exam i: ch6 - legal and ethical basis for practice Flashcards

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1
Q

what is the fundamental goal of psychiatric care

A

strike BALANCE between rights of patient and rights of society

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2
Q

branch of knowledge and philosophical beliefs about what is right or wrong in a society.

A

ethics

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3
Q

the study of specific ethical questions that arise in healthcare

A

bioethics

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4
Q

results when there is a conflict between two or more courses of action, each carrying favorable and unfavorable consequences.

A

ethical dilemma

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5
Q

what are the 5 basic principles of ethics

A
  • beneficence
  • autonomy
  • justice
  • fidelity
  • veracity
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6
Q

the duty to promote good

A

beneficence

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7
Q

respecting the rights of others to make their own decisions

A

autonomy

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8
Q

distribute resources or care equally

A

justice

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9
Q

maintaining loyalty and commitment; doing no wrong to pt

A

fidelity

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10
Q

one’s duty to always communicate truthfully

A

veracity

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11
Q

law that de-institutionalized the mentally ill

A

Community Mental Health Act of 1963

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12
Q

law that improved access to tx and equality in terms of payment

A

Mental Health Parity Act of 2010

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13
Q

law that provided funding for the mentally ill

A

Affordable Care Act of 2010:

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14
Q

list some criteria that is considered nursing malpractice

A
  • 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
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15
Q

why is releasing information to a pt’s employer bad? (3 reasons)

A

breach of confidentiality
invasion of privacy
violation of HIPAA

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16
Q

t/f: discussing pt hx with other nursing staff to determine tx is a breach of privacy

A

false

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17
Q

occurrence that causes death or serious injury to a patient who is under the care of professionals

A

sentinel events

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18
Q

examples of sentinel events

A
  • 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
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19
Q
  • 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
A

civil rights of mentally ill pts (same with every other citizen)

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20
Q
  • 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
A

basic rights of mentally ill pts

21
Q
  • 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
A

medication and tx rights of mentally ill pts

22
Q

admission sought by patient/guardian thru written application

A

voluntary admission

23
Q

admission of individual without consent; a judicial or administrative/agency determination

A

involuntary admission

24
Q

what are the 3 criteria for involuntary hospitalization

A
  • mentally ill
  • danger to self or others
  • unable to provide for basic necessities - food, clothing, shelter
25
Q

release that needs outpatient tx

A

conditional release

26
Q

release that has no requirements

A

unconditional release

27
Q

type of release where pts need to sign 5 day release form in which pts must be allowed to leave after 5 days

A

released AMA

28
Q

type of admission where person is demented/confused
- usually lasts 24-96 hrs for observation, dx, tx
- court hearing NEEDED before next discharge

A

emergency/temporary admission

29
Q

confining a person alone in a room or area, never PRN

A

seclusion

30
Q

how long can an adult or adolescent be in seclusion (how freq documentation)

A

adult = 4hrs
adolescent = 2hrs
q15min documentation

31
Q

how long after emergency restraints do you have to get a written/verbal order?

A

1 hour

32
Q

protects pt right to privacy and confidentiality

A

HIPAA

33
Q

what is the exception to HIPAA

A

duty to warn and child/elder abuse speculation

34
Q

the ethical responsibility of healthcare professionals that prohibits the disclosure of privileged information without the patient’s consent.

A

confidentiality

35
Q

when a pt reveals specific intent + specific person to injure/kill

A

duty to warn

36
Q

what did the tarasoff case result to?

A

duty to protect is added as exception to confidentiality, goes with duty to warn

37
Q

3 aspects associated with duty to warn

A
  • Assessing and predicting a patient’s danger of violence toward another
  • Identifying specific individual(s) being threatened
  • Identifying appropriate actions to protect victim(s)
38
Q

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

A

patient safety

39
Q

name that liability issue:
Voluntary acts to bring physical/mental consequence
Recklessness
No pt consent

A

intentional torts

40
Q

name that liability issue:
Carelessness
Foreseeability of harm

A

negligence/malpractice

41
Q

name that liability issue:
Threat to use force
Tx without consent
Offensive touching

A

assault/battery

42
Q

name that liability issue:
Intent to confine to specific area
Improper use of seclusion/restraints

A

false imprisonment

43
Q

name that liability issue:
Notifying parents of 21yr old that she is being treated on psychiatric unit

A

invasion of privacy

44
Q

name that liability issue:
telling friends and instagram followers that patient is local mayor and bad patient

A

defamation of character/slander/libel

45
Q

name that liability issue:
Unintended acts against another person that produces injury/harm

A

unintentional torts

46
Q

name that liability issue:
Leaving controlled substance medications in patient room

A

negligience

47
Q

name that liability issue:
Failure to follow up with patient teaching after finding orthostatic hypotension

A

malpractice

48
Q

when can you override the right to refuse medication (6 steps)

A
  1. after court hearing
  2. pt has serious mental illness
  3. ability to fxn deteriorating/threatening behavior
  4. tx > harm
  5. person cannot make reasoned decisions
  6. less restrictive services did not work