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Exam 4-DWB > Legal and Ethical standards > Flashcards

Legal and Ethical standards Flashcards

1
Q

What is the reason for legal requirements

A
  • assure health, safety, welfare of public;

- protect integrity of profession

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2
Q

legal regulations are grounded in

A

each state’s nurse practice act

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3
Q

who inforces rules and regulations

A

board of nursing

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4
Q

Using ethical principles and virtues to maintain individual and institutional integrity will promote

A

patient/client well-being and will be consistent and compatible with the ethical and legal needs of the workplace setting

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5
Q

Obligation to practice in a legally safe manner

A
  • each nurse is legally and professionally responsive for his or her actions;
  • develop a personal risk management plan
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6
Q

Nurses should develop a personal risk management plan by

A
  • understanding parameters of safe and effective practice;
  • understanding healthcare team roles to practice within scope of practice;
  • being clear and consistent verbal and written communication skills;
  • maintaining/updating nursing skills and competencies;
  • consider professional insurance
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7
Q

Legal standards

A

primary or individual accountability within a reasonable person standard;
- nurses are responsible and accountable for their actions;

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8
Q

Negligence

A
  • failure to exercise the degree of care that a person of ordinary prudence would exercise under the same circumstances;
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9
Q

A claim of negligence requires that there be

A

a duty owed by one person to another, that the duty be breached, and that the breach causes an injury

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10
Q

Traditional standard of nursing care is defined by

A

degree of skill, care, and diligence exercised by nurses commensurate with the individual’s level

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11
Q

Care standards vary based on

A
  • state nursing practice acts and regulations;
  • institutional policies and procedures;
  • codes of professional and ethical conduct;
  • professional associations;
  • case law
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12
Q

what defines the legal reasonable person standard

A
  • job title
  • job description;
  • policies;
  • procedures;
  • professional codes of conduct;
  • professional standards of nursing practice;
  • ethics;
  • occasional unwritten customary practice
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13
Q

Malpractice is covered under what law

A

tort law

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14
Q

Malpractice is

A

a dereliction from professional services resulting in injury, loss, or damages to the recipient of the services

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15
Q

malpractice relies on

A

the judgment that the professional has failed to perform according to the minimum reasonable standards of the preofession

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16
Q

What is tort

A

the injury or wrongful act for which a civil action is brought

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17
Q

Malpractice laws

A
  • vary by state;

- controlled by statute, regulations, and case law

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18
Q

Negligence

A

the doing or not doing of an act, pursuant to a duty, that a reasonable person in the same or similar circumstances would do r not do and the acting or failing to act is the proximate cause of the injury to another person or to her property;

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19
Q

Malpractice

A

a negligent act, or failure to act, committed in teh course of professional performance;

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20
Q

General standards of conduct

A
  • actions of reasonable professional in similar circumstances;
  • ## primary/individual accountability for action;
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21
Q

General standards of conduct is defined by

A
  • job description, including policies, procedures, professional codes of conduct and ethics, and unwritten customary practice
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22
Q

plaintiff

A
  • individual and/or spouse, child, or estate, alleging a medical malpractice/negligence or wrongful death claim
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23
Q

Defendant

A

medical professional and/or hospital, medical group, orgnaization

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24
Q

Elements of a malpractice claim

A
  • duty;
  • breach of duty;
  • proximate cause;
  • damages;
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25
Q

duty requires

A

proven provider-patient relationship

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26
Q

what is breach of duty

A

the nurse had a duty to patient but care fell below the acceptable standard;
- standards set per diagnostic profile can be written or unwritten;

27
Q

proximate cause

A

failure to provide care within the standard must be the proximate cause of the injury

28
Q

example of proximate cause

A

administering a drug in error but without injury does not meet criteria for malpractice claim

29
Q

damages requires

A

proof of harm

30
Q

Caveat to duty

A
  • can be established in workplace or informal setting;
31
Q

How is duty different from good samaritan laws

A
  • nurses may offer duty in emergency circumstances without liability;
  • if a nurse causes additional harm, he or she may not have immunity
32
Q

Brune vs. Belinkoff

A
  • standard asked whether the physician, if a general practitioner, had exercised the degree of care and skill of the average qualified practitioner, taking into account the advances in the profession.
33
Q

What is permissable when considering standards

A
  • considering medical resources/education when applying standard
34
Q

What is the authority for professional practice

A
  • state law;
  • federal agencies;
  • private companies;
  • professional societies;
35
Q

When considering standards what can be looked at

A
  • speciality;
  • specific standards {internal policy/procedures};
  • state/national standards {i.e code of nursing conduct, speciality statement/positions;
36
Q

how is breach determined

A

did the defendant, by his or her conduct, violate the duty of care;

37
Q

who has to prove a breach

A

it is the plaintiff’s burden to prove;

  • usually by preponderance of evidence
  • “50% plus a feather”
38
Q

What evidence may a plaintiff present to prove breach

A
  • medical records;
  • policies and procedures;
  • written standards;
  • testimony of expert witnesses;
39
Q

actual causation and harm the plaintiff

A

must have suffered personal injury, not simple economic harm

40
Q

Actual causation and harm examines

A
  • the probability that the defendant’s act caused by harm;
  • whether the exact same harm would have occurred without the act;
  • was the act a substantial factor in the harm
41
Q

Actual causation and harm: must consider

A

who the actors were and who had responsibilities;

42
Q

Proximate cause must involve

A
  • an injury that occurred within the risk of what happened;
  • the person who suffered within that risk;
  • is there any cause other than the alleged one
43
Q

When proving a medical malpractice claim the plaintiff must

A

introduce proof of the existence of the four elements necessary for malpractice claim

44
Q

proving a medical malpractice claim must include

A

proof of NP standard of care crucial to establishing the required elements of duty, breach, and proximate cause;

45
Q

medical malpractice cases require

A

expert testimony on duty, breach, and causal relationship

46
Q

presumption of negligence

A

violation of a statute

47
Q

Res ipsa loquitur

A

everyone involved is considered responsible until cause is defined

48
Q

When may a legal expert not be required

A

in jurisdictions where nursing negligence is not recognized as professional negligence

49
Q

What should you do if you are served with a lawsuit

A
  • call professional insurer;
  • notify institution/workplace;
  • do not contact plaintiff
50
Q

Building a defense

A
  • duty existed/owed;
  • actions reasonable/unreasonable;
  • assumption of risk;
  • contributory negligence;
  • comparative negligence;
  • statute of limitations;
  • immunities relating to status
51
Q

comparative negligence

A
  • if one event is comparable to another in causing harm, respnsibility does not rest with one individual
52
Q

how lawsuits begin and proceed

A
  • service;
  • answer;
  • discovery;
  • deposition;
  • negotiation;
  • settlement;
53
Q

Service

A

defendant receives document informing them of suit

54
Q

answer

A

most jurisdictions require a response within 120 days;

55
Q

discovery

A

insurer/attorney begin document search {both sides};

56
Q

Deposition

A

reps for plaintiff and defendant meet and ask questions

57
Q

Massachusetts medical malpractice Tribunal

A
  • case filed with tribunal;
  • three-member panel recommends whether to proceed;
  • plaintiffs can proceed without recommendation but must pay bond;
  • cases should proceed when there is real, evidentiary basis;
  • reform weeds out cases without merit
58
Q

most cases end with

A

negotiation and settlement;

  • trials are rare;
  • trials awards can be large
59
Q

Common liability issues

A
  • relationship with patient {failure to communicate/recognize pt;
  • failure to monitor/assess;
  • missed diagnosis;
  • failure to refer in timely manner;
  • medication errors;
  • documentation: fact-based, opinions should have clinical basis;
  • confusing legal/ethical standards;
60
Q

Factors that increase risk

A
  • deviation from the standard of care (be proficient and up to date);
  • failure to show concern/consideration;
  • failure to assess, diagnose, and refer
  • failure to communicate;
  • failure to follow chain of command;
  • failure to follow policies/procedures;
  • failure to understand/master equipment use;
  • failure to document appropriately/accurately;
  • failure to obtain informed consent;
  • competency issues
61
Q

Superintendent of belchertown state school vs Saikewicz

A

Saikewicz: mentally retarded young man unable to understand his cancer treatment;

  • could guardian say no to treatment on his behalf;
  • court said yes
62
Q

Rogers vs. Commissioner of the Dept. of mental health

A
  • substituted judgment by a court appointed guardian
63
Q

Albets vs. Devine

A

physician-patient confidentiality (built on later through HIPAA regulations)

64
Q

What records all malpractice claims

A

National Practitioner Data Bank

Exam 4-DWB (20 decks)

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