Ethics, Quality, Safety, and Legal Issues in Nursing: Week 2

Question 1

Advocacy

Answer 1

Process whereby a nurse objectively provides patients with the information they need to make decisions and supports the patients in whatever decisions they make.

Question 2

Autonomy

Answer 2

Ability or tendency to function independently

Question 3

Beneficence

Answer 3

Doing good or actively promoting doing good; one of the four principles of the ethical theory of deontology

Question 4

Code of ethics

Answer 4

Formal statement that delineates a profession’s guidelines for ethical behavior. A code of ethics sets standards or expectations for the professional to achieve.

Question 5

Confidentiality

Answer 5

Act of keeping information private or secret; in health care the nurse shares information about a patient only with other nurses or health care providers who need to know private information about a patient to provide care for him or her; information can only be shared with the patient’s consent.

Question 6

Fidelity

Answer 6

Agreement to keep a promise.

Question 7

Justice

Answer 7

Ethical standard of fairness.

Question 8

Non-maleficence

Answer 8

Fundamental ethical agreement to do no harm. Closely related to the ethical standard of beneficence

Question 9

Value

Answer 9

Personal belief about the worth of a given idea or behavior

Question 10

QSEN

Answer 10

The Quality and Safety in the Education of Nurses (QSEN) initiative is the commitment of nursing to the competencies outlined in the Institute of Medicine report related to nursing education. QSEN encompasses six competencies: patient-centered care, teamwork, collaboration, evidence-based practice, quality improvement, and safety.

Question 11

Quality Improvement

Answer 11

Monitoring and evaluation of processes and outcomes in health care or any other business to identify opportunities for improvement.

Question 12

National Patient Safety Goals

Answer 12

7 goals to improve patient safety. Identify patients correctly, improve staff communication, use medicines safely, use alarms safely, prevent infection, identify patient safety risks, prevent mistakes in surgery.

Question 13

The Joint Commission

Answer 13

National non-profit group that is the driver of quality improvement and patient safety in health care. Often associated with accreditation and setting national patient safety goals.

Question 14

Fall Prevention Techniques

Answer 14

Call light within reach, fall alert signs/bracelets, hourly rounding, orientation and cognitive assessments, bed low and locked position, fall risk assessments

Question 15

CAUTI

Answer 15

Catheter associated urinary tract infection: can be prevented with nurse-driven protocols focused on early removal [example of quality improvement]

Question 16

CLABSI

Answer 16

Central line associated blood stream infection: central line bundles, set of guidelines that instruct nurses and providers how to care for patients with these types of lines

Question 17

Seizure Precautions

Answer 17

Rescue equipment at bedside (oxygen, oral airway, suction equipment)
Pad side rails
IV access on patient
Bed low and locked
Remove items from room that are not necessary (Extra chairs, extra tables, etc)
Teaching caregivers/families do not restrain client during a seizure, protect head, remove nearby furniture

Question 18

RACE

Answer 18

Rescue: and protect patients in close proximity
Alarm: activate alarm systems and report fire
Contain: and confine, close doors, windows, turn off oxygen sources, ventilate clients on ventilators with bag/mask valve

Question 19

PASS

Answer 19

Pull the pine
Aim at the base of the fire
Squeeze the handle
Sweep the extinguisher from side to side, covering area of the fire

Question 20

Types of Physical Restraints

Answer 20

Mittens, soft wrist restraints [sometimes called 2-point non-violent restraints], ankle restraints, belt restraints, 4-point violent restraints

Question 21

Timing of Restraint Assessments

Answer 21

Every hour safety check
Toileting, repositioning, nutrition every 2 hours
Regular reassessment of need of restraints and order needed by HCP

Question 22

5 Rights of Delegation

Answer 22

Right task 
Right circumstance
Right person 
Right direction/communication 
Right Supervision

Question 23

Actions NOT Delegated

Answer 23

Assessment
Teaching
Evaluation

Question 24

Durable Power of Attorney for Health Care

Answer 24

Specific person or people who will manage health care decisions if a person becomes incapable of doing so.
Can be in a KY living will, or other type or advanced directive [or separate power of attorney document]

Question 25

Informed Consent

Answer 25

Process of obtaining permission from a patient to perform a specific test or procedure after describing all risks, side effects, and benefits.

Question 26

Malpractice

Answer 26

Injurious or unprofessional actions that harm another.

Question 27

Neglect

Answer 27

Pattern of misconduct by a person with a duty of care to provide services that maintain the physical and/or mental health of a child or vulnerable adult

Question 28

Negligence

Answer 28

Careless act of omission or commission that results in injury to another.

Question 29

Nurse Practice Acts

Answer 29

Civil state laws that define nursing and the standards you must meet within individual states. Distinguish nursing from other health professions

Question 30

Scope of Nursing Practice

Answer 30

Defines nursing and reflects the values of the nursing profession. Usually associated with the skills/abilities the profession can do in a certain state. Can be different in various states and institutions.

Question 31

HIPAA

Answer 31

Health Insurance Portability and Accountability Act– provides rights to patients and protect employees. Established a patient’s right to consent to the use and disclosure of protecting health information, to inspect and copy one’s medical record, and to amend mistaken or incomplete information; it limits access to the medical record.

Question 32

EMTALA

Answer 32

Emergency medical treatment and active labor act: prohibits the transfer of patients from private to public hospitals without appropriate screening and stabilization. Prevents ‘patient dumping’– ensures that when patients come to the emergency department or hospital, appropriate medical screening occurs.
Staff must assess ALL patients who enter the hospitals and cannot discharge/transfer until stable.

Question 33

Advanced Directive/Living Will

Answer 33

Instruments by which a dying person makes wishes known

Often where the durable power of attorney, or surrogate decision maker is listed

Question 34

Do Not Resuscitate [DNR]

Answer 34

A document or health care order that allows the patient to state the patient wants to refuse medical treatment; if a patient has this as a document, the order must be placed in the computer. These are reversible at ANY time if the patient changes their minds. The order should be reviewed periodically.

Question 35

Affordable Care Act Components

Answer 35

Consumer rights and protections
Affordable health care coverage
Increased access to care
Quality of care that meets the needs of patients

Patients bill of rights–> protection for people with pre-existing conditions

Question 36

Personal Health Information [PHI] Components

Answer 36

Name, address, date of birth, social security number, photograph, fingerprints, medical record number, telephone number, fax number, driver’s license number, Email address, website URL, IP address, Admit/Discharge dates