exam i: ch6 - legal and ethical basis for practice Flashcards
what is the fundamental goal of psychiatric care
strike BALANCE between rights of patient and rights of society
branch of knowledge and philosophical beliefs about what is right or wrong in a society.
ethics
the study of specific ethical questions that arise in healthcare
bioethics
results when there is a conflict between two or more courses of action, each carrying favorable and unfavorable consequences.
ethical dilemma
what are the 5 basic principles of ethics
- beneficence
- autonomy
- justice
- fidelity
- veracity
the duty to promote good
beneficence
respecting the rights of others to make their own decisions
autonomy
distribute resources or care equally
justice
maintaining loyalty and commitment; doing no wrong to pt
fidelity
one’s duty to always communicate truthfully
veracity
law that de-institutionalized the mentally ill
Community Mental Health Act of 1963
law that improved access to tx and equality in terms of payment
Mental Health Parity Act of 2010
law that provided funding for the mentally ill
Affordable Care Act of 2010:
list some criteria that is considered nursing malpractice
- The RN fails to completely perform their duties and that failure harms the patient
- Practicing outside their scope of practice
- Abandoning the patient under the nurses care
- Medication and /or treatment errors
- Falsifying documents; pre-charting on pts
- Adding information after the fact without specifying it is a late entry
why is releasing information to a pt’s employer bad? (3 reasons)
breach of confidentiality
invasion of privacy
violation of HIPAA
t/f: discussing pt hx with other nursing staff to determine tx is a breach of privacy
false
occurrence that causes death or serious injury to a patient who is under the care of professionals
sentinel events
examples of sentinel events
- Suicide in a hospital
- Surgery on wrong site or instrument left in a surgical patient
- Overdosing with medication
- A rape or assault that occurs on hospital property
- Right to vote and send and receive mail
- Right to practice religious freedom
- Right to refuse treatment (including medications)
- Confidentiality (exception: duty to warn and elder and child abuse)
- Care provided with respect, dignity and without discrimination
- Care in the least restrictive setting
Receive an education for school age kids
civil rights of mentally ill pts (same with every other citizen)
- Right to treatment and right to refuse treatment
- Right to informed consent-risks and benefits of treatment
- Right to the least restrictive measures
- Right to confidentiality
basic rights of mentally ill pts
- Right to withhold consent
- Right to withdraw consent any time
- Must be honored, whether verbal or written
- Right to refuse medication or treatments
- The right to refuse can be overridden if the patient becomes a danger to self or others and it must be clearly documented why
medication and tx rights of mentally ill pts
admission sought by patient/guardian thru written application
voluntary admission
admission of individual without consent; a judicial or administrative/agency determination
involuntary admission
what are the 3 criteria for involuntary hospitalization
- mentally ill
- danger to self or others
- unable to provide for basic necessities - food, clothing, shelter
release that needs outpatient tx
conditional release
release that has no requirements
unconditional release
type of release where pts need to sign 5 day release form in which pts must be allowed to leave after 5 days
released AMA
type of admission where person is demented/confused
- usually lasts 24-96 hrs for observation, dx, tx
- court hearing NEEDED before next discharge
emergency/temporary admission
confining a person alone in a room or area, never PRN
seclusion
how long can an adult or adolescent be in seclusion (how freq documentation)
adult = 4hrs
adolescent = 2hrs
q15min documentation
how long after emergency restraints do you have to get a written/verbal order?
1 hour
protects pt right to privacy and confidentiality
HIPAA
what is the exception to HIPAA
duty to warn and child/elder abuse speculation
the ethical responsibility of healthcare professionals that prohibits the disclosure of privileged information without the patient’s consent.
confidentiality
when a pt reveals specific intent + specific person to injure/kill
duty to warn
what did the tarasoff case result to?
duty to protect is added as exception to confidentiality, goes with duty to warn
3 aspects associated with duty to warn
- Assessing and predicting a patient’s danger of violence toward another
- Identifying specific individual(s) being threatened
- Identifying appropriate actions to protect victim(s)
name that liability issue:
Fail to take action on suicide risks
Fail to use restraints properly/monitor pt
Miscommunication/med errors
Violation of boundaries
Misdx
patient safety
name that liability issue:
Voluntary acts to bring physical/mental consequence
Recklessness
No pt consent
intentional torts
name that liability issue:
Carelessness
Foreseeability of harm
negligence/malpractice
name that liability issue:
Threat to use force
Tx without consent
Offensive touching
assault/battery
name that liability issue:
Intent to confine to specific area
Improper use of seclusion/restraints
false imprisonment
name that liability issue:
Notifying parents of 21yr old that she is being treated on psychiatric unit
invasion of privacy
name that liability issue:
telling friends and instagram followers that patient is local mayor and bad patient
defamation of character/slander/libel
name that liability issue:
Unintended acts against another person that produces injury/harm
unintentional torts
name that liability issue:
Leaving controlled substance medications in patient room
negligience
name that liability issue:
Failure to follow up with patient teaching after finding orthostatic hypotension
malpractice
when can you override the right to refuse medication (6 steps)
- after court hearing
- pt has serious mental illness
- ability to fxn deteriorating/threatening behavior
- tx > harm
- person cannot make reasoned decisions
- less restrictive services did not work
