Legal and Ethical Issues (Chapter 9)

Question 1

To be informed about benefits, qualifications of all providers,
available treatment options, and appeals and grievance procedures
• Least restrictive environment to meet needs
• Confidentiality
• Choice of providers
• Treatment determined by professionals, not third-party payers
• Parity
• Nondiscrimination
• All benefits within scope of benefit plan
• Treatment that affords greatest protection and benefit
• Fair and valid treatment review processes
• Treating professionals and payers held accountable for any injury
caused by gross incompetence, negligence, or clinically unjustified
decisions

Answer 1

Highlights of Patient’s Bill of Rights (Box 9.1)

Question 2

Clients hospitalized against their will under these conditions
are committed to a facility for psychiatric care until they no longer pose a
danger to themselves or to anyone else.

Answer 2

Involuntary Hospitalization

Question 3

A person can be detained in a psychiatric facility for __________ on an
emergency basis until a hearing can be conducted to determine whether or not
he or she should be committed to a facility for treatment for a specified
period.

Answer 3

48 to 72 hours

Question 4

Clients admitted to the hospital voluntarily have the right to leave, provided
they do not represent a danger to themselves or others. They can sign a
written request for discharge and can be released from the hospital against
medical advice.

Answer 4

Release from the Hospital

Question 5

If a voluntary client who is dangerous to him or herself or to
others signs a request for discharge, the psychiatrist may file for a _____________ to detain the client against his or her will until a hearing can take
place to decide the matter.

Answer 5

civil commitment

Question 6

________ is the requirement that
clients continue to participate in treatment on an involuntary basis after their
release from the hospital into the community.

Answer 6

mandatory outpatient treatment (legally assisted)

Question 7

Mandated outpatient treatment is sometimes also called ___________ or ______________.

Answer 7

conditional release

or outpatient commitment.

Question 8

The court appoints a person to act as a _________ who assumes many responsibilities for the person, such as giving informed consent, writing checks, and entering contracts.

Answer 8

Guardianship

Question 9

A person assigned by the court to manage all financial affairs of the client.

Answer 9

Conservatorship

Question 10

It means that a
client does not have to be hospitalized if he or she can be treated in an outpatient setting or in a group home. It also means that the client must be free of restraint or seclusion unless it is necessary

Answer 10

Least Restrictive Environment

Question 11

_____ is the direct application of physical force to a person without his
or her permission to restrict his or her freedom of movement. The physical
force may be human or mechanical or both

Answer 11

Restraint

Question 12

________ occurs when staff members physically control the client and move him or her to a seclusion
room.

Answer 12

Human restraint

Question 13

_________ are devices, usually ankle and wrist restraints, fastened to the bed frame to curtail the client’s physical aggression, such as hitting, kicking, and hair pulling.

Answer 13

Mechanical restraints

Question 14

________ is the involuntary confinement of a person in a specially
constructed, locked room equipped with a security window or camera for direct visual monitoring.

Answer 14

Seclusion

Question 15

Any sharp or potentially dangerous objects, such as pens,
glasses, belts, and matches, are removed from the client as a safety precaution.
Seclusion decreases stimulation, protects others from the client, prevents property destruction, and provides privacy for the client. The goal is to give the client the opportunity to regain physical and emotional self-control.

Answer 15

Seclusion

Question 16

Seclusion. For adult clients, use of restraint and seclusion requires a face-to-face
evaluation by a licensed independent practitioner within…….

Answer 16

1 hour of restraint or
seclusion and every 8 hours thereafter, a physician’s order every 4 hours,
documented assessment by the nurse every 1 to 2 hours, and close supervision
of the client.

Question 17

Seclusion. For children, use of restraint and seclusion requires a …..

Answer 17

physician’s order must be renewed every 2

hours, with a face-to-face evaluation every 4 hours.

Question 18

Nursing considerations for restraints/seclusion

Answer 18

• Assess for any injury and provided treatment as needed.
• Monitor 1-on-1 for first hour then by audio and video equipment.
• Monitor and document skin condition, blood circulation in hands and feet, emotional well-being, and readieness