Chapter 3: Legal and Ethical issues

Question 1

Ethics

Answer 1

The knowledge of right and wrong

Has a sense of duty and responsibility toward others

Tells us what we should do

Question 2

Laws

Answer 2

Based on ethics

Tells us what we must do

Question 3

Code of ethics

Answer 3

• 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

Question 4

Omnibus Budget Reconciliation Act (OBRA)

Answer 4

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

Question 5

Minimum Data Set (MDS)

Answer 5

A detailed form with guidelines for assessing residents

Must be completed for every resident within 14 days of admission and again each year

Question 6

Residents rights

Answer 6

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

Question 7

National elder abuse incidence study

Answer 7

1998

Estimated more than a million elders suffered abuse or neglect in a single year, many in LTCF

Question 8

The National Citizens Coalition for Nursing Home Reform (NCCNHR)1

Answer 8

A national non profit organizational founded in 1975 to protect the rights, safety, and dignity of long term care residents.

Question 9

Neglect

Answer 9

Harming a person physically, mentally or emotionally by failing to provide needed care.

Active neglect- purposely
Passive neglect - unintentionally

Question 10

Negligence

Answer 10

Actions or the failure to act or provide the proper care for a resident that result in unintended injury

Question 11

Malpractice

Answer 11

Occurs when a person is injured due to professional misconduct through negligence, carelessness or lack of skill

Question 12

Abuse

Answer 12

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

Question 13

Mandated reporters

Answer 13

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

Question 14

The Nursing Aide Training Competency Evaluation Program (NATCEP)

Answer 14

Makes the rules about training and testing NAs

If abuse has occurred, a report must be made to NATCEP

Question 15

Ombudsman

Answer 15

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

Question 16

The Older Americans Act

Answer 16

OAA

A federal law that requires all states to have an ombudsman program.

Question 17

Health Insurance Portability and Accountability Act

Answer 17

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

Question 18

Protected Health Information

Answer 18

PHI

Patients name, address, telephone #, SS#, email address and medical record number

Question 19

The Patient Self Determination Act (PSDA)

Answer 19

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

Question 20

Advance Directive

Answer 20

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

Question 21

Living will

Answer 21

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.

Question 22

Durable power of attorney for health care

Answer 22

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.

Question 23

Do not resuscitate (DNR)

Answer 23

Tool that helps medical providers honor wishes about care

Dont perform CPR.