Legal and Ethical Principles of Nursing Review For Quiz #2 Flashcards
Public law
Government is directly involved, regulates relationships between individuals and the government
Ex: law of no texting while driving
Private law
AKA civil law
Regulates relationships between people involving ownership of property, practice of nursing, medicine, pharmacy, and dentistry
Criminal law
Involves criminal actions, like theft
Nurse Practice Act
Law that affects nursing practice, each state has its own defining the legal scope of practice of nurses to protect the public
Each nurse is required to strictly work within their defined limits
If the nurse goes outside of their limits, that is when the legal aspect is involved
Scope of practice
Activities an individual healthcare practitioner is permitted to perform within a specific profession
Action WITHIN the scope of practice
Example: nurse has a patient who just had an appendectomy, scope of practice for that patient would be to assess for pain, dressing changes, possible infection, assessing drains, and giving medication
Action OUTSIDE the scope of practice
Nurse performs the appendectomy
Crime
A wrong against a person or his or her property, but the act is considered to be against the public as well
Tort
A wrong committed by a person against another person, or his or her property; regulated by civil law
*a nurses actions can become criminal if it does harm to the public. for example, medication errors to more than one patient
Intentional Torts
Assault or battery
Assault
Threat or attempt to do bodily harm
Assault example
A nurse making verbal threats to restrain a patient unnecessarily
Battery
Unauthorized physical contact; contact that takes place without the patient’s consent
Battery example
Forcing or administering medication after a patient has refused it
What are the exceptions for battery?
If a patient puts a nurse at risk, unauthorized contact is permitted to protect themselves from harm, but nurse needs to document all of that
Invasion of privacy
Occurs when confidential information is compromised
What are examples of intentional torts?
Trespassing or illegal search
Revealing personal information like a patient’s name
Photographing
Allow an unauthorized person to review chart
False imprisonment
Unjustified retention or prevention of the movement of another person without proper consent
Cannot detain a person without consent
What are false imprisonment examples?
Use of restraints, if it is not warranted
Patient cannot be forced to sign the AMA (against medical advice)
Unless it is a prisoner or mentally ill person who are dangerous to themselves or others
What are unintentional torts?
Negligence
Malpractice
Liability
Negligence
Harm because a person did not act reasonably ( ex: committing professional malpractices)
Based on what constitutes common sense
Malpractice
AKA professional negligence
Holds professionals to a higher standard
What is an example of malpractice?
You failed to follow the standards for administering insulin or other injectable medications
What is liability?
The obligation that legally binds an individual to settle a debt; has to meet four elements, including duty, breach of duty, causation, and damages
Duty
An obligation to provide care
Ex: nurses assignment to patients
Breach of duty
Failure to provide appropriate care
What is an example of a breach of duty?
A nurse has a patient with high blood pressure. However, the nurse did not re-check the blood pressure or notify the physician.
Causation (from 4 elements of liability)
Action or lack of action that caused harm
What is an example of causation?
A patient had a stroke because of high blood pressure but the nurse doesn’t know if it’s because of not checking the blood pressure or another reason
Damages
Physical, psychological, or financial harm / injury
What is an example of damages?
Cerebral vascular accident (CVA), a.k.a. stroke, paralysis on the left side for not checking blood pressure
How do you reduce liability?
Through the use of incident reports, maintaining HIPAA regulations, Good Samaritan laws, student liability, and malpractice insurance
What is an incident report?
Reports used by hospitals to document occurrences of anything of the ordinary that has potential to harm the patient
What is an example of when you would use an incident report?
When a patient falls out of bed because they didn’t want to call for assistance
What are Good Samaritan laws??
A law designed to help protect healthcare providers when giving aid in emergency situations outside of the hospital setting
How to maintain scope of practice
What is an example of one of you would use a Good Samaritan law?
if a nurse is on their way to work, and they witnessed a car accident, they can stop and help provide care. CPR is in their scope, however they break one of the patients ribs, but the nurse would not be liable for that.
What is malpractice insurance?
Protects the nurses best interest
For example, they are given an attorney in court and have monetary support if a case came to the conclusion that the nurse was liable for harm to the patient
What is informed consent?
When a patient gives the hospital staff permission to make physical contact
How are consent forms used?
The patient is asked to sign general permission for care which allows permission for care and treatment
Additional consents required for tests and surgery; must be signed by the patient/legal guardian
In an emergency, a consent is implied — immediate threat to life, and the physicians agreed to an emergency then consent can be implied if the patient or legal guardian can’t communicate this.
What is the procedure involved with informed consent?
It is the responsibility of the person performing the procedure (the surgeon) to inform the patient about the risks and benefits of the procedure
The forms have to be signed by parent / guardian for minors
What is the nurses role in informed consent?
If a patient is having a surgery, the nurse has to check if the patient signed a consent form, and all questions are answered by the person perform the surgery
If a patient is hesitant, the nurse has to contact the healthcare provider that will perform the surgery to explain the purposes/benefits/risks of the procedure
What are the HIPAA regulations?
Health Insurance Portability and Accountability Act of 1996
National standards for the protection of health information
Infractions are punishable by fines and / or prison
What are the patient rights in HIPAA regulations?
They are able to get a copy of their medical record, notice of privacy rights, and have the choice of how to receive health information
What HIPAA regulations are the nurse to abide by?
Protected health information
For example, demographics (name, address, birthday, Social Security number, MR number, health plan, name of relatives), diagnosis
How is health information protected?
By avoiding: discussion in public places, printed/electronic information in public view, client charts in open areas, protected health information in regular trash, unauthorized hearing of patient sensitive information, display of patient’s name and/or diagnosis, removing information from healthcare facility with identifying information, sharing information with individuals NOT involved in the care of the patient
What are ethics?
Philosophical principles that direct actions as being right or wrong
Code of Ethics
A list of written statements, describing ideal behavior, which serves as a model of conduct
Refer to the ANA code of ethics
What is involved and ethical decision making?
Ethical dilemma and ethical distress, as well as the nursing process
Ethical dilemma
Occurs when two or more clear, moral principles apply to a situation, but support mutually inconsistent courses of action
Ethical distress
Occurs when the nurse knows the “right” thing to do but personal or institutional factors make doing the “right” thing difficult
