)
  • Person must be unaware at the time that they are unable to move
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49
Q

Explain when it is okay to restrain a patient

A
  • Specific to each hospital
  • Specific guidelines on who can order restraints
  • Must be ongoing review, planning and managing of the restraint order
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50
Q

Identify the two types of restraint

A

Physical : eg. isolated room

Chemical : eg. medication

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51
Q

Outline what occurs if a person is unable to give consent

A
  • A competent person may appoint a subsist decision maker before they loose capacity to do so under the ‘Medical Treatment Planning and Decisions Act 2016’
52
Q

Identify the three ways in which a substitute decision maker can be appointed

A
  • Medical power if attorney (appointed before 12/3/2018)
  • Guardianship and Administration Act 2019 (if the person has a disability that creates incapacity
  • Under the Mental health act 2014
53
Q

Define medical power of attorney

A

A medical power of attorney allows someone to give and withhold consent to medical treatment on behalf of another person

54
Q

Identify the (3) requirements for a medical power of attorney

A
  • Patient must have decision making capacity at the time of appointing
  • Patient should choose someone they trust and who respects their values and preferences
  • Patient can appoint more than one person, but only one person may act at one time
55
Q

Explain the new law for medical power of attorney as of 12 March 2018

A

A person can appoint a ‘Medical Treatment Decision Maker’ without making an enduring power of attorney

56
Q

Define a guardian

A

A person appointed in a guardianship order as a guardian in relation to one or more specified matters

57
Q

Identify the law that allows a ‘guardian’ to be appointed for medical decisions

A

Guardianship and Administration Act 2019 (Vic)

58
Q

Outline the purpose of the Guardianship and Administration Act 2019 (Vic)

A

Is to protect and promote the human rights and dignity of persons with a disability

59
Q

Explain the role of guardianship in relation to patient decisions for treatment

A

This Act means for someone who has a disability contributing to incapacity to make decisions, a guardian is appointed to make these decisions for them in order to protect their rights and dignity

60
Q

Define refusal of treatment

A

Occurs when a patient chooses (when competent) to refuse treatment, which could ultimately lead to palliative care

61
Q

Define withdrawal of treatment

A

Occurs when the health team decide in consultation with a patient’s family to withdraw the patient from treatment, where they are not competent and treatment is futile

62
Q

Define futile treatment

A

Treatment which is not in the patients best interest, cannot achieve it’s purpose or is not clinically indicated

63
Q

Explain (3) factors which may affect treatment becoming futile

A
  • Patient’s diagnosis/prognosis
  • Treatment goals (whether they can be achieved)
  • Treatment alternatives (Are they worth it? risks? benefits?)
64
Q

Define advanced care planning

A

The process of thinking about/documenting your preferences for future healthcare. It is based on your individual values, beliefs, traditions and culture

65
Q

Define an advanced care directive

A

Is a legally binding document made under the Medical Treatment Planning and Decisions Act 2016 by a legally competent person and may contain a values directive, instructional directive or both

66
Q

Define instructional directive (ACD)

A

Contains legally binding instructions about future medical treatment you consent/refuse to (used as if the patient is there making the decisions)

67
Q

Define values directive (ACD)

A

Documents your values/preferences for your appointed Medical Treatment Decision Maker to consider when making decisions for you

68
Q

Define Voluntary Assisted Dying

A

Is the means of administering a medication for the purpose of causing death in accordance with the relevant steps/law

69
Q

Identify when the voluntary assisted dying law was passed in Victoria

A

19th of June 2019 (19/06/19)

70
Q

Outline the requirements for Voluntary assisted dying

A
  • Must be voluntary and initiated by the patient (often self administering medication)
  • Only for those who face inevitable, imminent death due to incurable disease, condition or illness
71
Q

Define NFR order

A

NFR orders prevent the use of cardiopulmonary resuscitation in situations where it is deemed futile/unwanted by the patient.

72
Q

Explain who decides on NFR orders

A

NFR orders are decided on by a competent patient themselves, or an appointed Medical Decision Maker

73
Q

Identify the (4) requirements for a NFR order

A
  • Further treatment must be futile
  • Decision must be made by a group of people consisting of a doctor, nurse and a family representative
  • Order must conform with law of consent and it’s requirements
  • Order must be clearly documented in the patient notes and reviewed regularly in case of the patients condition improving
74
Q

Define negligence in healthcare

A

Failure to provide a patient with proper professional care, resulting in injury

75
Q

Identify when a claim of negligence can be made

A

If the patient has suffered physical or psychological harm, or suffered a financial loss as a result of he care provided

76
Q

Outline the two types of negligence in healthcare

A
  • Criminal negligence: Where there is intent to cause harm

- Civil negligence: Act or omission which is casually linked to the injury

77
Q

Explain the (4) requirements for a claim of negligence to be valid

A
  • Patient was owed a duty of care by the death professional
  • Patient suffered harm, damage and loss as a result
  • There was a breach of duty of care (care fell below the standard)
  • The harm, damage and loss was a consequence of the health professionals actions
78
Q

Identify the possible defences to a general claim of negligence

A
  • To deny that a duty of care was owed
  • Defendants actions were reasonable at the time and widely accepted by colleagues
  • To establish that no harm was caused
  • To establish that their is no relationship between the duty of care and damage caused
  • The alleged harm/damage is too remote
79
Q

Define the doctrine of vicarious liability

A

When the employer is made liable when an employee has been proven to be negligent

80
Q

Outline the two effects caused as a result of vicarious liability

A
  • Financial responsibility is shifted to the employer

- Employer most likely to have the means to compensate the injured patient

81
Q

Explain the concept of the “egg shell principle”

A

The unexpected frailty of the person is not a valid defence to the seriousness of the injury e.g. some people will be more vulnerable to injury, but this doesn’t matter under this principle

82
Q

Identify the (3) requirements for Doctrine of vicarious liability

A
  • Person was an employee
  • Negligent act arose in conduct/scope of employment
  • Personal liability for the actions remains with the employee
83
Q

Explain the concept of a “Good Samaritan”

A

Someone who potentially saves a persons life, by taking a risk in an emergency situation that they would otherwise not do

84
Q

Outline the legal provisions which now stand for Good Samaritans

A

If your provide assistance/advice/care to an individual at risk of death/injury who no expectation of financial reward, you will not be liable for anything done or omitted to be in good faith at the scene

85
Q

Define an apology within healthcare

A

Is an expression of sorrow, regret or sympathy (including the word sorry) but does not include acknowledgement of fault

86
Q

Define an open disclosure

A

Open disclosure is a discussion within a document about an incident which resulted in harm whilst the patient was receiving healthcare

87
Q

Outline the (4) elements within an open disclosure

A
  • Apology/expression of regret
  • Factual explanation of what happened
  • Opportunity for patient to relate their experience
  • Explanation of steps taken to manage the situation and prevent recurrence
88
Q

Define privacy

A

Focuses on the collection, storage and handling of patient information

89
Q

Define confidentiality

A

Is concerned with inappropriate disclosure or communication of a patient’s information

90
Q

Identify when a patients information can be disclosed

A
  • When a patient consents
  • When the information does not identify the patient
  • To other HCW who are responsible for the patient’s treatment
  • When required by legalisation
91
Q

Identify the three Acts concerned with confidentiality and privacy

A
  • Privacy Act 1988
  • My Health Records Act 2012
  • Health Records Act 2001 (Vic)
92
Q

Explain the function of the Privacy Act 1988

A

Regulates the handling of personal information by private and public sector organisations and individuals

93
Q

Explain the function of My Health Records Act 2012

A

Limits how and when health information can be collected, used and disclosed

94
Q

Explain the function of Health Records Act 2001 (Vic)

A

Framework which enables patients to access their health information

95
Q

Identify what the Health Records Act 2001 consists of

A

Consists of 11 guiding principles relating to health information (Health Privacy Principles) (HPP)

96
Q

Outline the purpose of the Health Records Act 2001

A

To promote fair and responsible handling of health information by protecting the privacy and rights of patients to access their information

97
Q

Explain the requirements of transparency of health information

A
  • Providers must have a document explaining how they handle their health information
  • Document must be available to patients when they ask
  • Consumers have a general right of access to their own health records
98
Q

Identify some of the outcomes that could arise as a result of a breach

A
  • Possible termination
  • Complaints made to the HCC
  • Negligence (Possible defamation if the patients reputation has been damaged
99
Q

Identify the purpose of documentation

A
  • Communication between HCW
  • Accountability of HCW if something goes wrong
  • Legislative requirement
  • Professional responsibility
  • Quality research
100
Q

Outline the times in which a patients information can be disclosed due to legalisation

A
  • Child abuse
  • Reportable deaths to the Coroner
  • Infectious diseases
  • Blood/Drug test results
101
Q

Identify the 9 principles of documentation

A
  • contemporaneous
  • accurate and complete
  • objective
  • legible and clear
  • avoid total oliberation
  • late entries (cross reference)
  • signing/countersigning
  • avoid transcription (write once)
  • don’t rewrite reports
102
Q

Outline the possible outcomes of poor documentation

A
  • Often a deciding factor in a legal case
  • First thing they look at when things go wrong
  • If it isn’t in the notes, it didn’t happen
103
Q

Explain (3) elements of good practice regarding documentation

A
  • Health/medical information is highly sensitive
  • Keep track of records and files at all times
  • Don’t leave records open on desks
  • Shred documents
104
Q

Define the coroners court

A

Investigates deaths that are unexpected, unnatural, accidental or violent. Inquisitorial system actively investigates

105
Q

Define criminal law

A

Protecting society as a whole, where the crime is against the state. They are public wrongs initiated by the state

106
Q

Identify the common penalties for criminal law

A

Incarceration or Fine

107
Q

Identify the two components of criminal law that must be proven

A

Mens Rea

Actus Reus

108
Q

Define Mens Rea

A

The mental intention carry out the offence, through intent, negligence or recklessness

109
Q

Define Actus Reus

A

Proves that the activity or conduct constitutes the offence and physical act of crime

110
Q

Explain the principle of double effect

A

Refers to when a patient is terminally ill and requires a large amount of analgesia, which may hasten death or bring it on at a quicker rate than normal

111
Q

Explain when homicide/manslaughter can be associated with healthcare delivery

A

Where someone dies as a result of negligence e.g. unlawful administration of medication

112
Q

Explain when suicide can be associated with healthcare delivery

A

If a nurse discusses Voluntary assisted dying with a patient, this may be considered incitation of suicide

113
Q

Explain when rape can be associated with healthcare delivery

A

E.g. No consent before inserting a suppository. Must be free agreement before the medical treatment

114
Q

Explain when abortion can be associated with healthcare delivery

A

An abortion after 24 weeks with no approval from doctors is considered a crime

115
Q

Explain when female mutilation can be associated with healthcare delivery

A

Prohibits the removal of the clitorial hood (female girl or baby) or any genital area (e.g. for cultural or non therapeutic reasons). Therefore, not abiding this rule is considered a crime

116
Q

Identify the (2) relevant legalisations associated with criminal law and coronal jurisdiction

A

Crimes Act 1958 (Vic)

Coroner’s Act 2008 (Vic)

117
Q

Identify the (3) actions of the Coroner’s Court

A
  • Investigates deaths and fires
  • Reduce preventable deaths
  • Promote public health/safety and administration of justice
118
Q

Identify the distinguishing features of Coroners Court

A
  • Preliminary Exams (Visual exam, collection/review of personal and health information, collect bodily fluids/fingerprints
  • Autopsies (Post mortem) by a pathologist, examination of a body/body parts
119
Q

Define reportable deaths

A

Where a persons death was unexpected, unnatural, violent or a result of a medical procedure.
Also occur in deaths that occur in prison, when a HCW doesn’t sign and death certificate or when the identify is unknown

120
Q

Define reviewable deaths

A

Occur when the death of a child is the second or subsequent child of either parents to have died

121
Q

Define an inquest

A

Is a court hearing into a single death, multiple deaths or a fire led by the coroner to understand why it occurred

122
Q

Identify what the coroners findings usually compromises

A
  • Identity of the person who died
  • Cause of death
    May also include:
  • Circumstance in which the death occurred
  • Comments or recommendations
123
Q

What is the role of the nurse/midwife in a coroners case

A
  • Minimal interference when the death occurs e.g. Not touching the body before the coroner’s review)
  • Leave nasogastric NGT, IV, IDC. drain tubes etc in situ
  • May also need to act as witnesses, or providing evidence to a medico legal investigation
124
Q

Identify the national act that regulates health practitioners

A

Health Practitioner Regulation National Law Act 2009

125
Q

Identify the purpose of the Health Practitioner National Law Act 2009

A

To provide a national registration and accreditation scheme for registered health practitioners

NUR1111 (2 decks)

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