Federal Statutes Impacting Nursing Practice

Question 1

Patient Protection and Affordable Care Act (ACA)

Answer 1

(1) consumer rights and protections,
(2) affordable health care coverage,
(3) increased access to care, and
(4) quality of care that meets the needs of
patients.

Question 2

Emergency Medical Treatment and Active Labor

Act (EMTALA)

Answer 2

prohibits the transfer of patients from private to public hospitals without appropriate screening and stabilization. prevent dumping. This act ensures an appropriate medical screening occurs. Staff must assess all patients who enter the hospital and
cannot discharge or transfer them until their conditions stabilize. Exceptions: if patient requests transfer or
discharge in writing after receiving information about the benefits and risks of the transfer or if a physician or nurse practitioner certifies that the benefits of transfer outweigh the risks.

e.g. pulmonary embolism

PATIENT MUST BE STABILISED BEFORE A TRANSFER IS APPROPRIATE

Question 3

Health Insurance Portability and Accountability

Act (HIPAA)

Answer 3

describe how personal health information may be used and how client can access info. provides rights to patients and protects employees. It includes standards regarding accountability in the health care setting. It establishes the basis for privacy and confidentiality concerns. Privacy is the right of patients to keep personal information from being disclosed.
Confidentiality protects private patient information once it is disclosed in health care settings.

CONFIDENCIALITY

• nurse should avoid discussing patients medical records in public health care setting with other medical professionals.
• nurse must protect any private information about the patient once it has been disclosed in health care setting.
• message boards in patients room should not should not reveal patients medical condition.

PRIVACY
- right of patient to keep personal information from being disclosed

Question 4

Health Information Technology Act (HITECH)

Answer 4

in response to new technology and social media. nurses must ensure that patient PHI (personal health info) is not inadvertently conveyed on social media and that protected data are not disclosed other than as permitted by patients.

Question 5

Americans With Disabilities Act (ADA)

Answer 5

civil rights statute that protects the rights of people with physical or mental disabilities. prohibits discrimination and ensures equal opportunities for people with disabilities.

DEAKS WITH EQUAL ACCESS FOR INDIVIDUALS

Question 6

Mental Health Parity and Addiction Equity Act (MHPAEA)

Answer 6

requires health insurance companies to
provide coverage for mental health and substance use disorder (SUD)
treatment, just as they do for medical coverage.
Suicidal patients should be admitted to mental health units for supervision

Question 7

Patient Self-Determination Act (PSDA)

Answer 7

requires health
care institutions to provide written information to patients concerning their rights to make decisions about their care, including the right to refuse treatment and to formulate an advance directive - An advance directive is a document developed by the patient that
instructs others to do tasks before, during, and after his or her death. At a minimum, an advance directive includes patient’s wishes if a respiratory or cardiac arrest occurs and a copy of the patient’s durable power of attorney for health care (DPAHC) - legal document that designates person that make health care decisions for individual that can’t make decisions on his or her own behalf.. When a patient is determined to be incompetent, a guardian is appointed to make decisions
regarding care the patient will or will not receive. No other person, including family members or providers, has the power to override the
guardian’s decisions. To do so, that person must return to court and explain why the guardian’s decision should not be honored.

Living wills - dying person makes wishes known can be changed at any time whilst competent.

DNR - do not resusitate order needs to be in the chart - if not in chart then CPR can be carried out.

ADDRESSES PATIENT RIGHT TO REFUSE TREATMENT

health care proxy, living wills and durable powers of attorney for health care all under this umbrella.

Question 8

Uniform Anatomical Gift Act (UAGA)

Answer 8

18 at least can have organ donation upon death unless patient parents sign if under 18.

Question 9

The Omnibus Budget Reconciliation Act (1987)

Answer 9

Physical or chemical restraints has led to death - must be last resort not first intervention nonadherent, aggressive, or
combative. Other alternatives must be tried first. Only used to ensure physical safety and only used on written order of health care provider.