legal/ ethical power point Flashcards
provide safe and compassionate care based on
ethical and legal standards of care
current clinical facility policies
evidence-based practice guidelines
ethics is
branch of philosophy concerned with
distinction between right and wrong based on body of knowledge, not based only on opinions
Morality is
– behavior in accordance with customs or
traditions – usually reflects personal religion/beliefs
Moral/Ethical Principles are
fundamental values or
assumptions about the way individuals should be treated and cared for. Codes that direct or govern
Nursing Action.
Autonomy moral/ethical principles
A client’s right to SelfDetermination Without
Outside Control.
Freedom to make
choices even if not in
agreement with health
care team
Rational thinking on the
part of the individual
Challenged when the
individual infringes upon
the rights of others
Autonomy Nursing moral/ethical principles
The client must be informed to
make a decision
Informed consents – (informed
and voluntary decision to
accept or decline medical
care)
Not impose our own
opinions/beliefs
Communication between
client & the healthcare
providers
Advance Directives can help
Examples of Autonomy
A pregnant mother refuses blood transfusion,
refusing could result in death of her /fetus –
Jehovah Witness Beliefs
Beneficence Moral/Ethical Principles
Duty to Actively Do
Good for Clients
Compassionate Care for
all people in all
circumstances
Not paternalism
(healthcare provider
always knows best)
Who defines “good”?
(client, family, nurse,
healthcare provider?)
Beneficence Nursing Moral/Ethical Principles
Goal is to achieve the
highest level of function
What is best for the
needs of others, not
myself
Preserving humanity,
dignity, caring,
promoting well being.
Examples of Beneficence
Post Surgery – Encourage ambulation,
TCDB
Providing the Evidence Based Practice
to care for the client.
Health promotion, teaching and safety
Nonmaleficence Moral/Ethical Principles
Duty to Prevent or Avoid
Doing Harm, Whether
Intentional or
Unintentional
Nonmaleficence Nursing
Follow the Scope of
Practice
“First do no harm”
Knowledgeable of skills,
care, medications.
justice Moral/Ethical Principles
The Duty to Treat All
Clients Fairly, Without
Regard to Age,
Socioeconomic Status,
or Other Variables.
Equitable distribution of
potential benefits and
tasks.
Who will be treated first?
VIP, underinsured.
justice nursing Moral/Ethical Principles
Optimal level of care for
all.
Being an advocate if this
is not being done – go to
person, the manager.
Examples of Justice
Moving an unstable patient in ICU to
another regular floor to make room for
the surgeon’s post op patient.
fidelity Moral/Ethical Principles
The Duty to Be
Faithful to
Commitments
fidelity nursing Moral/Ethical Principles
Nursing
Keeping promises of care
Examples of Fidelity
Returning with information about the
Endoscopy as promised
Walking the client in the hall as
requested
veracity Moral/Ethical Principles
The Duty to Tell the
Truth
Honesty improves
the Nurse-Patient
Relationship
Respect for others
and honesty builds
trust.
Veracity nursing moral/ethical principles
Give honest answers
when the client asked
questions.
Do not lie to the client
advocacy Moral/Ethical Principles
Be An Advocate
Patient advocate is a
person who speaks up
for or acts on the
behalf of the client,
protects the client’s
rights to make his/her
own decision.
American Nurses
Associates Bill of Rights
for Registered Nurses
advocacy Nursing Moral/Ethical Principles
Collaborate and
coordinate patient
care - Ex. Contact
referral agencies
and network with
other health care
professionals
Speak up for the
patient’s needs and
benefit.
Accountability Moral/Ethical Principles
Accepting
responsibility and
consequences for
one’s actions.
Learns and practices
best nursing
practices based on
evidence-based
research.
Accountability Nursing Moral/Ethical Principles
Readily admits to
action without having
to be questioned by
others
Researches the new
medication before
administering
Confidentiality Moral/Ethical Principles
Limits sharing private
patient information to
only authorized
individuals and
agencies.
Health Insurance
Portability and
Accountability Act
(HIPAA)
Confidentiality Nursing Moral/Ethical Principles
Patient had a previous
abortion, Who needs to
know this information?
Responsibility Moral/Ethical Principles
Dependable
Reliable
Responsibility Nursing Moral/Ethical Principles
➢ *Adheres to
professional
standards of care
➢ *Complies with
institutional policies
➢ *Meets requirements
for continuing
education
➢ *Follows orders
prescribed for the
patient
The Code of Ethics is not
legal documents
Ethical codes promotes
s behavior that is of a
higher standard than is required by law
VALUES are
Beliefs/attitudes that are considered important
and frequently influence an individual’s behavior
and process of decision makin
can values change
yes values can change over time
values can affect actions
True/False
true
BIOETHICS definition
the study of ethical and philosophical
issues in biology and medicine
examples of bioethics
Genetic Testing, Cloning & Embryonic
Stem cell Research, End of Life Care, Organ
transplantation, Expensive Diagnostic Equipment
and Medications
Ethical Dilemma is when
Conflict between two
or more ethical
principles
No correct decision
exists
Moral Distress
/Resilience
Ethical Reasoning Think it through
Own religious beliefs
Benefits and burdens
to the client
Caring – preserve
humanity and dignity,
promoting well-being
Sources of Law Impacting Nursing
Practice
Constitutional Law
Statutory Law
Regulatory Law
Case Law
Criminal Law
Prevent harm to individual citizens
Misdemeanor is
Punishable by a fine or up to 1-year local incarceration
Felony is
Punishable by imprisoned in state or federal facility for more
than 1 year.
Civil Law governs
unjust acts against individual citizens
Lawsuits are filed under civil law
the two types of TORTS
Intentional Torts
Unintentional Torts
Intentional Torts are
Assault
Battery
Defamation of Character
False Imprisonment
Invasion of Privacy
Assault is
Threat of bodily harm or violence; feeling of imminent harm
or danger
Battery is
Actual physical harm.
The threat is carried out
Defamation of Character is
public statement made that is false and injurious
Defamation of Character (Libel) is
written, broadcasting, or reading aloud
Defamation of Character (Slander) is
spoken untrue, jeopardizing that
person’s reputation
False Imprisonment is
Unauthorized restraint or detention of a person
Invasion of Privacy is when
Accessing a chart if a nurse/student does not have the responsibility of care
Asking patients about their personal wills/personal affairs
Sharing that a person is hospitalized/treated with another
person
Fraud is
Illegal activity, willful and purposeful
misrepresentation that could cause, loss or harm to a person or property
Describing a myth regarding a treatment (e.g., telling a client a treatment ill not hurt, when pain is involved in the treatment)
this is an example of
fraud
unintentional torts are considered
malpractice
Negligence is
Failing to do something that a
reasonable person would ordinarily do
Doing something that a reasonable
person would ordinarily not do
Malpractice is
Negligence committed by a person
functioning in a professional role.
Unethical
Deficient skills
Fails to practice Standards of Care
The legal guidelines for nursing
practice:
Usually involves “What a reasonable
and prudent nurse would do in the
same or similar circumstances.”
A breach of nursing standards must be
proven in a tort of nursing negligence
malpractice
Professional Misconduct includes
Practice outside the scope of Nursing
Delegate to unqualified person
Abandon/neglect patient
Abuse
Lack of documentation of care
Failure to supervise
Substance Use Disorder LAW
HIPAA violation/social networking
All nurses are responsible for knowing
the State Practice Act for Nurses (Standards of Care) and the regulatory laws passed by the Kentucky Board of Nursing
the policies and procedures of the facility in
which they work
You are legally responsible for the
assignment you accept
TRUE/FALSE
true
The Four D’s for Malpractice
DUTY
Dereliction
DAMAGES
DIRECT CAUSATION
The Four D’s for Malpractice duty
The nurse owed a DUTY to the client
The Four D’s for Malpractice Dereliction
There was a Dereliction (failure to fulfill one’s obligations) Breach of DUTY, it was not carried out (Testimony of expert witness, facility policy and procedures, state standards of practice)
The Four D’s for Malpractice DAMAGES
The client suffered DAMAGES or harm
The Four D’s for Malpractice DIRECT CAUSATION
The nurse’s failure to carry out the duty was
DIRECT CAUSATION of the harm
Licensure requires
Initial license – Pass the National Council Licensure Examination
(NCLEX)
Complete the annual mandatory Continuing Education and
licensure requirements
Enhanced Nurse Licensure Compact (eNLC)
Practice responsibly within the scope of personal capabilities, professional experience and education.
includes
Keep current with Kentucky standards of Care
Scope of Practice,
ACEN (Accrediting Commission for Education in Nursing) – our
school
Keep updated by continuing education programs, professional
journals, participating in profession organization (ANA, KNA, NLN)
Delegation
Accept only assignments for which you are qualified
How to Delegate
Suitable person with appropriate skill set
Prepare the person; explain task clearly & ask for feedback
Necessary authority
Keep in touch & monitor progress
Retain responsibility
Praise & acknowledge job well done
RN’s Responsibilities
Initial nursing assessment, subsequent
assessments, & clinical judgment
Nursing diagnosis, nursing care goals, &
progress plans
Interventions that require nursing
knowledge & skills for teaching
Unstable patients
5 rights of Delegation
Right task
Right circumstance
Right person
Right direction/
communication
Right supervision
LPNs may
May be delegated the care of patients that are stable and predictable and
rapid change is not anticipated
LPNs may collect data to report to the RN but are not responsible for the same
level of assessment that the RN conducts
!!!!!RN must be available to LPN if client shows
change in assessment
UAP can do
Routine nursing care & basic nursing procedures
Guidelines with Legal Boundaries
Document promptly and accurately
Develop a caring rapport with the
client and family while observing
professional boundaries
Communicate with the patient and
explain procedures
Maintain confidentiality
General Consent
Informed Consent
Medication Errors/Controlled Substance
practices
Practice the rights and checks every time
administering medication.
Follow up on patient concerns prior to giving
If you question the order or feel it is incomplete
or seems inappropriate, Clarify it.
Comply with legal requirements for handling
and disposing of controlled substances.
Student Nurses are responsible for
their own actions
TRUE/FALSE
TRUE
what is General Consent
giving permission for treatment
Informed Consent is required for
all invasive treatments, hazardous procedures and surgery
whos responsibility is it to explain procedure and risks
MD’s
Key components for informed consent
Exact details of the treatment
Necessity of the treatment
All known benefits and risks
Available alternatives
Risk of treatment refusa
Advance Directive includes
Living Will
Durable Power of Attorney
Health Care Proxy
living will purpose
Addresses end of life and
circumstances under which
treatment would be withheld
or stopped
Durable Power of Attorney is who
Makes legal decisions if unable
or not permitted to make their
own
Health Care Proxy is
The durable power of attorney
for medical care
