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pnur 202 legal > week 1 laws impacting nursing > Flashcards

week 1 laws impacting nursing Flashcards

1
Q

Functions of Law in Nursing

A

Provides a framework depicting which nursing actions are
legal
Differentiates the nurse’s responsibilities from those of
other health professionals
Establishes boundaries of independent nursing actions
Makes nurses accountable under the law

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2
Q

Constitutional Law

A

public Statutory law
Federal and State
criminal laws

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3
Q

Administrative law

A

public Statutory law
federal-Osha
state board of nursing
local city depart

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4
Q

criminal law

A

public Statutory law
federal drug transport
state-murder
local - parking violation

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5
Q

contract law

A 
private law (common law)
written and verbal contracts
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6
Q

law of torts

A 
private law (common law)
Legal wrongs not included
under contracts
 Negligence
 False imprisonment
 Confidentiality
 Defamation of character
 Consent
 Assault and battery
 Fraud
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7
Q

statutory law

examples of

A 
Also known as Public Law
 Developed by the legislative branch of the state
 Nurse Practice Acts
 Or in Michigan – the Public Health Code
 Other examples
 Speed limits
 Helmet law
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8
Q

common law

examples of

A

Now known as Case Law
“Judge made law” that originates in the courts
Judge makes the decision that sets the precedent for future
similar cases
Examples
Informed consent
Right to refuse treatment

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9
Q

nursing practice what is it under

A

Governed by Administrative Law
The Board of Nursing “administers” the law that was
created and approved by the state legislature, and signed by
the Governor of the State.
State BON’s have the legal authority to interpret, implement
and enforce the laws governing nursing.
Includes nursing practice
Education
Licensure

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10
Q

in Michigan we don’t have what

A

nurse practice act

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11
Q

criminal law examples

A 
Misdemeanor
 Felony
 Requires proof beyond a
reasonable doubt
 When criminal case is
complete, a civil case is
possible, regardless of outcome
 Punishment is incarceration or
death
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12
Q

civil law examples

A 
Intentional Tort
 Intended to cause harm
 Unintentional Tort
 Did not intend harm
 Proof established by
preponderance (majority) of
evidence
 Punishment is always
compensation (money)
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13
Q

civil law affecting nursing

intentional tort

A 
Intentional Torts (private/civil)
 Defamation
 Libel – written or pictures
 Slander - verbal
 Invasion of privacy
 Assault and battery
 False imprisonment
 Abandonment
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14
Q

negligence

A

Negligence—failing to do something a
reasonably prudent person with the same
background and experience would do (or not do)
• Conduct which falls below the established standards

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15
Q

malpractice

A

Malpractice—negligence by a professional

person according to the standards of care

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16
Q

Proving Negligence
4 elements needed
tested on

A
  1. Duty – the nurse had a responsibility to provide care
  2. Breach of duty – the nurse did not adhere to the standard
    of care
  3. Damages – there was some harm done by the nurse. The
    patient has to prove this damage.
  4. Proximate cause – The nurses action actually caused the
    damage.
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17
Q

Common Sources of

Malpractice

A

Medication errors
Treatment errors
Lack of observation and timely reporting
Defective equipment
Infections caused by or worsened by the nurse
Poor communication of important information
Failure to intervene to protect the patient
“Failure to rescue

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18
Q

Types of Laws Affecting
Nurses
Criminal

A 
Homicide, manslaughter
Theft
 Arson
 Active euthanasia
 Illegal possession of drugs
 Sexual assault
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19
Q

Occupational Safety

and Health Act

A

Passed in 1970 to improve the work environment
in areas that affect workers’ health or safety
• Includes the handling of infectious or toxic
materials, radiation safeguards, and electrical
equipment safety
• Requires mandatory orientation and education in
many topics such as blood-borne pathogens,
exposure, fire, bomb threats, lifting procedures,
and evacuation procedures

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20
Q

Child Abuse Prevention and Treatment Act

A

Federal Law passed in 1973 (redefined in 1996)
• Defines what constitutes child abuse and neglect as “any
recent act, or failure to act, that results in imminent risk of
serious harm, death, serious physical harm or emotional
harm, sexual abuse or exploitation of a child by a parent or
caretaker who is responsible for the child’s welfare
• Requires licensed health-care providers to report child
abus

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21
Q

Selected Legal Aspects of Nursing
Practice
Abuse and Neglect

A 
Mandated reporters
 Child and Elder Abuse (CPS and APS)
 Social work referral
 Call Police if evidence of crime
 Stabbing, shooting, rape…..
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22
Q

Discrimination

A

Discrimination: making a decision or treating a person
based on a class or group to which he or she belongs,
such as race, religion, or sex
• Law passed in 1964 prohibits employers from
discriminating against employees based on race, color,
religion, sex, or national origin
• Law was amended to protect people with disabilities and
the aged, people with HIV or AIDS, or recovering drug or
alcohol addicts

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23
Q

Good Samaritan Laws

A

Those laws that protect a health care professional from
liability if he or she stops to provide aid in an emergency
outside the clinical setting
• Most states do not have laws requiring nurses to provide
care in an emergency outside of the clinical setting.
• Emergency response workers are not covered under
these laws

24
Q

Patients’ Rights

A

Developed in 1972 and revised in 1992
• Developed by the American Hospital Association
• A list of rights that patients could expect
• Also includes a list of responsibilities the patient has

25
Q

The Medical Record

A

A legal document, the property of the hospital
• Patient does have the right to access
• All parts considered confidential
• Should not be copied and taken from the institution; all
entries must be made in ink
• Health Insurance Portability and Accountability Act

26
Q

Consents

A

Permission given by the patient or his or her
representative
• Patients have the right to consent to and also to
refuse treatment
• They must be competent in order to make the
decision

27
Q

legal competency

A

18 or older
Pregnant or married women
Self-supporting minor

28
Q

Clinical competence is a patient who can:

A

Clinical competence is a patient who can:
Identify the problem
Understand the options and consequences
Make a decision
Provide sound reasons for the option chosen

29
Q

informed consent

A

the risks and benefits of a procedure
are explained to the patient in terms the patient can
understand. Informed consent is obtained by the person
providing the service.
Usually for a procedure
Written permission
PN is not responsible for getting this signature

30
Q

informed consent entails

A 
Responsibility is on who is going to
perform the procedure
 Nurses are responsible for three
things:
 Consent was voluntary
 Signature is authentic
 Client appears to be competent
 Call doctor to come up and see
patient again if necessary
 Nurses should educate your patients
before you perform any procedures
with implied consent
 DOCUMENT
31
Q

General consent (Implied consent)

A

Obtained at admission
OK for PN to get this consent
Implied because they came in voluntarily to seek care
They may revoke portions of this consent
Example – they can refuse a shot, or a test, etc.

32
Q

Patient Self-Determination Act

Advance Directives

A

Sometimes called a living will
• A consent to allow treatment to a certain level before the need
arises, in case the patient becomes unresponsive or
incompetent
• Usually spell out whether a patient would want to live or die in
certain situations
• Regulated differently by each state

33
Q

Advance Directives

A

Durable power of attorney
• Give legal power to a person to make health care
decisions for patients if they become unable to make
them for themselves
• Need to be accessible (preferably as part of the
medical record)
5 Wishes
Valid in Michigan
Michigan requires your patient advocate to sign that they
have accepted this responsibility.

34
Q

how many states recognice a living will

A

47 and Michigan is not one of them

35
Q

what does the 5 wishes entail

A 
who you want to make decisions
treatment that you want
how comfortable you want to be
how you want people to treat you
do you want your loved ones to know
36
Q

Do-Not-Resuscitate (DNR) Orders

A

Written by physicians when patients have indicated that
they do not want to be resuscitated
• May be in conflict with the families’ wishes
Performing CPR on a patient with a DNR order is
considered battery
Not performing CPR on a patient who does not have a
DNR order is considered practicing without a license.
DNR does not mean “Do Not Provide Care”
DNR orders can be written with limitations

37
Q

Decreasing Legal Risk

A

Maintaining nursing competence
Defined as possessing the suitable skills, knowledge, and
experience necessary to provide adequate nursing care
• Identification of dissatisfied patients
• Occurrence reporting
Generally not part of the patient’s chart
• Liability insurance

38
Q

Reasons to Carry Malpractice Insurance

A

Jury’s award exceeds the limits of the agency’s coverage.
Agency pays the award (settles out of court) and then
counter sues you.
Employers insurance may only cover you while you are
employed.
Agency settles out of court but the patient then sues you
personally.
Do you really know if the agency is paying their
insurance?
The agency pays for the case, but then the agency’s
insurer sues you personally for the money spent.
You choose your own lawyer when you have your own
insurance. That way you don’t have to be represented by
the agency’s lawyer.

39
Q

The Profile of Patient’s Prone to Sue

Accountability

A

Wishing to see staff disciplined and

called to account

40
Q

The Profile of Patient’s Prone to Sue

explanantion

A

Explanation: A combination of wanting an
explanation and feeling ignored or neglected after the
incident

41
Q

The Profile of Patient’s Prone to Sue

standards of care

A

Standards of Care: Wishing to ensure that a similar

incident does not happen again

42
Q

The Profile of Patient’s Prone to Sue

compensation

A

Compensation: Wanting compensation and an
admission of negligence. There seems to be a profile
of patients who tend to sue health care providers.
Overly dependent
Hostile
Uncooperative
Noncompliant
Blame others
Insecure

43
Q

Traits of Nurses Who Trigger Lawsuits

A

Have difficulty developing close relationships
Tend to shift blame to others
Insensitive to patient complaints
Fail to take patient complaints seriously
Aloof
More concerned with technology and machines than
the patient
Delegates to others to avoid patient contact

44
Q

Professional Accountability

A

Professional accountability is a nurse’s responsibility
to meet the health care needs of the patient in a safe,
caring way.
• Accountability means asking for assistance when
unsure and performing tasks in a safe prescribed
manner.
• Accountability means documenting care delivered and
the patient’s response to that care.

45
Q

STANDARDS OF CARE

A

Purpose is to protect the public
Sources for the Standards of Care
Job descriptions, credentials, education, agency P&P
Nurse Practice Acts
ANA, AMA, MNA, specialties such as; Critical Care Nurses,
Telephone Triage, Orthopedic Nurses……Orthopedic
Surgeons…….
JCAHO, Medicare, CDC, NIH

46
Q

student nurse risk

A

Run the same risk for liability as do professional
nurses
Must follow the same standards as the nurses
Liability may extend to the instructor or preceptor
Students have a responsibility not to attempt
assignments for which they are not qualified, and to
not perform tasks that they were not assigned

47
Q

the impaired nurse

A

67% or higher for reported disciplinary actions
You will be working with someone at some point who is
chemically dependent
Report any suspicions to HPR or supervisor

48
Q

common sources of nursing liability

A 
Medication errors
Falls
Failure to report changes
Violation of P&P
Doctor’s Failure to Respond
Defective Equipment
Improper Patient Teaching
Infection caused or worsened by nursing care
49
Q

FALLS

A 
Injuries caused by falls are
the most common cause of
negligence lawsuits
against hospitals and
nurses
 Those who are at risk
include the elderly,
sedated, blind, dizzy,
confused or immediately
postoperative
50
Q

failure to observe

A 
As a nurse one of your
greatest responsibilities
is to assess and monitor
your patient
 You have a duty to
properly assess for
symptoms or changes
that are indicative of
deterioration
51
Q

Violation of P&P

A

If you violate an established policy, the court will most
likely say that you breached your duty
You are responsible for knowing the policy and following
the procedure

52
Q

Failure to Notify Doctor

A

Along with assessment it
is your duty to report
any pertinent
information to the doctor

53
Q

if the doctor fails to respond could you be held responsible

A

yes

54
Q

Defective Equipment

A 
Law states that nurses
are responsible to
inspect equipment and
remove it from patient
areas if defective
55
Q

Improper Patient Teaching

A

Teach your patients according to policy
Instruct them when to seek medical care and when to call
911
Document that the patient understands all instructions
Have a teaching record and use it
Nurses fail to take credit for all the teaching that we do

pnur 202 legal (2 decks)

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