Chapter 3: Legal and Ethical issues Flashcards
Ethics
The knowledge of right and wrong
Has a sense of duty and responsibility toward others
Tells us what we should do
Laws
Based on ethics
Tells us what we must do
Code of ethics
- be honest at all times
- protect residents privacy
- keep staff info confidential
- report abuse or suspected abuse of residents
- follow the care plan and report mistakes
- do not perform any tasks outside your scope of practice
- report all resident observations and incidents to the nurse
- document accurately and promptly
- follow rules on safety and infection control
- do not accept gift or tips
- do not get personally or sexually involved with residents or their family members
Omnibus Budget Reconciliation Act (OBRA)
Due to reports of poor care and abuse in LTCF, the OBRA was passed in 1987
- set minimum standards for NA training : must complete at least 75 hrs of training and pass an evaluation before they can be employed
- must attend regular in service education to keep their skills updated
- requires state to keep a current list of NA’s in a state registry
- sets guidelines for minimum staff requirements : specifies minimum services that LTCF’s must provide
- requires complete assessment on every resident
Minimum Data Set (MDS)
A detailed form with guidelines for assessing residents
Must be completed for every resident within 14 days of admission and again each year
Residents rights
How residents must be treated while living in a facility.
- quality of life
- services and activities to maintain a high level of wellness
- the right to be fully informed about rights and services
- the right to participate in their own care
- the right to make independent choices
- the right to privacy and confidentiality
- the right to dignity, respect, and freedom
- the right to security of possessions
- rights during transfers and discharges
- the right to complain
- the right to visits
- rights with regard to social services
National elder abuse incidence study
1998
Estimated more than a million elders suffered abuse or neglect in a single year, many in LTCF
The National Citizens Coalition for Nursing Home Reform (NCCNHR)1
A national non profit organizational founded in 1975 to protect the rights, safety, and dignity of long term care residents.
Neglect
Harming a person physically, mentally or emotionally by failing to provide needed care.
Active neglect- purposely
Passive neglect - unintentionally
Negligence
Actions or the failure to act or provide the proper care for a resident that result in unintended injury
Malpractice
Occurs when a person is injured due to professional misconduct through negligence, carelessness or lack of skill
Abuse
Purposely causing physical, mental or emotional pain or injury to somene.
- physical abuse: causing harm to a persons body
- psychological abuse: emotionally harming a person
- verbal abuse
- assault: threatening to touch a person w/o permission
- battery: a person is actually touched w/o permission
- sexual abuse
- financial abuse:stealing or improperly using the money, property or other assets of another
- domestic violence: abuse by spouses, intimate partners or family members.
- workplace violence: abuse of staff by residents or other staff members
- involuntary seclusion: separating a person from others against the persons will
- sexual harassment
- substance abuse
Mandated reporters
Ppl who are legally required to report suspected or observed abuse or neglect b/c they have regular contact w/ vulnerable populations such as the elderly in healthcare facilities.
NA’s are mandated reporters in some states
The Nursing Aide Training Competency Evaluation Program (NATCEP)
Makes the rules about training and testing NAs
If abuse has occurred, a report must be made to NATCEP
Ombudsman
Assigned by law as the legal advocate for residents
They help resolve conflicts and settle disputes concerning residents health safety welfare and rights
- advocates for residents rights and quality care
- educates consumers and care providers
- investigates and resolves complaints
- appears in court
- works with others to resolve complaints
- gives info to public
The Older Americans Act
OAA
A federal law that requires all states to have an ombudsman program.
Health Insurance Portability and Accountability Act
HIPAA 1996
Helps keep health info private and secure
Can be fined or imprisoned if they break rules that protect patient privacy
Fines ranging from $100 to $250,000
Prison sentences of up to 10 yrs
Protected Health Information
PHI
Patients name, address, telephone #, SS#, email address and medical record number
The Patient Self Determination Act (PSDA)
Passed in 1990 as an amendment to OBRA
Requires all healthcare agencies receiving Medicare and Medicaid money to give adults during admission or enrollment, info about their rights relating to advance directives
- the right to participate in and direct healthcare decisions
- the right to accept or refuse treatment
- the right to prepare an advance directive
- info on the facility’s policies that govern these rights
Advance Directive
Legal documents that allow ppl to choose what medical care they wish to have if they cannot make those decisions themselves
You can also name someone to make decisions
Ex: living wills and durable power of attorney for healthcare
Living will
States the medical care a person wants or does not want in case he or she becomes unable to make those decisions
Aka directive to physicians, healthcare declaration, or medical directive
Not same as a will.
Durable power of attorney for health care
A signed, dated and witnessed paper that appoints someone else to make the medical decisions for a person in the event he or she becomes unable to do so.
Do not resuscitate (DNR)
Tool that helps medical providers honor wishes about care
Dont perform CPR.
