Legal Integrity Flashcards
The nurse is legally responsible for the surgical count.
What type of law deals with injury to a person such as a retained object?
Tort law
A tort action law suit is filed when there
is injury to a person caused by another person. A retained object is tort claim.
The surgical patient is consented for a right breast biopsy. During the procedure the surgeon discovers the left breast tissue is worse and performs a left breast biopsy instead. This is an example of what?
Battery- touching someone without permission, does not imply harm
Except in emergencies, surgical procedures
should not be performed without documentation of the patient’s consent to the procedure (including side and site) in the medical record.
Forensic specimen handling
Place in paper bag or envelope
Do not use plastic bags due to condensation
Do not use metal instruments
Secure specimen until transfer to law enforcement
Critical thinking
Requires purposeful, outcomes-directed thought, and is driven by patient need 
When correcting a patient care entry in the electronic health record, the perioperative nurse should
Add a rationale for the correction 
Res ipsa loquitur (“the thing speaks for itself”)
A doctrine likely to be involved in cases involving retain surgical items to prove medical negligence
Allow natural death order
A specific directives written by a physician about end of life decisions
Informed consent
Understanding between surgeon and patient
Consent form
Documentation of understanding
Can be done by nurse after talking to Surgeon, and no questions from patient (done with order)
Pre-procedural verification
H&P and anesthesia assessment are complete
Blood, implants, and special equipment are available
Consent is accurate, signed and witnessed
Patient must be _____ in order for informed consent
Knowledgeable
Willing
Competent
Two witnesses sign consent if
Patient is unable to sign
Telephone consent
Exceptions to consent (implied consent)
Patient is unable to give consent and there is a threat to life, limb, function, or organ
Must have documentation of emergency in staff notes
ANA code of ethics for nurses
Nurse practices with compassion and respect for every person
Remain professional and civil
Ethical principles in nursing: Autonomy
Making decisions for self
Ethical principles in nursing: Beneficence
Contribute to well-being of another
Ethical principles in nursing: Nonmaleficence
Do no harm
Ethical principles in nursing: Justice
Fairness
Ethical principles in nursing: Veracity
Truthfulness
Ethical principles in nursing: Fidelity
Faithfulness to commitments
Statutory law
Made by legislative branch
Example: nurse practice act in each state (what license covers in state)
Common law
Derived from principles rather than rules and regulations
Civil law
Based on rules and regulations, compensation
Criminal law
Harmful to society
Example: practicing without a license
Tort law
Civil wrong, allows compensation
Example: malpractice
Negligence
Doing or not doing some thing a reasonable person would or would not do in similar situation
-Deviation from standard of care
-Can be ignorantly negligent
Malpractice
Professional negligence
-Misconduct or lack of skill in carrying out job
-Implies intent
Elements of malpractice
Four D’s
1. Duty of care
2. Dereliction of duty (did not provide care)
3. Direct causation
4. Damages
Intentional torts
Violating patient’s rights
-No actual harm necessary
-Most common: assault, battery and false imprisonment 
Intentional tort: Assault
Place person in fear of being touched
Intentional tort: battery
Touch without permission
Intentional tort: false imprisonment
Unjustified detention
Quasi intentional torts
No intent to injure or cause stress to another person
Protect patient rights
-patient abandonment
-Defamation of character
-Invasion of privacy
-breach of confidentiality 
Perioperative nursing data sets (PNDS)
Standardize vocabulary for perioperative nursing
Recognized by the ANA since 1990 
DNR/AND (allow natural death)
AND includes palliative care always
End of life wishes
Not automatically suspended
Conversation between MD and patient to make a plan for surgery
Cannot be altered by a nurse
