Legal Issues in Nursing Flashcards
What are the CNO entry to practice competencies that are related to consent?
- ensures that informed consent is provided as it applies to multiple contexts (consent for care, refusal of treatment, release of health information, consent for participation in research)
- supports clients in making informed decisions about their health
- advocates for clients or their representatives, especially when they are unable to advocate for themselves
What are the goals of the Health Care Consent Act (HCCA; 1996)?
- promoting individual autonomy and communication among patients/practitioners and families
- includes decisions for: specific treatments/plan, admission to a care facility, personal assistance services
- HCP do not have authority to make treatment decisions on behalf of clients except in an emergency when no authorized person is available
What are the principles of informed consent?
- patients have the right to refuse consent to treatment, regardless of whether that treatment is considered in their ‘best interest’
- nursers should always explain to the client the treatment or procedure they are performing
- consent is an ongoing process and can be withdrawn at any time
- informed consent does not always need to be written
- nurses should assume that a patient is capable unless there are reasonable grounds to believe otherwise
What are the conditions for informed consent?
- patients must have capacity to make decisions
- medical provider offers disclosure of information
- patient is able to comprehend information
- consent obtained voluntarily
- consent must be specific to the proposed treatment or procedure
- consent must specify who will perform the procedure or treatment
What is the substitute decisions act (SDA)?
if the person is incapable, consent or refusal is to be obtained from the highest ranked available substitute decision-maker from the HCCA hierarchy who is willing to make the decision
What is the HCCA hierarchy?
- court appointed guardian of personal care
- an attorney for personal care
- a representative appointed by the CCB
- the spouse, common law, or partner
- parents and children
- brothers and sisters
- any other relative by blood, marriage or adoption
- the public guardian and trustee; there is no one else, no one else wants to, or two or more potential substitutes of equal and highest ranking claim the role but disagree as to the decision
What are the key characteristics of autonomy?
- choice, privacy, self-mastery, freedom, self-determination
Describe how a nurse can promote autonomy.
- informed consent
- understanding meaning of experience from patient perspective
- be aware of the potentially oppressive cultural space in which care is provided and challenge unjust practices
- develop awareness of personal biases and assumptions
- help foster the autonomy of group members who are potentially oppressed
- provide adequate time and counselling to ensure patient understanding
How are standards used in legal cases?
- in negligence lawsuit, standards are used to determine if the nurse acted as a reasonably as a prudent nurse in the same setting with the same credentials would act
Describe assault and give an example.
Verbal or physical act that creates fear of imminent harmful contact
- threatening to give an injection for a person who has refused consent
Describe battery and give an example.
Intention physical contact without the person’s consent
- actually giving the injection they have refused
Describe invasion of privacy and give an example.
Intrusion into private life or health history
- accessing health files not in your circle of care
Describe false imprisonment and give an example.
Held involuntarily
- preventing someone leaving a health care facility, unjustified use of restraints
What are some of the most common reasons for nurses to be sued?
- conduct that does not meet the standard of care established by law
- unintentional; committed by inattention, thoughtlessness or carelessness, performing a procedure for which the nurse is not educated, even if done carefully that results in patient harm
What are some common negligent acts?
- medication error resulting in injury
- IV therapy errors
- burns
failure to use aseptic technique - failure to give report or giving an incomplete report
- failure to monitor a patient’s condition adequately
