Legal and ethical issues in nursing Flashcards
Scope of nursing practice
defines nursing and reflects the values of the nursing profession
American Nursing Association (ANA)
organization to protect and advance the profession of nursing
The Joint Commission
requires each institution to have all policies (what scope of practice is based on) written and accessible by all nurses
7 National Patient Safety Goals
- Identify patient correctly
- Improve staff communication
- Use medicine safely
- Use alarms safely
- Prevent Infection
- Prevent Safety Risk
- Prevent Surgical mistakes
Nurse Practice Act
state laws related to licensure (have to be licensed in practicing state)
Compact licensure
can be licensed in multiple states
Patient protection and affordable care act
Every American has access or the ability to get healthcare insurance.
“obamacare” or “afforable care act”
4 components of the affordable care act
- Consumers rights and protections
- Affordable care coverage
- increased access to care
- quality of care that meets the need of patients
Patient bill of rights
protection for people with pre-existing conditions
HIPPA
Health Insurance Portability and Accountability Act
Establishes patient rights regarding privacy of their health information and records
Allowed patient the right to their own medical records
Limits who can have access to charts
What are the 13 protected health information ?
- Name
- Address
- DOB
- SS#
- Photographs
- Fingerprints
- Medical Record #
- Telephone #
- Fax #
- Drivers License #
- Email, URL, IP address
- Admit/ discharge dates
- Any other unique ID #
What is HIPPA compiant?
- Privacy Rule (keep PHI private)
- Security Rule (firewalls, lock cabinets)
- Breach Notification Rule (notify pt of breach)
- Safety Rule (protect identifiable PHI during research or quality improvement)
Patient self determination act
requires health care institutions to provide WRITTEN information to patients concerning their rights to make decisions about their care, including the right to REFUSE CARE and to formulate an ADVANCE DIRECTIVE
What is the minimum that a advanced directive must state?
wishes related to respiratory and cardiac arrest and power of attorney
Informed consent
- An explanation of the procedure or treatment
- The names and qualifications of people performing and assisting in the procedure
- A description o the serious harm, including death, that may occur as a result of the procedure and anticipated pain/ discomfort (side-effects)
- Right of refusal
Advanced directives
-Patent Self-determination Act
-Developed by patient that instructs others to do tasks before, during and after their death
-Patient must have decision making capacity to sign an advanced directive
Hospitals must ask if they have one, obtain copy, or ask if they want information to create one
Living Will
Type of advanced directive that gives more information about end of life preferences
-Can include DNR information, enteral feedings, and other decisions about end of life care
-Pt must have decision making capacity to make Will
DNR
-Do not Resuscitate
-Does NOT mean “do not care”
-Do not do CPR and other acts that may or may not be stated in living will/advanced directive
-Can be revoked at any time by patient with decision capacity
EMTALA
when someone comes to ER they have to be treated
Americans with Disability Act (ADA)
protects rights of people with physicial or mental disabilities
Mental Health Parity and Addiction Equity Act
Health insurance has to cover for SOME mental health and substance use treatment
Ex. therapy or rehab
Omnibus Budget Reconciliation Act
protection of OLDER adults particularly in nursing homes with the use of RESTRAINTS
Good Samaritan Law
-limits liability and offer legal immunity if a nurse helps at the scene of an accident
-Do whats in your scope of practice Ex. can do CPR but don’t start a central line
Public Health laws
laws affect individuals, populations, and communities that are intended to improve the health of people
Ex. Vaccines
The uniform determination of Death Act
determines actual death
Value
A deeply held belief about the worth of an idea, attitude, custom, or object that affects choices and behaviors
Value clarification
-Ethical dilemmas almost always occur in the presence of conflicting values.
-To resolve ethical dilemmas, one needs to distinguish among values, facts, and opinions
Ethical dilemma
when two opposing courses of action can both be justified by ethical principles
Ex. Jehovah’s witness doesn’t allow usage of blood products. Pt dies in surgery due to blood loss. You are have opposite view and are anger/stressed.
Moral dilemma
instead of competing options for action, the nurse feels the need to take a specific action while believing that action is wrong
What are the 4 professional code of ethics?
- Advocacy- advocate for nursing profession
- Responsibility- responsibly practice
- Accountability- held accountable for actions as a nurse
- Confidentiality- keep what you do as a nurse private
What is “To Err is Human?”
Medicine publication identified that healthcare systems need to be aware of errors and how they affect patients
Common errors in healthcare?
- Medication (wrong dose, pt, time, route, etc)
- Surgery (wrong site)
- Diagnostic inaccuracy (wrong treatment)
- Equipment failure (IV pump)
- Transfusion Error (blood type inaccuracy, wrong patient)
- Laboratory (incorrect labeling)
- System failure (insufficient staffing)
- Environment (spills, exposure)
