Legal Aspects of Patient Care Flashcards
California Board of Registered Nursing
regulates the practice of registered nursing and certified advanced practices nurses
Nursing Practice Act
each state has their own set of laws that protect the public by broadly defining the legal scope of nursing practice.
Liability
four elements that must be established to prove that malpractice or negligence has occurred
- duty, breach of duty, causation, damages
Negligence
doing something a careful person wouldn’t do in the same situation or failing to do something a careful person would do.
Malpractice
when a professional, like a nurse or doctor, fails to meet standard of care, causing harm to a patient
Accountability
nurses are fully responsible and answerable for their action in assessing, diagnosing, planning, interveneing, and evaluating patient care.
Advocacy
supports patients in making their own health decisions, providing information, clarifying options, and involving the right people in the process.
According to the Patient’s Bill of Rights, what should you expect during your hospital stay?
CHHHIP
- Clean and safe environment.
- Help when leaving the hospital.
- Help with your billing claims.
- High quality hospital care.
- Involvement in your care.
- Protection of your privacy.
How should nurses provide high-quality hospital care?
- Follow infection control guidelines
- Use evidence based practices
- Show pt your name
- Update white board
-> Dietary restrictions: (Note type of diet: NPO, Pureed, etc)
-> Name of nurse, CNA, physician
How do nurses provide a clean and safe environment?
- Maintain sanitary environment:
-> Correct PPE
-> Hand Hygiene - Environment free from abuse
Who should be involved in your care?
- IDT team: Interdisciplanry teams
-> phsicians, nurses, cna, RT, OT, pharmacists, etc - Family members
How is patient privacy protected?
-
HIPAA - protects pt privacy
-> if someone asks for patient info -> write information and verify with pt
How should a nurse prepare a patient and their family for discharge?
Educate pt and family:
- provide proper instruction on how to use equipments, treatment, etc.
- document 3x thats that pt understands instructions
How can the nurse “assist” with billing and insurance claims?
nurse refer patient to contact the hospital’s billing department for any issues or problems
Why would it be more beneficial to discharge a patient before noon rather than later in the evening?
patients who are discharged before noon have an easier time settling down at home.
T/F: The Patients Bill of Rights (1972) and the Patient’s Care Partnership (2003) are different guidelines with different protocols.
False: the Patients Bill of Rights as later renamed to the Patient’s Care Partnership in 2003.
A patient’s family member calls and asks for updates on their loved one’s condition. How should you respond while maintaining patient confidentiality?
Politely inform them that patient information is confidential and cannot be shared over the phone unless they have proper authorization.
Abby and Karen are in teh hosiptal cafeteria, talking about a patients recent surgery and health complications. A nearby nurse overheard their conversation and was able to recognize the patients name.
What is wrong with interaction between Karen and Abby? What can they do to fix this?
Abby and Karen were discussing confidential patient details in a public space.
Abby and Karen should refrain from discussing patient information in a public space. If discussing a case is necessary, conversations must be done in a private and secure location. They should also not use any information that can be used to identify the patient.
Josh printed out a patient’s test results, but a code blue alarm sounded. Josh dropped everything he as doing to go help in the code blue. A patient found the test results on the ground and started reading and sharing the information.
What mistake did Josh do? How can he fix his mistakes?
Josh left confidential medical records unattened in a public space and put patient information at risk.
Patient records should always to be secured and should never be left unattended.
Karen prints extra copies of a patient’s lab results to help a coworker, but instead of shredding the extra copies, she takes them home by mistake. Later, her roommate finds the papers on the kitchen table.
What did Karen do wrong? What can she do to fix this?
Karen made extra copies and failed to dispose of them properly.
You should only print essential copies and immediately dispose of extras in HIPAA-complaint shredding bin.
What are the nurses legal resposibility in regards to informed consent?
- Nurse must be present to witness and confirm the patient’s signature
- Confirm presences of consent on chart prior to procedure
What are the four componets of informed consent?
- Disclosure
- Comprehension
- Competence
- Voluntariness
What is the most important component of informed consent?
disclosure
T/F: Nurses are allowed to disclose information about a procedure to a patient.
False: only the person doing the proocedure is able to disclose information about the procedure
If pt is unclear about the procedure, which types of questions can you answer? Which types of questions can you not answer?
Can:
- Questions regarding aftercare (diet, woundcare, medication etc.)
- Questions regarding informed consent process
Cannot:
- any questions regarding proceudre
How can a nurse check if a patient understands informed consent?
ask the patient to repeat or explain the procedure back in their own words.
How do you determine if a patient is competent to give informed consent?
- Is the patient competent enough to make decisions for themselves?
- Are they incapacitated?
- Is the patient 18yrs or older?
- Is there a power of attorney put in place
Can a patient be forced to give consent to a procedure?
no, consent must be voluntary anf without pressure
T/F: A patient is allowed to revoke their consent at any time if they are able to articulate a reason why.
false, a patient has the right to revoke their consent at any time for any reason
What are the elements of disclosure that must be explained by the performing clinician?
Dont Panic, Risks Are Covered!
- Describe the procedure
- Purpose of the procedure
- Risks and benefits of the procedure
- Alternatives to procedure
- Consequences of not having procedure
In regards to the four elements to prove malpractice or negligence
What is duty? Give 3 examples of duty.
Obligation to use due care
- nurses are responsible for accurate assessmetns
- alerting chnages in pt’s conditions
- initiating safety measures for pts
In regards to the four elements to prove malpractice or negligence
What is a breach of duty? Give an example of a breach of duty.
- Failure to meet stadard of care actually caused the injury
Example:
- Not reporting that a previously alert patient is showing confusion.
- Failing to document or apply safety measures.
In regards to the four elements to prove malpractice or negligence,
What is a causation? Give an example of a causation.
MOST DIFFICULT ELEMENT OF LIABILITY TO PROVE
- Proof that breach of duty directly caused injury
Example:
- A patient falls trying to get out of bed becase all siderails were down.
In regards to the four elements to prove malpractice or negligence,
What are damages? What are examples of damages?
- Actual harm or injury suffered by the patient
Examples:
- Fractured hip
- Pain and suffering
- Need for rehabilitation
WHat is the most difficult element of liability to prove?
causation
What are the factors in accountability for nurses?
I RAAT
- Integrity
- Responsibility for your own actions/words
- Adequate training/knowledge
- Accurate and timely documentation
- Truthfulness
Your state’s ______ ______ ____ is the most important law affecting your nursing practice
nursing practice (care?) acts
_ practice beyond your scope
DO NOT
What can happen if you practice beyond your scope of education?
- Disciplinary action, including revocation of license
- Excludes unlicensed persons from practicing nursing
Compare direct care vs indirect care. Provide examples of both
Direct care:
- Involves direct interaction between a healthcare providers and a patient
- Ex: Administering Medications, Immunizations, Skin Tests,
Indirect care:
- activities that involve patient care but do not involve direct interaction with the patient
- Ex: managing patients environment, consulting other healthcare professionals, documenting care
Nurses should be able to recognize ____ ____ in a patients status that require intervention.
rapid changes
What must a nurse do before carrying out a physician’s order?
Critically examine the order to ensure it is correct and safe
You are recieving a verbal or phone order from a physician. What should you do?
- Have two nurses listen to the order (if possible).
- Document the order, including:
-> Time & date
-> Provider’s name
-> Confirmation of readback
——»» Repeat the order back to the physician to ensure accuracy
Telephone orders should be ________ to ________ situations where there is no other alternatives
limited; emergency
