Exam 4-DWB > Legal and Ethical standards > Flashcards

Legal and Ethical standards Flashcards

(64 cards)

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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
duty requires
proven provider-patient relationship
26
what is breach of duty
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
proximate cause
failure to provide care within the standard must be the proximate cause of the injury
28
example of proximate cause
administering a drug in error but without injury does not meet criteria for malpractice claim
29
damages requires
proof of harm
30
Caveat to duty
- can be established in workplace or informal setting;
31
How is duty different from good samaritan laws
- nurses may offer duty in emergency circumstances without liability; - if a nurse causes additional harm, he or she may not have immunity
32
Brune vs. Belinkoff
- 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
What is permissable when considering standards
- considering medical resources/education when applying standard
34
What is the authority for professional practice
- state law; - federal agencies; - private companies; - professional societies;
35
When considering standards what can be looked at
- speciality; - specific standards {internal policy/procedures}; - state/national standards {i.e code of nursing conduct, speciality statement/positions;
36
how is breach determined
did the defendant, by his or her conduct, violate the duty of care;
37
who has to prove a breach
it is the plaintiff's burden to prove; - usually by preponderance of evidence - "50% plus a feather"
38
What evidence may a plaintiff present to prove breach
- medical records; - policies and procedures; - written standards; - testimony of expert witnesses;
39
actual causation and harm the plaintiff
must have suffered personal injury, not simple economic harm
40
Actual causation and harm examines
- 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
Actual causation and harm: must consider
who the actors were and who had responsibilities;
42
Proximate cause must involve
- 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
When proving a medical malpractice claim the plaintiff must
introduce proof of the existence of the four elements necessary for malpractice claim
44
proving a medical malpractice claim must include
proof of NP standard of care crucial to establishing the required elements of duty, breach, and proximate cause;
45
medical malpractice cases require
expert testimony on duty, breach, and causal relationship
46
presumption of negligence
violation of a statute
47
Res ipsa loquitur
everyone involved is considered responsible until cause is defined
48
When may a legal expert not be required
in jurisdictions where nursing negligence is not recognized as professional negligence
49
What should you do if you are served with a lawsuit
- call professional insurer; - notify institution/workplace; - do not contact plaintiff
50
Building a defense
- duty existed/owed; - actions reasonable/unreasonable; - assumption of risk; - contributory negligence; - comparative negligence; - statute of limitations; - immunities relating to status
51
comparative negligence
- if one event is comparable to another in causing harm, respnsibility does not rest with one individual
52
how lawsuits begin and proceed
- service; - answer; - discovery; - deposition; - negotiation; - settlement;
53
Service
defendant receives document informing them of suit
54
answer
most jurisdictions require a response within 120 days;
55
discovery
insurer/attorney begin document search {both sides};
56
Deposition
reps for plaintiff and defendant meet and ask questions
57
Massachusetts medical malpractice Tribunal
- 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
most cases end with
negotiation and settlement; - trials are rare; - trials awards can be large
59
Common liability issues
- 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
Factors that increase risk
- 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
Superintendent of belchertown state school vs Saikewicz
Saikewicz: mentally retarded young man unable to understand his cancer treatment; - could guardian say no to treatment on his behalf; - court said yes
62
Rogers vs. Commissioner of the Dept. of mental health
- substituted judgment by a court appointed guardian
63
Albets vs. Devine
physician-patient confidentiality (built on later through HIPAA regulations)
64
What records all malpractice claims
National Practitioner Data Bank

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