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Concept #2 Communication > Nursing 101; Legal and Ethics > Flashcards

Nursing 101; Legal and Ethics Flashcards

1
Q

Veracity

A

Truthfulness

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2
Q

Justice

A

Equal access under the law

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3
Q

Moral Courage

A

Overcoming the fear of speaking or taking an action. Standing up for one’s core values.

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4
Q

Altruism

A

Showing concern about others

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5
Q

Fidelity

A

Keeping your word; loyalty; honoring your committments

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6
Q

Utility

A

Doing the greatest good for the greatest number

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7
Q

Automony

A

The right to self-determination

ex.: Patient’s right to choose or refuse treatment

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8
Q

Beneficience

A

Positive action taken to help another person

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9
Q

Nonmaleficence

A

Do no harm

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10
Q

Moral Distress

A

Knowing the right thing to do but having to do the opposite due to employer policy

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11
Q

Conscientious Objection

A

Rejecting an action by a provider because it would violate a deeply held value

ex.: Jehovah’s Witness hanging blood products

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12
Q

Advocate

A

Person who speaks on someone else’s behalf

***Nurses have ethical responsibility to be client advocates

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13
Q

ANA Code of Ethics

A

Guide that nurses use as a social contract for how we should act/behave with the public

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14
Q

Ethics Committee

A

Resource used for helping to solve ethical dilemmas and answer ethical questions

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15
Q

Ethical Dilemma

A

Exists when 2 or more values are in conflict with each other

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16
Q

Values Clarification

A

Ongoing process of examining one’s values

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17
Q

Personal Values

A

Mostly influenced by family members

Develop from individual experience, social traditions and cultural, ethnic, religious norms

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18
Q

Tort

A

A type of Civil Law

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19
Q

Informed Concent

A

Physician must obtain

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20
Q

Malpractice

A

Professional negligence

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21
Q

Plaintiff

A

Person who brings a case against another in a court of law

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22
Q

Battery

A

Physical touching of someone without their permission

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23
Q

Privacy invasion (example)

A

Failure to knock before entering a patient’s room

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24
Q

Nurse Practice Act (NPA

A

Law that defines and regulates our professional practice

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25
Q

Advance Directive

A

May include a living will

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26
Q

Violation of NPA

A

Failure to report an employee who is suspected of substance abuse

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27
Q

Childline

A

Resource to notify authorities of suspected child abuse

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28
Q

State Board of Nursing (SBON)

A

agency that administers NCLEX exam, issues licenses to RNs and Temporary Practice Permits

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29
Q

National Council of State Boards of Nursing (NCSBN)

A

Writes the NCLEX exam

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30
Q

HIPAA

A

Privacy protection law

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31
Q

False Imprisonment

A

Refusing to allow a patient to leave their room

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32
Q

Breach of Duty

A

One element that must be present to win a malpractice claim

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33
Q

Omission

A

Forgetting to carry out an action which then causes the patient harm

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34
Q

Compact Nursing Licensure

A

Multistate License

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35
Q

Durable Power of Attorney for Healthcare

A

Patient designated individual who makes health care decisions if the patient can no longer speak for himself

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36
Q

Decision Making Capacity

A

Ability of a person to understand all information about health condition;may fluctuate, determined by HCP.

ex.: Patient who has taken pain medication/narcotic

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37
Q

Competence

A

Legal determination made by a judge to determine incapacity

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38
Q

Two Sources of Laws

A

Statutory Administrative

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39
Q

Statutory Laws

A

Laws made by legislative branches at federal state, and local levels Nurse Practice Act, Americans with Disabilities Act, Child Abuse Act, Good Samaritan Act

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40
Q

Administrative Laws

A

Laws made by administrative agencies Nurse Practice Act

*** NPA is both an administrative and statutory law

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41
Q

Criminal Law (Crimes)

A

defines conduct harmful to another individual or society

May be punishable by fines, imprisonment, or both

42
Q

Civil Law (Torts)

A

deals with rights and duties of private persons

43
Q

Tort Law

A

A type of civil law that can be intentional or unintentional

44
Q

Intentional Tort Law

A

Includes assault, battery, false imprisonment, invasion of privacy

45
Q

Unintentional Tort Law

A

Includes negligence, malpractice

46
Q

Negligence

A

Conduct that deviates from what a responsible person would do in a particular circumstance

Occurs when individual damages person or property without *intent* to injure

Carelessness

Failure to maintain reasonable care resulting in injuries to the aggrieved party (care falls below the standard)

47
Q

Commission

A

Mistake that results in harm to a patient

48
Q

Professional negligence or malpractice

A

Ocdurs when person with professional status fails to do what they are supposed to

49
Q

Five elements that must be proven for malpractice

A

Duty - nurse/patient relationship

Breach of duty- patient was harmed during relationship

Foreseeability - ability to predict or reasonably expect harm

Causation - relationship between mistake and injury

Injury or harm - patient must have suffered injury or harm

50
Q

Statute of Limitations for professional negligence or malpractice

A

In Pennsylvania patient has two years from incident or for minors, until the age of 20

51
Q

Statute of Limitations

A

Amount of time that can pass between recognition of harm and filing a suit

52
Q

Medication Errors

A

Top 3 cause of death

Top 5 reason

HCPs are sued

Ongoing issue

Must be clearly documented and discussed with client

53
Q

Strategies to prevent incidents of Professional Negligence/Malpractice

A

Practice Zero Tolerance

Communicate care concerns, key information about client condition

Ensure physician’s orders are clear

Understand how to use equipment

Providing appropriate mentoring, assessment, care plan for clients

Maintain client safety

Apply the Six Rights of medication administration to minimize the risk of medication errors

Use effective communication

54
Q

Fall Risk

A

All patients must be assessed for fall risk every 12 hours

If a patient falls, assess for injury before attempting to move them

55
Q

Six Rights of Medication Administration

A
  • Right patient
  • Right drug
  • Right dose
  • Right route
  • Right time
  • Right documentation

Use 3 checks before passing medication to patient

56
Q

Using Effective Communication

A

Helps decrease risk of bad outcomes

Attentive/active listening is essential

Poor communication skills may make the client think that the nurse is less than competent

Accurate documentation and reporting

57
Q

Professional Liability Insurance

A

Can be individual, group, or employer sponsored

Nurses are generally required to carry

Manages own personal financial risk

Many hospitals will cover their employees

Requirements/coverage for nursing students depends on the school and/or hospital

58
Q

ANA Standards of Professional Practice Standards of Nursing Practice Standards of Care

A

Maintaining standards of care helps avoid lawsuits

59
Q

Apply nursing process to client, family care

A

Provide correct level of assessment

Analyze/interpret assessment data accurately

Plan care of client, identify expected outcomes - every patient is required to have a plan of care

ex.: do not report patient as lethargic if they are just tired

60
Q

Informed Consent

A

A process, not just a patient’s signature on a piece of paper

Must contain three elements:

Preconditions, Information, Consent

Physician is responsible for obtaining

Required by both Federal and State Law

Students are NOT permitted to witness informed consent

61
Q

Preconditions of Informed Consent

A
  • Must be voluntary - patient was not coerced into signing consent
  • Must be competent - patient must have the ability to understand what they are signing
  • If patient is at least 18 and oriented, they are considered competent
  • Signature should be obtained before any sedatives or opioid medications are given
  • Ensure patient is in right state of mind and cognitive ability to make decisions. ex. not upset, too anxious or impaired from medication
62
Q

Informed Consent: Information

A

Physician is solely responsible for this part

Description of procedure

Risks vs Benefits - material risks - those that are severe (death, neurological deficit) and those that occur frequently (bleeding, infection)

All medically viable alternatives ex.: continued PT vs surgery

Must be given in language that patient understands

63
Q

Informed Consent: Signature

A

RN signs as wetness to signature of patient

If phone consent, must be witnessed by two individuals (physician and RN both need to be on phone to obtain consent)

If patient is non-English speaking, a medical interpreter must be used to obtain consent

64
Q

Special Considerations of Informed Consent

A

Life Threatening Emergencies - can treat without consent to save patient’s life

Can’t obtain consent of a patient that has been pre-medicated

Patient has a right to refuse treatment at any time - even on the operating table before procedure has begun

65
Q

Instances when minors can give own concent

A
  • Emancipated minor
  • HS graduate
  • Hx of pregnancy
  • Married
  • Lives independently from family (military)
66
Q

When is informed consent needed?

A
  • Surgical procedures
  • Administration of anesthesia (separate consent needed)
  • Administration of chemotherapy or radiation
  • Administration of a blood transfusion
  • Insertion of a surgical device or appliance
  • Administration of experimental device or medication
  • Specific consent forms must be used for autopsy, HIV testing, organ donation, ECT, Research, sterilization and breast surgery
67
Q

Controlled Substances Act

A

Federal law requiring that drugs be classified according to risk/potential for abuse, medical use and safety risk

  • Schedule I - highest risk - Heroin, marijuana, ecstasy
  • Schedule II - high risk - morphine, opium, cocaine, fentanyl, methadone, phenobarbital
  • Schedule III - moderate risk - tylenol w/ codeine, anabolic steroids, buprenorphine, ketamine
  • Schedule IV - lower risk - alprazolam, clonazepam, lorazepam, midazolam, diazepam
  • Schedule V - lowest risk - cough medicine with codeine, ezogabine
68
Q

Good Samaritan Law

A

Encourages healthcare providers to help victims in an emergency

Protects healthcare workers from potential liability

Nurse is responsible for following through with emergency care

*** If you start care you must continue or follow through until ambulance or help arrives.

69
Q

Green Book

A

PA’s book that defines scope of practice for nurses

70
Q

Nurse Practice Act (NPA)

A

Defines scope of practice, standards for educations programs, licensure requirements, grounde for disciplinary actions

Enforced by state boards of nursing (BONs) NPA

May vary from state to state

71
Q

Nursing Licensure

A

Allows nurses legal privilege to practice as defined by each state’s NPA

Each BON oversees administration of a licensure exam

72
Q

National Council of State Boards of Nursing (NCSBN)

A

Writes NCLEX exam for RNs and LPNs

Nurse is required to meet responsibilities to clients, healthcare system

Membership of all 50 states, DC and four US territories

Provides services to member of BONs

NOTE: NCLEX is administered by SBON

73
Q

Professional Misconduct

A

PA SBON oversees professional misconduct and handles any disciplinary action

Actions can be taken against any nurse found guilty of:

Giving false information, withholding infomation

Being convicted of a crime

Taking patient’s medication

Substance abuse (common cause of disciplinary action)

74
Q

Nurse Licensure Compact

A

Mutual recognition model

Single license that confers privilege to practice in other states

Nurse held accountable to adhering to the laws and rules of state

Similar to driver’s licence

Non-compact state requires specific state license to practice in that state

75
Q

Credentialing

A

Credentialing requires additional education or certification in a specialty through the American Nurses Credentialing Center (ANCC)

76
Q

Guidelines for Clinical Performance for Nursing Students

A
  • Ensure client safety
  • Know facilities policies, procedures before undertaking any clinical assignment
  • Ensure knowledge about client;s condition, interventions, medications, treatments
  • Never perform care if unprepared
  • Seek help before beginning procedure if unsure

***Students do not practice on a faculty member’s licence. The only individual that can legally practice on a license is the individual whose name appears on the license.

*** Student nurses are held to the same standard as an RN.

77
Q

HIPAA

A

Health Insurance Portability and Accountability Act

More that just about patient confidentiality

Minimizes exclusion of preexisting conditions

Designates special right for those who lose other health coverage

Protects all individually identifiable health information

Notice of privacy practice is given to all patients upon admission to hospital or at visit to HCP office

78
Q

Privacy

A

Right of individuals to keep their personal information from being disclosed

79
Q

Confidentiality

A

Assurance client has that private information will not be disclosed without client’s consent

Breach of confidentiality can also be invasion of privacy

80
Q

Examples of HIPAA Compliance

A

Never post patient’s name on door

Printed copies of HPI not kept on printer/fax

Never take home HPI/nurse handoffs

Password required to access patient charts

Lower voice levels in nurses’ station

Keep charts in a secure, non-public location

Do not participate in gossip

Curb others from participating in breaches of confidentiality

81
Q

Patient’s Rights

A

Right to informed consent guaranteed by federal law

States have additional laws protecting patients

Health care facilities’ patient bill of rights

ANA Standards of Practice, Code of Ethics

Joint Commission standards for accreditation

Speak Up Program

82
Q

Speak Up

A

Patient Rights from the Joint Commission

Patients have the right to:

  • Be informed about their care - view chart
  • Get information in their language - understand
  • Get information in a way that meets their sensory needs - large font, verbal instructions, etc.
  • Make decisions about their care
  • Refuse care
  • Know the names of their caregivers
  • Safe care
  • Have their pain addressed
  • Care that is free from discrimination
  • Know when something goes wrong
  • Get a list of all medications
  • Be listened to
  • Be treated with courtesy and respect
  • Have a personal representative

***Along with every right comes a responsibility. Patients are responsible for reciprocating some these things towards staff as well.

83
Q

Nursing Practice

A

Following ANA Code of Ethics - best bet to stay out of trouble and avoid law suits

Adhere to employer’s policies

Make use of additional resources

Identify appropriate individual to provide informed consent -whether it is patient, parent, durable POA, etc

Written materials in client’s spoken language - available through NIH

84
Q

Advance Directive

A

Legal document

Expresses and individual’s desires regarding medical treatment

Document to make an advance directive can be given to patient by nurse

Can include a living will

85
Q

Living Will

A

Document that determines what measures patient wants at end of life

86
Q

Durable Power of Attorney for Healthcare

A

Assigns person to make decisions on patient’s behalf in the event that they become unable to make decisions for themselves.

Can also be referred to as Proxy, Surrogate

87
Q

Elements of an Advance Directive

A
  • Consent to or refuse medical treatment or diagnostic procedure
  • Hire or discharge medical providers
  • Authorize admission to medical and long term care facilities
  • Consent to comfort care, pain relief measures
  • Have access to all medical records
  • Take any measures to carry out wishes

***Choose person that can be trusted to carry out your wishes

88
Q

Role of the Nurse in Advance Directives

A

Reassure clients and families that they have option to change their decision when competent

Assess whether clients, families have accurate understanding of life-sustaining measures

Be supportive of clients’ decisions

89
Q

Ethics

A

System of moral principles or standards governing behaviors and relationships

Standards of right and wrong

90
Q

Morality

A

Private, personal standards of right and wrong

91
Q

Values

A

Person beliefs about truth and worth of behaviors, thought, objects

Values influence ethical conduct

Things we value have worth to us

92
Q

Beliefs

A

Interpretations or conclusion that one accepts as true ex.: religious beliefs

93
Q

Professional Values

A

Nurses acquire by socialization into nursing profession by faculty and other nurses (formation), clinical and life experiences, following established code of ethics

94
Q

Values essential for the professional nurse

A
  • Altruism
  • Autonomy
  • Human Dignity
  • Integrity
  • Social Justice
95
Q

Interrelated Concepts that contain an ethical component

A
  • Comfort
  • Teaching
  • Communication
  • Advocacy
96
Q

Clarifying Client’s Values

A

At times nurses need to assist patient’s to reach decisions about their own care

Purpose:

Client’s values influence, relate to problem

Helpful when there is conflicting values so that problems can be resolved

Process:

List alternatives

Examine possible consequences of choices

Choose freely; feel good about choice

Affirm choice

Act on choice

Act with pattern -making the same decision if faced with making choice again

97
Q

Principles of Ethical Decision Making

A

Autonomy - right to self determination (choose or refuse care)

Beneficence - positive action to help another person

Non-maleficence - do no harm

Justice - fairness

Veracity - truthfulness

Utility - doing the greatest good for the greatest number (ex. socialized healthcare, vaccinations)

Fidelity- keeping your word

98
Q

Nursing Code of Ethics

A

General codes of ethics - expectations that nurses live and practice by These are guides we use as a social contract with the public

  1. ANA Code of Ethics for Nurses (what we follow)
  2. International Council of Nurses (ICN) Code of Ethich
99
Q

Highlights of ANA Code of Ethics

A

Right to self-determination RN primary commitment to the client Autonomy in research, Privacy, HIPPA

The responsibility and accountability for each nurse’s actions and judgments belongs to the individual nurse

Creating a supportive and health work environment

Shaping public policy

100
Q
A

Concept #2 Communication (5 decks)

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