T1: Legal Considerations (CH 8) Flashcards
Nurses must know basic __ and confirm their practice falls within sound boundaries.
laws
Gero nurses function in __ roles.
autonomous
Gero nurses supervise unlicensed personnel and are accountable for ___ ___.
their actions
Some problems faced by older adults may lead to __ __.
legal issues
Nurses need to advocate for __ __ __.
older adults rights
What are some situations that can result in the risk of liability?
- working with insufficient resources
- not following agency policies and procedures
- bending rules
- taking shortcuts
- working when physically/emotionally exhausted
You are liable for ___ when your performance deviates from standard of care.
malpractice
___ acts do NOT always warrant damages.
Negligent
What are 3 conditions that warrant malpractice?
DNI
Duty
Negligence
Injury
Malpractice can occur when you ___ responsibilities to others.
delegate
Malpractice can occur when you have __ __.
Increased Responsibilities
What are some situations that can result in negligence?
- failing to take action
- contributing to patient injury
- failing to report a hazardous situation
- handling patient possessions inappropriately
- failing to follow policies and procedures
What does HIPAA stand for?
Health Insurance Portability and Accountability Act
Nurses need to be familiar with policies and procedures to protect __ __.
patients’ privacy
__ must be obtained prior to any med/surg procedure.
consent
Consent must be __.
informed
What are the 5 elements of Informed Consent?
- written description of the procedure and its purpose
- explanation by the person performing the procedure
- alternatives to the procedure
- expected consequences and risks
- signature of the patient, witnessed, and dated
Patients who are mentally incompetent are able to give consent. T/F?
False
The next of kin will always be the legal guardian.
FALSE
Guardianship differs from __ __ __ for health care.
power of attorney
There are various forms of legal guardianship and all are __ appointed.
court
What are some risks for nurses in the supervisory role?
- permitting unqualified persons to deliver care
- failing to follow up on delegated tasks
- assigning tasks to unqualified staff
- allowing staff to work under conditions with known risks
What does OBRA stand for?
Omnibus Budget Reconciliation Act
___ imposes strict standards on use of restraints: both chemical and physical.
OBRA
___ is anything restricting movement.
restraints
Their is a high caseload of ___ ill older adults in gerontological nursing.
terminally
___ act requires health care facilities to ask a patient about advance directives.
Patient Self-Determination Act
Nurses can be the legal witness to a will. T/F?
FALSE
Pronouncement of death falls within the scope of ___ in PA.
medical
Consent for autopsy must be obtained, except for cases of __, __, or __.
criminal act
malpractice
occupational disease
Caregiver stress can lead to __.
abuse
Elder abuse can be : (7)
PESENAF
physical emotional sexual exploitation neglect abandonment financial
__ __ __ helps identify those being abused.
Elder Assessment Instrument
Indications of possible abuse include:
dehydration and malnutrition
The scope of nursing practice and the requirements for being licensed as a home health agency fall under the enforcement of (public/private) law.
public
___: a relationship between the nurse and the patient in which the nurse has assumed responsibility for the care of the patient
Duty
___: failure to conform to the standard of care (i.e., malpractice)
Negligence
___: physical or mental harm to the patient or violation of the patient’s rights resulting from the negligent act
Injury
Measures to help manage behavioral problems and protect the patient without using restraints include:
alarmed doors, wristband alarms, bed alarm pads, beds and chairs close to the floor level, and increased staff supervision and contact.
When restraints are deemed absolutely necessary, a physician’s order for the restraints must be obtained, stating what 3 things?
the specific conditions for which the restraints are to be used, the type of restraints, and the duration of use.
___ ___ should exist for the use of restraints and should be followed strictly.
Agency policies
Detailed documentation about restraints should include what 3 things?
the times for initiation and release of the restraints, their effectiveness, and the patient’s response.
The patient requires __ __ while restrained.
close observation
If counseling does not help the patient and family understand the risks involved in not using the restraint, the agency may wish to have the patient and family sign a __ __ __.
release of liability
A release of liability for restraints states:
the risks of not using a restraint and the patient’s or family’s opposition.
Every conscious and mentally competent adult has the right to __ __ for a procedure.
refuse consent
To protect the agency and staff, it is useful to have the patient sign a release stating that consent is denied and that ___.
the patient understands the risks associated with refusing consent.
If the patient refuses to sign the release for refusal of consent, what should happen?
it should be witnessed, and both the professional seeking consent and the witness should sign a statement that documents the patient’s refusal for the medical record.
Accepting telephone orders predisposes nurses to considerable risks because:
the order can be heard or written incorrectly or the physician can deny that the order was given.
__ are statements of individuals’ desires for the management of their affairs after their death.
Wills
A __ __ describes a patient’s preferences and gives instructions to health care providers if at a future time he or she is unable to make or communicate decisions and has no one appointed as proxy.
living will
A ____ is a document that appoints a person selected by the patient to make decisions on the patient’s behalf should the patient be unable to make or communicate his or her decisions.
durable power of attorney
If a patient is dying and wishes to dictate a will to the nurse, the nurse may write it exactly as stated, sign, and date it; have the patient sign it if possible; and ____
forward it to the agency’s administrative offices for handling.
___ law governs the relationship between government and private parties; it includes issues such as the scope of practice, regulations that care settings must abide by, and criminal law.
Public
___ law involves the relationships among individuals or between individuals and organizations and includes issues such as assault, battery, false imprisonment, and invasion of privacy.
Private
A deliberate threat or attempt to harm another person that the person believes could be carried through (e.g., telling a patient that he will be locked in a room without food for the entire day if he does not stop being disruptive).
Assault
Unconsented touching of another person in a socially impermissible manner or carrying through an assault. Even a touching act done to help a person can be interpreted as this (e.g., performing a procedure without consent).
Battery
Unlawful restraint or detention of a person. Preventing a patient from leaving a facility is an example of this.
False imprisonment
Invading the right of an individual to personal privacy
Invasion of privacy
Unlawful taking of another person’s possession
Larceny
Willful and intentional misrepresentation that could cause harm or cause a loss to a person or property (e.g., selling a patient a ring with the claim that memory will be improved when it is worn).
Fraud
