Exam 2 legal Flashcards
leagl issu
What is the most important legislation for nursing?
Texas NPA (Nursing Practice Act)
Practice boundries are defeined
leagl issue/Nursys?
Mnitors nurses’ licensure status in all states
✓ the only national database for verification of nurse licensure for RNs, LPN/VNs and APRNs licensed
a) What is public law?
b )Constitutional law?
a) defines citizen’s relationship with government
b) highest lwa, the rights of the people.
Freedom of religion, right to die, right to abortion
Legislative law?
enact/make laws that govern us (codes, statues)
NPA
The nurse can violate sections of the NPA but the BON will CHOOSE (has the power) to decide what sanctions to assign the nurse!
Administrative law?
Protect citizen’s rights at federal & state
Authority to act by the legislative laws
how to enforce(apply) legislative laws
Criminal law
intentionally harm others
Relationship with goverment
Administrative law
FEDERAL (national) EX
Civil Rights Act 1964 (federal)
No discrimination in the workplace
HIPAA
Protect medical information
(we don’t get sued or go jail to vaiolated HIPPA)
OSHA
Establish safe workplace
protect employees from infection(PPE) & workplace violence, immunization, “sharps” container,
Social Security, Medicare
Administrative law
state level
BON enforces NPA
Texas Nurse Practice Act
a) §217.11
b) §217.12
a) The standard practice establish a minimum acceptable level of nursing practice
Failure to meet theses standards may result in action against the nurse’s licence even if no actual pt injury result
b) Listed unprofessional conduct
a) Civil law, what is it?
b) Tort law
a) how individuals relate to each other in everyday matters(between people)
A wrongful act committed against another person, organization, or their property, that causes harm
You have a personal, direct liability
Joint liability
liability=responsibility
Institute responsible/accountable for maintaining safe, quality environment
Hiring the “best” is essential
Pt will sue not just you, but hospital too
What are are intentional torts?
Assault, battery, false imprisonment, invasion of privacy, defamation, and slander
Intentional tort
a) assault
b) battery
1: jsut threat to touch another
threaten to give a treatment against patient’s will
Ex: threaten to give medication if they don’t calm down
b) actual touching another person without their consent
Force a treatment against patient’s will
Ex: restraining them without an order
Intentional tort
False imprisonment
Person incorrectly led to believe they can’t leave a place
Restrain a patient who is of sound mind and not in danger of hurting self or others
a) Quasi intentional tort?
b) Defamation?
a) Mix of unintentional and intentional
b) false communication or publication
* libel (L= letter, written word)
✓ documenting something in the EMR that is not true/social media
* slander (S= speech)
✓ stating something during handoff report that is not true
Invasion of right of privacy
What are expectation?
HIPPA
Exceptions! pt abuse, specific infectious diseases, blood alcohol level
Negligence?
Failure to provide the care
Didn’t do something what someone should do
(but not intentional)
General term for carelessness
Malpractice?
Professional negligence
wrongful conduct (misbehavior)
Standard of practice
basis of quality, competent healthcare
protect the public
➢ It helps determine what a reasonable, prudent nurse should do
Things that impact our standards of practice:
a) Internal Standards set by
b) external Standards set by
a)Institutional policy & procedure (will be different between hospitals)
b) SBO
Professional organizations
Federal Organizations/Guidelines
Violating standards of care
Example 5
NOT DOCUMENTING CARE
Charting an action was done but it was not done
Crushing medications that cannot be crushed
Giving IVP, IVPB medications too rapidly
Not setting alarm limits appropriately
STEP 1 BROKEN DOWN
a)Duty of care
b) Breach of duty
a) Standard care must be established
b) Fell below standard care
a) Omission?
b) Commission?
a) nothing was done when something should have been done (negligence)
b) Acting in a way that causes injury to the patient (always nonintentional) (malpractice)
STEP 3 BROKEN DOWN
Foreseeability
➢ Nurse must had knowledge or availability of information
Certain events may be resonably expected to cause specific results
STEP 4 BROKEN DOWN
Causation
breach of duty caused injury (I did not do the duty of care I should have so it caused injury to my patient)
How to avoid malpractice claims?
Always put patient rights and welfare first
✓ Be kind, caring
Practice within scope of Nurse Practice Act
Use EBP
Be aware of relevant law
Practice in areas of individual competence
Upgrade skills
Good Samartian Law
A person who in good faith administers emergency care at the scene of an emergency or in a hospital is not liable in civil damages for an act performed during the emergency unless the act is willfully or wantonly negligent.
DON’T EXCEED YOUR SCOPE OF PRACTICE
Law vary with states so stay informed
Informed consent
Consent is giving who has legal capacity
who can get it and who not?
Competent adult
Legal guardian or person with durable power of attorney
Emancipated or married minor
Parent/state/legal guardian of a child less than 18 years old, court order
Informed consent
a) Voluntary action
b) If pa refuses care?
a) It has to be voluntary consent not forced consent
b) We must understand the pt will (Dr. needs to explain this as well)
Informed consent
Person giving consent must be given sufficient information means?
FULL DISCLOSURE
Risks involved+ side effect
Expected or desired outcomes, benefits
Options
Alternative therapies, including no therapy at all
Name of person performing treatment/procedure (so you don’t explain this!)
Patient can withdraw consent
Informed concent
Nurses role
a) Ensure provider gave necessary information means?
b) Ensure client understood information means?
c) if pt has more queststion, what to do?
a) we are Not responsible for explaining the procedure
b) patient advocate
reinforcing information originally given by provider
do not give new information
c) Notifying provider
Implied concent
Treatment is immediately needed & in patient’s best interest.
Pt unable to sign the consent
Validated by 2 provider
Patient Self Determination Act
Advance Directive
a) Includes?
b) If pt has an AD?
c) If pt revokes AD?
a) living will, durable power of attorney, DNR
b) ask for a copy of the document. Post to pt records
c) document pt decision and notify MD
Nurse should not be a witness to signing AD
Living Will
Legal document pt’s wishes if pt becomes unable to express desires when facing end of life issues
✓ 2 witnesses required
Medical Power of Attorney
a) Durable Power of Attorney
Proxy(agent) makes health care decisions for client unable to make decisions
Proxy knows client and their wishes
Advance directive
Nursing role
Provide written information
Document client’s AD status
Ensure AD current, reflect client’s current decision
Recognize client’s choice takes priority
Inform health care team of client’s AD
Incident report
a) unexpected and unusual happen to who?
b) this can not be subpoenaed as evidence, why?
c) example?
a) client, employee, volunteer, visitor
b) Confidential information
c) ✓Med errors
✓ Procedure/treatment errors
✓ Equipment related injuries
✓ Needle stick injuries
✓ Client falls/injuries
✓ Loss of property
Nurse role in reporting incidets
- 1st Assess for injuries
- Institute immediate care to decrease further injury
- Notify provider
- Carry out provider orders
- Complete incident repor
incident report
a) Complete within?
b) Can share with pt?
c) Document in EMR?
d) What this use for?
a) 24 hours of event
b) NO! Confidential
c) NO!
d) data useful to performance improvement
Incident report
What include?
Pt’s name, date/time/location of event
Factual description of event & injuries incurred
Name of witnesses & client comments regarding incident
Corrective action taken, provider notified
Name, dose of medication or equipment involved in event
Patient Bill of Rights
High quality hospital care
Clean, safe environment
Professional involvement, advocacy in care
Protection of privacy
Help when leaving hospital
Help with billing claims
