fundamentals- chapter 3 Flashcards
professional accountability
- a nurse’s responsibility to meet health care needs of a patient in a safe and caring way
- students must apply classroom learning and theory in a clinical setting
- commitment to stay current and knowledgeable
advance directive
- written statement expressing the patient’s wishes regarding future consent for or refusal of treatment if the patient is incapable of participating in decision making
- durable power of attorney
- gives legal power to a health care agent
- person chosen by the patient to make decisions on their behalf
- can be changed at any time
- most current form supersedes any prior ones
- may be called a “living will”
assault
- the threat to harm another
- the threat to touch another without that person’s permission
- the person being threatened must believe that the other person has the ability to carry out the threat
battery
- the actual physical contact that is carried out against another’s will
- performing a procedure without consent
competent
mentally and emotionally capable to understand and act (make choices); able to appreciate consequences of actions
confidential
kept private
consent
- legal documentation that records the patient’s permission to perform a treatment or surgery, or to give information to insurance companies or other heath care providers
- legal representative (medical power of attorney/next of kin) must consent if patient is impaired/ mentally unfit
- no abbreviations allowed on consent forms
- if no one is available to give consent in a life threatening situation, two doctors of the relevant specialty must sign saying that a procedure is necessary to save the patient’s life
defamation
- one person makes remarks about another person that are untrue, and the remarks damage that other person’s reputation
- slander (verbal) and libel (written)
delegation
- assignment of duties to another person
- LPNs may supervise CNAs, technicians, or other LPNs
- delegating nurse’s duty is to supervise and evaluate care that a licensed or unlicensed person provides (some states recognize delegation to an unlicensed person as “assignment”)
discrimination
- making a decision or treating a person based on a class or group to which he belongs, such as
do not resuscitate (DNR) orders
- may also be called Allow Natural Death (AND) orders
- patient has indicated decision to be allowed to die if their breathing or heart stops
- no CPR or assisted breathing will be started
euthanasia
the act of ending another person’s life, with or without their consent, to end potential suffering. this is not legal in any US state
false imprisonment
- preventing a person from leaving, or restricting movements in the facility
- when involuntary admission is made against a patient’s wishes
- patients may be detained for a short time without consent if it is to protect himself or others from harm
health care agent
- surrogate decision maker
- chosen by the patient to make decisions on their behalf
incident report
- includes facts about incident and who was involved or witnessed
- used by risk management
- generally not filed as a part of the patient’s medical record
invasion of privacy
- a violation of the confidential and privileged nature of a professional relationship
- unauthorized persons learn of the patient’s history, condition, or treatment from the professional caregiver
- leaves patients in a position that might cause loss of dignity or embarrassment
laws
rules of conduct that are established by our government
- Constitution and Bill of Rights
- laws made by elected officials
- regulations made by agencies created by elected officials
liability
responsibility
libel
written defamation
malpractice
- negligence by a professional person
- person does not act according to the professional standards of care as a reasonable and prudent professional would
- a reasonable and prudent person in nursing is a similarly educated, licensed, and experienced nurse
negligence
- failure to meet the standard of care
- failure to do something a reasonably prudent person would do or not do
nondisclosure agreement
- NDA
- gives an employer legal recourse if it can prove an employee broke confidentiality
nurse licensure compacts
certain participating states allow nurses to practice in any state belonging to the compact
nurse practice acts
- define the scope of nursing practice
- regulate the profession by a state’s board of nursing
- include the definition of nursing for the RN and LPN and may include definitions for advance practice nurses
- differ by state
Occupational Safety and Health (OSH) Act
- passed in 1970 to improve the work environment area’s that affect worker health and safety
Occupational Safety and Health Administration (OSHA)
- regulations on handling of infectious/toxic materials, radiation safeguards, and electrical equipment
- requires orientation and education on safety hazards
- requires facilities to keep a list of hazardous materials and MSDS
patient advocate
a person who speaks for and protects the rights of a patient
privilege
permission to da what is usually not permitted in other circumstances
protective devices
- highly regulated
- may be physical (restraints) or chemical (drugs)
- try to use less restrictive techniques before resorting to protective devices
- physician order needed (must consult with supervisor in an emergency situation)
- must follow facility policy for for providing toileting, hydration, and mobility
- the inappropriate use of devices that limit a person’s mobility can result in charges of false imprisonment
prudent
sensible and careful
Quality and Safety Education for Nurses (QSEN) project
reciprocity
recognition of one state’s nursing license by another state
release
- legal form to excuse one party from liability
- common release is a Leave Against Medical Advice (AMA)
- may also refer to forms used to authorize an agency to send confidential health care information to another agency, school, or insurance company
sentinel event
an unexpected patient care event that results in death or serious injury (or risk of such) to the patient
- most frequent cause is lack of communication among caregivers
sexual harassment
- unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature
- illegal when used as a condition of employment or promotion or when it interferes with job performance
- must let offender know actions are not wanted/warranted
- needs to be documented (paper trail)
slander
verbal defamation
standards of care
- provide a way of judging the quality and effectiveness of patient care
- in legal cases, determine whether a nurse acted correctly
statutes
laws; either civil or criminal
tort
violation of a civil law; a wrong against an individual
whistle-blowing
reporting illegal or unethical actions
judicial law
results when a law or court decision is challenged in the courts and the judge affirms or reverses the decision. “establishing a precedent”
administrative law
comes from agencies created by the legislature
constitutional law
provides for basic rights and creates legislative bodies
civil law
guarantees individual rights
acuity
level of care
licensure
- eligibility determined by a state’s board of nursing
- each state sends a representative to the National Council of the state’s Board of Nursing, which develops the National Council Licensure Examination (NCLEX)
- passing score on the NCLEX-PN is accepted in all states as a requirement for licensure
student nurses
- held to the same standards as a licensed nurse
- legally responsible for their own actions or inaction
- responsibility to consult with the instructor when unsure in a situation, or when patient’s condition is changing rapidly
- need to know their state’s nurse practice act
- must not exceed the scope of practice
professional discipline
- state boards of nursing are responsible for discipline within the profession
- most common charges brought against nurses are substance abuse, incompetence, and negligence
- it is considered negligence to not report another professional’s misconduct
- penalties may result in temporary suspension or loss of licensure
continuing education (CE)
- many states require evidence of continuing education after a nurse has passed the licensing exam
- nurses must continue education to keep abreast of changes in health care practice, pharmacology, and technology in order to practice safely
laws and guidelines affecting nursing practice
- OSHA
- Child Abuse Prevention and Treatment Act
- discrimination
- sexual harassment
- Good Samaritan laws
- Patients’ Rights
- National Patient Safety Goals
- Health Insurance Portability and Accountability Act (HIPAA)
- consents and releases
Child Abuse Prevention and Treatment Act (CAPTA)
- defines child abuse and neglect
- licensed health care professionals are required to report child abuse
Good Samaritan Laws
- protects a health care professional from liability if he stops to provide aid in an emergency
- liability is limited unless there is evidence of gross negligence or intentional misconduct
- protects actions within your scope of practice done with good/sound intentions
Patient’s Right’s
- revised to “The Patient Care Partnership: Understanding Expectations, Rights, and Responsibilities” in 2003
National Patient Safety Goals
- provide evidence and expert based solutions to problem areas in terms of patient safety
- all nurses should review these goals annually
medical records
- a legal document that includes records of all assessments, tests, and care provided
- kept confidential
- only people directly associated with the care of that patient have legal access to the information in the chart
- property of the hospital, agency, or physician- NOT the patient
- patients have the right to to access the documents, but they must go through the medical records department to get a complete copy
- copies may not be made
Health Insurance Portability and Accountability Act (HIPAA)
- regulations regarding patient privacy and electronic medical records
- failure to comply with the rules may lead to civil penalties
- intentional violation of the regulations can lead to sizable fines and time in jail (civil and criminal repercussions)
informed consent
- indicates the patient’s participation in the decision-making process
- person signing must have knowledge of what the consent allows and be able to make a knowledgable decision
- person signing must be told:
1. the risks and benefits
2. possible consequences of forgoing the procedure
3. alternatives to the treatment
4. name of the professional who will perform the procedure
inferred/implied consent
is assumed when consent cannot be obtained from the patient or family in the event of a life threatening emergency
emancipated minor
established independence by:
- moving away from parents
- service in the armed forces
- marriage
- pregnancy
witnessing wills or other legal documents
- you cannot witness any documents at a facility you work at
- facilities have notaries for this purpose
- if the will is contested, nurses can testify regarding the patient’s mental state or relationship to visitors
codes of ethics
- A respect for human dignity, the individual,
and provision of nursing care that is not
affected by race, religion, lifestyle, or culture - A commitment to continuing education,
maintaining competence, and contributing to
improved practice - The confidential nature of the nurse-patient
relationship, outlining behaviors that bring
credit to the profession and protect the public
ethical committees
- Many health care facilities have ethics
committees that are composed of people from
various departments - They collaborate to develop policies, address
issues in their facility, and come to a better
understanding of ethical dilemmas from
different viewpoints
ethical dilemmas
examples:
- Life-prolonging treatment versus refusing such treatment
- Initiating or terminating life support or treatment
- Assisted suicide
- Euthanasia
autonomy
control over personal decisions
justice
giving patients their due and treating them fairly
beneficence
to “do good”
non-maleficence
to be faithful to the charge of acting in the patient’s best interest when the capacity to make free choice is no longer available
PHI
protected health information
