Legal Issues

Question 1

Examples of Public Law

Answer 1

constitutional, criminal and administrative (fed/state) laws

Question 2

Examples of Civil Law

Answer 2

contract/tort law

Question 3

What is Constitutional law

Answer 3

rights, privileges, and responsibilities from U.S. Constitution including the Bill of Rights

Question 4

What is Criminal Law

Answer 4

public concerns regarding an individuals unlawful behavior threatening society

Question 5

What is Administrative Law

Answer 5

rules/regulations passed by the Board of Nursing

Question 6

examples of criminal actions (harmful to society as a whole)

Answer 6

felonies/misdemeanors

violations of RN practice act

Question 7

examples of civil actions (private rights/interests btw individuals in the case)

Answer 7

malpractice
negligence
informed consent

Question 8

legal actions are for

Answer 8

deliberate or unintentional violations

Question 9

what happens in a civil action

Answer 9

plaintiff files a lawsuit for compensation for damages suffered from perceived wrong

Question 10

what are the 2 types of torts

Answer 10

unintentional (incidents/accidents) or intentional (deliberate acts)

Question 11

which is the most common malpractice tort claim

Answer 11

unintentional

Question 12

what are the basic elements of malpractice

Answer 12

must have a duty
must have breached that duty
your breach = foreseeable cause of pt. injury
damage/injury must have occurred

Question 13

was there a breach of duty?

Answer 13

must prove standard of care wasn’t met

must demonstrate you did not act as a reasonable/prudent nurse under the circumstances

Question 14

did the breach cause the injury?

Answer 14

causation must be proven

Question 15

well documented observations include

Answer 15

patients physical/mental condition upon admission/discharge
after incident, note pt mental/physical condition
pt non-compliance with medical directives
any pt. complaints/non-complaints
exactly what pt. says
note pt. own admissions
clear discharge instructions
allergies or lack of

Question 16

did pt. suffer damages/injury

Answer 16

must be proved - breach of duty caused injury to pt.

damages

Question 17

who might have liability in a claim?

Answer 17

Personal Liability
Physician/Other Liability
Supervisory Liability
Institutional Liability

Question 18

what is personal liability

Answer 18

Each individual is accountable for their own actions

Held to prof. stand. of practice

Question 19

what is physician/other liability

Answer 19

NOT responsible for everything that happens to the pt. Nurses follow orders BUT not those unsafe for pt. OR out of scope of practice

Question 20

what is supervisory liability

Answer 20

Task properly assigned to competent worker
Adequate supervision provided
RN provided approp. follow-up and eval. of delegated task

Question 21

what is institutional liability

Answer 21

Respondeat Superior
Carry insurance
Policies or lack of common claim in court

Question 22

what defenses might be available in malpractice claims

Answer 22

Standard of care was appropriate
No causation
No damages

Question 23

nurses notes must reflect current condition of pt. T or F

Answer 23

True

Question 24

what evidence can help in a lawsuit

Answer 24

medical record - complete and accurate (integrity)

Question 25

what makes a claim defensible or indefensible

Answer 25

the medical record

Question 26

what is the best defensive action in a claim

Answer 26

good documentation | document extensively, accurately and factually

Question 27

how to avoid a malpractice claim r/t med errors

Answer 27

follow the 6 rights avoid miscalculations (drug interactions) listen to pt. re: new meds; re-check anything amiss take time to admin. correctly (saves time)

Question 28

how to avoid a malpractice claim r/t safe environment

Answer 28

know how equip works remove hazards (chemicals) make environment free from hazards document any incident correctly

Question 29

how to avoid a malpractice claim r/t falls

Answer 29

``` 1st duty is to the pt. Notify MD to assess/trt Ensure pt. is protected from another fall Notify the family Document what occurred ```

Question 30

what is a primary risk to a pt 2nd to med. errors

Answer 30

pt falls

Question 31

what is a source of physical/psycho injury to elderly pt.

Answer 31

falls

Question 32

how to avoid a malpractice claim r/t equipment failure

Answer 32

know standard of care connected with equipment use as directed is the equipment properly maintained is the equipment working properly remove the equipment from service if necessary

Question 33

Intentional Torts include these acts

Answer 33

assault/battery false imprisonment defamation (libel, slander)

Question 34

how to avoid intentional tort

Answer 34

Don't communicate pt. info. w/o pt. consent Confidentiality - keep info about pt. to themselves, share only w/other healthcare workers Invasion of Privacy - photographing procedures; going through pt. belongings, talking about pt private life publicly

Question 35

what is an ethical and legal consideration in nursing

Answer 35

maintaining confidentiality

Question 36

defense for intentional torts

Answer 36

Informed consent - pt is informed of nature of care, trt, meds, procedures Potential benefits, risks and S/E Likelihood of achieving care, trt, service goals Reasonable alternatives, risks, and benefits of refusing interventions

Question 37

What criminal acts pose a risk to the RN

Answer 37

Theft/misappropriation of property RN practice violations Violations of the FDA

Question 38

2 types of malpractice insurance

Answer 38

individual | institutional

Question 39

individual malpractice insurance

Answer 39

not expensive, not used much

Question 40

institutional malpractice insurance

Answer 40

lg policies covering acts/omissions by employed RN's | Individual policies are secondary to institutional

Question 41

what happens when I go to court

Answer 41

deposition

Question 42

how to behave at a deposition

Answer 42

``` Look/act professional Be clear/concise Do not give opinions Speak slowly Ask for questions to be repeated Correct misstatements Don't be angry or emotional Avoid Always, Never, Maybe, I think, Possibly Don't answer more than what is asked ```

Question 43

how you represent yourself as a nurse is key to be taken seriously, be professional. T or F

Answer 43

True

Question 44

what is an Impaired RN

Answer 44

an RN who is unable to fxn due to some type of substance abuse

Question 45

s/s of an impaired RN

Answer 45

heightened awareness significant impact on safe/effective care high stress/easy access contributes to the problem many states have taken a rehab approach to this problem (NJ-RAMP)