Law RN practice

Question 1

protection for persons in care act 2010

Answer 1

applies to publicly funded service providers in alberta = hospitals, nursing homes and lodges, group homes, mental health facilities
excludes = home care, correctional facilities, student housing, doctors offices, day care

Question 2

Service provider responsibilities

Answer 2

Protect clients from abuse
Maintain reasonable level of safety for clients
When notified of reported abuse, ensure clients are safe
Make information about the act available to anyone working in a facility including volunteers
Criminal records checks

Question 3

Definition of abuse

Answer 3

An act or omission that:
Causes serious bodily harm
Causes serious emotional harm
Inappropriate administration, prescription or withholding of medication resulting in serious bodily harm
Non-consensual sexual activity
Misappropriating money or valuables
Failure to provide adequate nutrition or medical attention resulting in serious bodily harm

Question 4

Range of physical harm

Answer 4

Minor = not requiring any treatment
Moderate to extreme = must be reported, requiring first aid treatment or relatively minor intervention up to harm resulting in permanent disability or death

Question 5

Range of psychological harm

Answer 5

Minor = brief with only temporary stress or embarrassment
Moderate or major harm = with increasing levels of distress
Traumatic = significant and life changing

Question 6

PPC act offences

Answer 6

Failure to report abuse
Failure of a service provider to comply with their duties
Failure of a service provider or individual involved to comply with the director’s decision
Service provider taking adverse action against a person who reports abuse or assists in an investigation or inquiry

Question 7

Complaints

Answer 7

Must be made within two years of the incidence
Complaints are protected
It is against the law to not report abuse

Question 8

Complaints officer makes an initial assessment and then can decide

Answer 8

Not to pursue the complaint
To refer to a PPC investigator
To refer to a professional college
To pass on to the police

Question 9

PPC investigators

Answer 9

Access to records
Interviews clients and others associated with the abuse
Submits regular reports and makes final recommendations
PPC director makes decision based on report and can require action by service provider

Question 10

Mental health act actions

Answer 10

Apprehension and detention
Admission and treatment
Community treatment orders

Question 11

Compulsory admission

Answer 11

Examining physician must believe that a person is:
Suffering from a mental disorder
Likely to cause harm to that person or others, or to suffer substantial mental or physical deterioration or serious physical impairment
Unsuitable for admission to a facility other than as a formal patient
All three criteria must be met

Question 12

Compulsory admission process

Answer 12

Physician completes a form 1: admission certificate
Person can then be held for 24 hours within which
A second physician completes a second form 1: admission certificate
The person can then be held for up to 1 month
Neither physician has to be a psychiatrist

Question 13

Renewal certificates

Answer 13

Hospitalization can be continued beyond 1 month if two physicians - one of whom must be a psychiatrist - complete form 2 renewal certificates before the month is up
Renewal can be for a 1 month period x2
Renewal is then for a 6-month period

Question 14

Community treatment orders (CTO)

Answer 14

Intended to support people in the community with severe and persistent mental disorder who have history of non-compliance with treatment
Treatment plan under supervision of psychiatrist- individual is involved in making or at least informed of decision (if not competent, guardian or substitute decision-maker)
Person can be apprehended on psychiatrist order if fails to comply
Person has right to request review

Question 15

Patient rights/staff obligations

Answer 15

The person has to be given a copy of the admission certificates and have the reason for the compulsory admission explained to them
They have to be given verbal and written information about the review process and the mental health advocates office

Question 16

Patient rights

Answer 16

To see a lawyer
To contact the mental health patient advocates office
To request a review panel
To consent to or refuse treatment if mentally competent (additional certificate process for compulsory treatment)

Question 17

Review panels

Answer 17

Made up of the chair (lawyer), psychiatrist, a physician, and a member of the general public
At patient request or after 6 months of hospitalization or after first renewal (6 months) and every subsequent second renewal of a community treatment order
Further appeal is possible to the court of queens bench

Question 18

Advance care planning

Answer 18

A way to help patients think about, talk about, and document wishes for health care when they are competent and capable, should they not be able to in the future

Question 19

Goals of care designations (GCD)

Answer 19

Comfort care = symptom control rather than cure
C1 = symptom comfort care
C2 = terminal care
Medical care = cure or control of medical condition, but would not benefit from ICU
M1 = medical care with transfer to acute care and without option for ICU
M2 = medical care without transfer to acute care and without option for ICU
Resuscitative care = cure or control, where patient would benefit from, and want ICU
R1 = medical care including ICU, WITH intubation and chest compressions
R2 = medical care including ICU, WITH intubation but NOT chest compressions
R3 = medical care including ICU, WITHOUT intubation or chest compressions

Question 20

Personal directive act

Answer 20

Standard form available
Signed and witnessed - does not need lawyer
Unless otherwise specified, determination of capacity by two service providers including one physician or psychologist

Question 21

Adult guardianship and trusteeship act

Answer 21

When a person is deemed to lack decision-making capacity

When there is no personal directive naming an alternate decision maker

Question 22

Capacity assessment: example of interprofessional practice

Answer 22

Medical diagnosis = physician
Cognitive testing = OT, nurse, physician, psychologist
Functional assessment - ADLS, IADLs = OT/PT, nurse
Care needs and support network = SW, nurse
Collateral information from family - changes over time = nurse, SW
Comprehensive interview with person = any of above, designated capacity assessor

Question 23

Activities of daily living

Answer 23

Bathing and toilet use
Dressing
Eating
Mobility

Question 24

Instrumental activities of daily living

Answer 24

Managing medications
Dealing with money, keeping track of finances
Housework, cooking
Shopping 
Driving 
Using the phone, other technology

Question 25

Health professions act (HPA)

Answer 25

Provides a regulatory structure for all self-governing health professions in Alberta
Intended to make professional legislation transparent to the public and recognizes that professions have overlapping scopes of practice

Question 26

The college

Answer 26

Consists of its regulated members and any other members
Has capacity and rights and powers and privileges of a natural person
Performs activities and governs regulated members to protect and serve the public
Provides direction and regulates professional practice of regulated members
Establishes, maintains and enforces regulations, standards for registration, of continuing competence and standards of practice for the profession
Establishes, maintains, and enforces code of ethics
Performs activities, duties and functions of college
Approves programs of study and education courses for registration requirements

Question 27

The college cannot

Answer 27

Set or negotiate professional fees unless approved by the minister
Be a bargaining agent (negotiations are handled by the united nurses of Alberta (UNA))

Question 28

Common framework for all health professions regulated under the health professions act

Answer 28

Establish a college as governing body for members
Establishes and implements registration
Establishes and implements continuing competence
Identifies restricted activities
Investigation of complaints and instigates discipline
Protection of title of the profession

Question 29

The college develops

Answer 29

Regulations which include = requirements for registration and annual practice permits, continuing competence programs, authority to provide restricted activities
Bylaws = to direct operations of college
Code of ethics = a set of guidelines and principles that govern the conduct of the professional practitioners
Standards of practice = direct the provision of professional services

Question 30

Governance committees

Answer 30

Appointments committee 
Finance, audit and pension committee 
Leadership review committee 
Nominations committee 
Provincial executive committee

Question 31

Operational committee

Answer 31

Awards selection committee

Question 32

Regulatory committees

Answer 32

Appeal committee 
Competence committee 
Complaint review committee 
Hearing tribunal 
Nursing education program approval board 
Registration committee 
Registration review committee

Question 33

Purpose for nursing practice standards

Answer 33

Mandatory for a self-regulating profession
Promote responsibility, reputation, and importance of profession of nursing
Provide legal guidelines for measuring quality of nursing care
Applicable to all nurse roles
Identifies and communicates the role of nursing on the health-care team