CH 3. Ethics, Laws and Delegation in Nursing

Question 1

value

Answer 1

belief in somethings worth

Question 2

ethics

Answer 2

values that influence our behavior and decisions

Question 3

Why do we need to identify our own values and ethics in order to provide ethical care for our patients?

Answer 3

to ensure we are providing the best care for the patient in terms of respect, compassion, and honesty

Question 4

What does it mean to advocate for the patient and why is it important?

Answer 4

Advocating for your patient means to speak up for them for the patient’s best interest and it is important to do so because some patients are unable to

Question 5

Ways to provide ethical care

Answer 5

treat patients with respect, honoring their feelings, treat patient with dignity, care for patients with honesty, provide compassion

Question 6

Civility

Answer 6

treating others with respect, courtesy, politeness even if you disagree

Question 7

Statutory laws affecting nurses

Answer 7

nursing practice and license are subject to federal laws, so nurses/students are responsible for doing tasks competently
includes the nursing practice act

Question 8

Health insurance Portability and Accountability Act of 1966 (HIPAA)

Answer 8

provides for confidential maintenance of protected health info.
- includes privacy rule and security rule

Question 9

Health Information Technology for Economic and Clinical Health (HITECH)

Answer 9

adoption of EHR & notify patients when health information has been breached
- put in place the breach notification rule

Question 10

Nurse practice acts

Answer 10

each state has NPA that defines the scope of practice
ex: Oklahoma’s NPA covers LPN, RN, advanced-practice RNS, and authorized assistive personnel

Question 11

Boards of Nursing

Answer 11

• administer and enforce the NPA
• authority to license nurses, take disciplinary actions towards nurses who don’t follow NPA & regulate practice of nursing/education

Question 12

mandatory reporting laws (statutes)

Answer 12

• protect the public and track outbreaks of disease
• child abuse, elder abuse, abuse on disabled (physical, sexual, emotional/verbal)
• require nurses report certain communicable disease to CDC

Question 13

Five areas of tort laws that affect nurses

Answer 13

• malpractice, negligence, false imprisonment, assault, battery & sexual harassment

Question 14

Legal Docs: Patient Health Record & LVN’s responsibility

Answer 14

LVN responsibility to protect the patient information; no assumptions, accurate, in time manner

Question 15

Legal Docs: Informed Consent & Responsibility

Answer 15

voluntary agreement to proceed with procedure; if not it can be charged as assault & battery
LVN responsibility to make sure informed consent is obtained & inform health-care provider if they change their mind

Question 16

Legal Docs: Advanced Directives & Responsibility

Answer 16

written documents that state their medical decisions when they are unable to do so.
proxy directive: power of attorney
instructional: living will
LVN responsibility to ask patient whether they have a living will or advance directive - document

Question 17

Legal Docs: Incident Reports & Responsibility

Answer 17

unusual occurrence or accident
LVN responsibility to report what happened, who was involved, who witnessed it, & treatment
- also known as unusual occurrence reports or variance reports

Question 18

Professional Responsibilities

Answer 18

being accountable, securing professional liability insurance, est. professional boundaries, delegating tasks in nursing. achieving competence, following standards of care, continuing education

Question 19

5 Rights of Delegation est. by National Council of State Boards of Nursing

Answer 19

the right task, under the right circumstances, to the right person, with the right directions and communication, under the right supervision and evaluation

Question 20

Good Samaritan Law

Answer 20

protects nurses who volunteer to assist in an accident from legal liability

Question 21

What legal documents fo LPN/LVNs have responsibilities over?

Answer 21

patient’s health record, informed consent, advanced directives, and incident reports

Question 22

standards of care

Answer 22

statements of actions that are consistent with minimum safe professional conduct under specific guidelines

Question 23

Who are the people required to provide their signatures on the informed consent form?

Answer 23

the health-care provider, the patient or custodial parent or legal parents (stepparents cannot sign in most states) and a witness

Question 24

When is the only time that a medical treatment may be provided without written consent?

Answer 24

when there is a life-threatening emergency - law then allows for implied consent

Question 25

medication-related errors

Answer 25

administering meds by the wrong route, to wrong patient, wrong time, administering meds that should not have been given, or failing to administer meds at all

Question 26

treatment and care-related errors

Answer 26

failing to provide care, giving incorrect care, misinterpreting order for treatments, ignoring the need for care

Question 27

patient abuse-related errors

Answer 27

depriving patients to their rights, abusing patients physically, verbally, sexually, emotionally, or simply ignoring patient needs

Question 28

conduct-related errors

Answer 28

unprofessional behaviors with patients or patients’ families, diversion of patient meds, or inappropriate behavior in the workplace

Question 29

assessment-related errors

Answer 29

failing to do a complete assessment, thereby missing injuries or illness, failing to report assessment findings to the health-care provider for further treatment and care

Question 30

scope of practice-related errors

Answer 30

result of LVN/LPN acting outside their scope of practice and performing tasks that their are not educated to perform

Question 31

documentation-related errors

Answer 31

documenting on wrong chart, documenting opinions rather than facts=, and failing to document what occurred and the care that was given

Question 32

if informed consent is not obtained for a procedure or surgery, what can be brought in court?

Answer 32

a charge of assault and battery

Question 33

When should consent forms never be signed?

Answer 33

after the patient has received mind-altering medications or has consumed alcohol

Question 34

Centers for Disease Control & Prevention

Answer 34

the federal agency that supports health promotion and prevention of disease that also helps health-care professionals be prepared to respond to outbreaks of diseases and illnesses

Question 35

FOUR necessary qualities for ethical patient care:

Answer 35

• respect, dignity, honesty,, compassion

Question 36

What is the standard regarding documentation in patient’s record in a court of law and what does it mean?

Answer 36

“if it is not charted, it wasn’t done”
- nurse cannot prove the care they provided for patient if it wasn’t charted
- this is considered fraud if you documented something you didn’t do

Question 37

Which of the following nursing actions would be considered proactive prevention of lawsuits?

Answer 37

• meeting your patient’s needs
• treating your patient with dignity
• developing good nurse-patient rapport
• explaining procedures and ensuring the patient understands before performing the procedure

Question 38

Who owns the hospitalized patient’s medical record?

Answer 38

the hospital