Ethics, Quality, Safety, and Legal Issues in Nursing: Week 2 Flashcards
Advocacy
Process whereby a nurse objectively provides patients with the information they need to make decisions and supports the patients in whatever decisions they make.
Autonomy
Ability or tendency to function independently
Beneficence
Doing good or actively promoting doing good; one of the four principles of the ethical theory of deontology
Code of ethics
Formal statement that delineates a profession’s guidelines for ethical behavior. A code of ethics sets standards or expectations for the professional to achieve.
Confidentiality
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.
Fidelity
Agreement to keep a promise.
Justice
Ethical standard of fairness.
Non-maleficence
Fundamental ethical agreement to do no harm. Closely related to the ethical standard of beneficence
Value
Personal belief about the worth of a given idea or behavior
QSEN
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.
Quality Improvement
Monitoring and evaluation of processes and outcomes in health care or any other business to identify opportunities for improvement.
National Patient Safety Goals
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.
The Joint Commission
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.
Fall Prevention Techniques
Call light within reach, fall alert signs/bracelets, hourly rounding, orientation and cognitive assessments, bed low and locked position, fall risk assessments
CAUTI
Catheter associated urinary tract infection: can be prevented with nurse-driven protocols focused on early removal [example of quality improvement]
CLABSI
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
Seizure Precautions
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
RACE
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
PASS
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
Types of Physical Restraints
Mittens, soft wrist restraints [sometimes called 2-point non-violent restraints], ankle restraints, belt restraints, 4-point violent restraints
Timing of Restraint Assessments
Every hour safety check
Toileting, repositioning, nutrition every 2 hours
Regular reassessment of need of restraints and order needed by HCP
5 Rights of Delegation
Right task Right circumstance Right person Right direction/communication Right Supervision
Actions NOT Delegated
Assessment
Teaching
Evaluation
Durable Power of Attorney for Health Care
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]
Informed Consent
Process of obtaining permission from a patient to perform a specific test or procedure after describing all risks, side effects, and benefits.
Malpractice
Injurious or unprofessional actions that harm another.
Neglect
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
Negligence
Careless act of omission or commission that results in injury to another.
Nurse Practice Acts
Civil state laws that define nursing and the standards you must meet within individual states. Distinguish nursing from other health professions
Scope of Nursing Practice
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.
HIPAA
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.
EMTALA
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.
Advanced Directive/Living Will
Instruments by which a dying person makes wishes known
Often where the durable power of attorney, or surrogate decision maker is listed
Do Not Resuscitate [DNR]
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.
Affordable Care Act Components
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
Personal Health Information [PHI] Components
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
