Legal Considerations In The Practice Of Nursing Flashcards
It is the application and interpretations of regulations, laws, and principles of laws to the practice of nursing
Ethicomoral and Legal Considerations in the Practice of Nursing .
Why is nursing regulated by laws?
The practice of nursing exposes individuals to possible risks, especially if nurses are not adequately prepared for the practice of nursing.
It is governed by many legal concepts
Nursing practice
Why do nurses need to know the basics of legal concepts?
Nurses are accountable for their professional judgement and actions
Is an essential concept of professional nursing practice and the law
Accountability
Knowledge of laws that regulate and affect the nursing practice is needed for two reasons:
- To ensure that the nurses’ decision and actions are consistent with the current legal principles
- To protect the nurse from liability
The Philippine Nursing Law of 2002
RA 9173
When and who signed RA 9173
October 21, 2002 by Gloria Macapagal Arroyo
The Philippine Nursing Act of 1991
RA 7164
An act providing for a more responsive nursing profession, repealing for the purpose of Republic Act No. 7164, also known as the Philippine Nursing Act of 1991, and for other purposes
The Philippine Nursing Act of 2002 (RA 9173)
- was enacted on 2002 to provide a comprehensive definition and understanding of the nursing profession
- delineates the scope of work of Registered Filipino Nurses (Article VI, Section 28)
- establish linkages with community resources
- requires updating of professional knowledge in the nursing field
- to make the law more germane to the present and future health situation and needs of the country
Philippine Nursing Act of 2002 or RA 9173
- as independent practitioners, nurses are primarily responsible for promotion of health and prevention of illness.
- as members of the health team, nurses shall collaborate with other health care providers for the curative, preventative, and rehabilitative aspects of care, restoration of health, alleviation of suffering, and when recovery is not possible, to a peaceful death
Article VI, Section 28
(5) It shall be the duty of the nurse to:
- Provide nursing care through the utilization of the nursing process.
- Establish linkages with community resources and collaboration with the health team.
- Provide health education to individuals, family, and community.
- Teach, guide, and supervise students in nursing education programs including the administration of nursing services in varied settings; undertake consultation services, engage in activities that use the knowledge and decision-making skills of a registered nurse.
- Undertake nursing and health human resource development program and research to the advancement of nursing practice.
Amzdemendments provided for RA 9173
- Restructuring of scope and practice of nursing
- Expanding the powers of BON
- Additional educational requirements for different levels of nursing practice
Refers to the need for certification and specialization programs
Restructuring scope and practice of nursing
- strengthening its role in the decision making process
Expanding the powers of the BON
- science of morals
- area of philosophical study involved in systemizing, defending, and recommending concepts of right and wrong behavior
Ethics
- the science of morals, the area of philosophical study involved in systematizing, defending, and recommending concepts of right and wrong behavior
- it examines human acts to determine what is right or wrong, what is good or bad, or what ought to be in a given situation
Ethics
- Patients can make independent decisions
- recognizing each patient’s right to self determination and decision making
Autonomy
- is acting for the good and welfare of others
- is defined as kindness and charity
Beneficence
There should be an element of fairness in all medical and nursing decisions and care
Justice
To do no harm
Nonmaleficence
- are enduring beliefs or attitudes about the worth of a person, object, idea, or action
- important because they influence decision and actions, including nurses ethical decision making
Values
Refer mainly to guiding principles
Morals
Specific rules, actions, or behaviors
Ethics
An idea or action drive by the desire to be good
Moral precept
Set of rules that’s defines allowable actions or correct behavior
Ethical code
- systematic guides for developing ethical behavior
- provides direction for nurses to act normally
Ethical codes
- promulgated by the BON and PRC
- underwent consultation with accredited professional organizations like the Philippine Nurses Association
Code of Good Governance
The code of ethics serves as a guide for: 2
- Carrying out nursing responsibilities that would tackle difficulties and decisions that a profession might be facing.
- Gives clear instruction on what would be considered ethical right in a given circumstance.
Registered nurse and people
Article II, Section 4 and 5
Registered nurse and practice
Article II, Section 6-11
Registered nurses and coworkers
Article IV, Section 12-13
Society and environment
Article V, Section 14 and 15
Registered Nurses and the Profession
Article VI, 16 and 17
Chairman of the PNA Special Committee on 1982
Dean Emeritus Julita V. Sotejo
She developed a Code of Ethics for Filipino Nurses, approved by the House of delegates of the PNA but not implemented
Dean Emeritus Julita V. Sotejo
When was the code of ethics approved by the general assembly of PNA
October 25, 1990
When and where : Accredited professional organizations decided to adopt a new code of ethics under the RA 9173
October 23, 2013. Ilo-ilo city
When: public hearing was conducted as comments, suggestions, and recommendations were discussed
January 2012
When: last phase of the refinement was done, giving birth to revised NCCS of Nursing Practice
May 2012
The PRC Modernization Act of 2002, Section II
RA 8981
(2) Legal Bases of Core Competency Standards development
RA 8981
RA 9173
States that the Board of nursing shall monitor and enforce quality standards of nursing practice in the Philippines and exercise the powers necessary to ensure the maintenance of efficient, ethical, and technical, moral and professional standards in the practice of nursing taking into account the heath needs of the nation
RA 9173, Article 3, Section 9
(3) National Nursing Core Competency Standards
A. Beginning nurses role on client care
B. Beginning nurses role on leadership and management
C. Beginning nurses role on research
List of guarantees for those receiving medical care. It may take the form of a low or a non-binding declaration.
Patient’s Bill of Rights
Patient is treated without any discrimination
Right to appropriate medical care and humane treatment
Patient have the right to know everything (sickness, bill, treatment)
Right to information
The patient has the right to choose the hospital
The right to choose a health care provider and facility
Patient has the right to avail any treatment
Right to self-determination
Patient has the right to ask for medical records
Right to medical records
Patient will sign the DAMA
Right to leave
- patient has the right to complain
- nurse should listen and attend to the complaint
Right to grievances
- Done upon admission of the hospital and will be ask to sign
- as much as possible, explain in their own dialect
Right to be informed of his rights and obligations as a patient
13 Patient’s Bill of Rights
- Right to appropriate medical care and humane treatment
- Right to informed consent
- Right to privacy and confidentiality
- Right to information
- Right to choose a health care provider and facility
- Right to self-determination
- Right to religious beliefs
- Right to medical records
- Right to leave
- Right to reuse participation in medical research
- Right to correspondence and receive visitors
- Right to grievances
- Right to be informed of his rights and obligations as a patient
- is a clearly defined, legal expectations, to which nurses are held accountable
Standard of conduct
- refers to the commission or omission of an act according to duty, that a reasonably prudent person in the same or similar circumstance would or would not do, and acting or the non-acting of which is the proximate cause of injury to another person or his property
Professional Negligence
- implies the idea of improper of unskillful care of a patient by a nurse
Malpractice
- lack of ability, legal qualifications, or fitness to discharge the required duty
Incompetence
Data privacy act
RA 10173
- an act protecting individual personal information in information and communications systems in the government and the private sector, creating for this purpose a national privacy commission, and for other purposes
Data privacy act, RA 10173
Law that seeks to protect all sorts of information, be it private, personal or sensitive. It is meant to cover both natural and juridical persons involved in the processing of personal information.
Data Privacy Act, RA 10173
What does the data privacy act ential?
- All personal information must be collected with reasons that are specific, legitimate, and reasonable.
- Personal information must be handled properly.
- Personal information must be discarded in a way that does not make it visible and accessible to unauthorized third parties.
PHIE
Philippine Health Information Exchange
an electronic health (eHealth) initiative of the Department of Health (DOH), the Department of Science and Technology (DOST), and the Philippine Health Insurance Corporation (PhilHealth) that would ensure accurate and timely health information exchange that can be instrumental in improving the services of these three agencies as well as the other organizations that could use the said data.
PHIE (Philippine Health Information Exchange)
It is an agreement by a client to accept a course of treatment or a procedure after being provided complete information, including benefits and risks of treatments, alternatives to the treatment, and prognosis if not treated by a health care provider.
Informed Consent
- defined as the patient’s choice to have a treatment or procedure which is based on their full understanding of the treatment or procedure, and any alternatives to the particular treatment of procedure
Informed consent
Goal of informed consent
Assure the client’s autonomy.
2 types of consent
Express consent, implied consent
- Oral or written
- the more invasive and greater risk, the more need for a written consent
Express consent
Exist when the individual’s non verbal behavior indicates an agreement
When an individual cannot provide express consent due to a physical condition
Implied consent
Characteristics of valid informed consent (4)
A. Competence
B.amount and accuracy of information
C. Patient understanding
D. Voluntaries
Of sound mind, at least 18 years old, and not under the influence of drugs or liquor
Competence
Relevant
factual data about a procedure and/or treatments, its benefits, risks, and possible complications or outcomes
Amount and accuracy of information
Education, language, and dialect
Patient understanding
Make an autonomous decision without force or intimidation, and understands that he/she can withdraw consent anytime without consequence
Voluntaries
Informed Consent has 3 Major Elements:
- The consent must be given voluntarily.
- The consent must be given by a client or
individual with the capacity and competence to
understand. - The client or individual must be given enough
information to be the ultimate decision-maker.
not responsible for explaining the procedure but for witnessing the client’s signature on the form.
Nurse
The nurses’ signature confirms 3 things!
- The client gave consent voluntarily
- The signature is authentic
- The client appears competent to give consent
• Perform a complete admission assessment or design a plan of care.
• Adhere to standardized protocols or institutional policies and procedures (ex. using an improper injection site)
• Follow a primary care provider’s verbal or written orders.
Failure to follow standards of care
• Notify a primary care provider in a timely manner
when conditions warrant it.
• Listen to a client’s complaints and act on them.
• Communicate effectively with a client (ex.
inadequate or ineffective communication of
discharge instructions).
• Communicate important assessment findings to
the nurse for the oncoming shift.
• Seek higher medical authorization for a
treatment.
Failure to communicate
- complete a shift assessment
- implement a plan of care
- observe a client’s ongoing progress
- interpret a client’s signs and symptoms
- recognize significant changes in a client’s condition and communicate them promptly
Failure to assess and monitor
- question discharge orders when a client’s condition warrants it
- question incomplete or illegible medical orders
- provide a safe environment
Failure to act as client advocate
(6) Categories of Negligence that Result in Professional Negligence Lawsuits
- Failure to perform standards of care
- Failure to use equipment in a responsible manner
- Failure to communicate
- Failure to document
- Failure to assess and monitor
- Failure to act as client advocate
(3) Nursing Error Includes
- Failing to read the medication label, misreading, or incorrectly calculating the dosage
- Failing to identify the client
- Preparing the wrong concentration, or administering a medication by the wrong route
(4) Categories of orders that nurses must question to protect themselves legally
- Question any orders a client questions.
- Question any orders if the client’s condition has changed.
- Question and record verbal orders to avoid miscommunication.
- Question any orders that is illegible, unclear or incomplete
- unusual occurrence report
- agency record of an accident or unusual occurrence
- used to make all facts available to agency personal, to contribute to statistical data about accidents or incidents, and to help health personnel prevent future incidents or accidents
Incident Report
Influences others to work together to accomplish a specific goal.
Nurse as a leader
Often visionary, they are informed, articulate, confident, and self-aware
Nurse as a Leader
- outstanding interpersonal skills and are excellent listeners
- have initiative and the ability and confidence to innovate change, motivate, facilitate, and mentor others
Nurse as a leader
Participate in and guide teams that assess the effectiveness of care, implement evidence-based practice and construct process improvement strategies
Nurse as a LEader
They may be employed in various positions
Nurse as a Leader
- employee of a organization who is given authority, power, and responsibility for planning, organizing, coordinating, and redirecting the work of others, and for establishing and evaluating standards
Nurse as a Manager
- understand organization structure and culture
- control human, financial, and material resources
Nurse as a Manager
They set goals, make decisions, and solve problems
They initiate and implement change
Nurse as a Manager
Some nurses assume a position within the organization as unit manager, supervisor, executive
Nurse as a Manager
As a manager, the nurse is responsible for: (4)
- Efficiently accomplishing the goals of the organization
- Using the organizations resources
- Ensuring effective client care
- Ensuring compliance with institutional, professional, regulatory, and governmental standards
(3) Levels of Management
- First level managers
- Middle level managers
- Upper level (top level) managers
- responsible for managing the work of non-managerial personnel and the day-to-day activities of a specific group or groups
First-level managers
- supervise a number of first-level managers and are responsible for the activities in the departments they supervise.
Middle-level managers
