Week 12; legal class Flashcards
What 5 main elements must be present for a professional to be held liable for malpractice or professional negligence?
- duty
- breach of duty
- injury
- causation
- Foreseeable harm
What kind of liability is negligent supervision?
individual and direct liability
What 5 things is negligent supervision?
- negligent delegation
- failing to act upon reports
- unreported unsafe care
- failing to ensure that supervised staff know and follow policies and procedures
- unbalanced or inadequate staffing
What kind of liability is corporate liability?
direct
What 4 things do corporate liability principles hospitals have a duty to?
- Use reasonable care in maintaining safe and adequate facilities and equipment
- Formulate adequate policies to ensure quality of care for patients
- Oversee all persons who practice within it’s walls (organizational structure)
- Select and retain competent physicians and staff (Dearman, n.d.)
What are examples of breaches of a health care facility’s corporate duty?
Slippery floor; inadequate lighting Broken patient care equipment Out of date or missing patient safety policies Understaffed nursing units Negligent hiring (verifying licenses) Failing to fire incompetent staff
A staff nurse failed to take appropriate action on behalf of a patient with c/o SOB & chest pain and who subsequently died of a massive MI. For which type of liability (individual, corporate, negligent supervision) might the bedside nurse be held?
individual or direct liability
A staff nurse failed to take appropriate action on behalf of a patient with c/o SOB & chest pain and who subsequently died of a massive MI. For which type of liability (individual, corporate, negligent supervision) might the charge nurse be held?
it depends. (Negligent supervision and individual).
A staff nurse failed to take appropriate action on behalf of a patient with c/o SOB & chest pain and who subsequently died of a massive MI. For which type of liability (individual, corporate, negligent supervision) might the the nurse manager be held?
it depends. (negligent supervision and individual).
A staff nurse failed to take appropriate action on behalf of a patient with c/o SOB & chest pain and who subsequently died of a massive MI. For which type of liability (individual, corporate, negligent supervision) might the the hospital be held?
It depends. Would be corporate.
Which is true about vicarious liability? (select all that apply)
a. is dependent on the legal relationship between two entities
b. most commonly involves a relationship between employer and employee
c. is based on the legal principle of respondeant
d. is a form of direct liability
A, B, C. (form of indirect liability)
What is direct liability a breach of?
breach of duty
What 2 liabilities are direct liability?
- individual liability
a. negligent supervision - direct or individual - corporate liability
What type of liability is negligent Supervison?
individual liability
What’s indirect liability not a breach of?
not a breach of duty
What is vicarious liability?
indirect liability
What is Arizona’s Good Samaritan law?
the law provides that any person who renders aid at the scene of an emergency is not liable for any damages as a result of an act or omission so long as the care was provided.
What 3 things must be met in order to have no liability for any problems that arise in Arizona’s Good Samaritan law?
1) in good faith; 2) for no money or other consideration; and 3) the person was not grossly negligent.
What is the volunteer protection act 1997?
A volunteer of a nonprofit organization or governmental entity is not liable for harm caused by an act or omission done in the scope of responsibility on behalf of the organization.
When does the volunteer protection act apply?
This applies if the volunteer was properly authorized and licensed, if such authorization is needed.
What is A.R.S. volunteer protection?
“A volunteer is immune from civil liability in any action based on an act or omission resulting in damages if volunteer acted in good faith and within scope of official functions and duties for a non-profit corporation or non profit organization, hospital or governmental entity”
What is the exception of the volunteer protection?
willful, wanton, or grossly negligent misconduct.
When should you complete an incident report?
- Any time a patient makes a (significant) complaint
- Medical errors (including medication errors)
- Medical device/equipment malfunctions
- Patient, staff member, or visitor is assaulted or threatened with assault
- Patient, staff member, or visitor is injured or involved in an incident with significant risk of injury
- And any incident as defined in your organizations policies and procedures
What are other legal responsibilities of the nurse manager?
Policy and procedures Chain of command Monitoring patient care Auditing medical records Staff education Best practice standards; disseminating research Communication --> healthy work environments --> creating safe environment for reporting poor/unsafe care
According to a AZSBON advisory opinion, it is within the scope of practice of the RN to do what 2 things?
- to obtain informed consent for treatments and procedures that the RN will perform
- to witness signatures on documentation indicating understanding of informed consent provided by other practitioners, such as physician assistant, nurse practitioner, and physician (expressed consent).
According to a AZSBON advisory opinion, it is NOT within the scope of practice of the RN to do what?
It is NOT within the scope of practice of the RN to obtain informed consent for medical treatment plans.
A minor’s legal rights to give consent is based on which type of law?
a. common
b. state
c. federal
d. mature minors doctrine
e. Supreme Court decisions
All of them!
What is unwritten law based on precedent; used when there is no other law?
common law
Which statements are true about incident reports?
a. they are part of the patient’s legal medical record
b. they are considered confidential communications among hospital personnel
c. They can be used as evidence in a lawsuit
d. they must be received and signed by a patient.
B, C.
What is age of consent (18 in most states) and exceptions?
state law
Nurses seeking expressed consent for a medical procedure must first…….:
a. verify the patient’s identity and watch him/her sign the consent form
b. witness the physician provide all necessary info about the procedure to the patient
c. assess the patient’s understanding of the info provided as part of the informed consent process
d. provide information on the medical procedure to patients based on identified knowledge deficits.
A, C.
- it is within the scope of practice of the RN to obtain informed consent for treatments and procedures that the RN will perform.
- It is within the scope of practice of a RN to witness signatures on documentation indicating understanding of informed consent provided by other practitioners, such as PA, NP, and physician.
- NOT within the scope to obtain informed consent for medical treatment plans.
What is the right to privacy when seeking contraception and abortion?
Supreme Court decisions
What are the exceptions to state minors’ consent law from state to state?
mental health services, contraception, pregnancy, substance abuse, homeless teens, emancipated teens, legally married
State minors’ consent law are not always what?
intuitive
What is the state minors’ consent law usually tied to?
privacy/confidentiality
What is best practice for state minors’ consent law?
include minors and parents in medical consent and decisions whenever possible.
what is discrimination in the workforce?
Hiring, firing , demoting, promoting, training, wages, benefits and disciplining an employee based on any of the following categories
What can you not discriminate based on the workplace?
Age (40+) Race, ethnicity or national origin Citizenship (and status) Disability Sex Sexual orientation* Gender identity* Gender expression* Marital status Religion Pregnancy and children Genetic information Whistle blowers or people who have filed a discrimination complaint Political association People represented by a union or who wish to form, join, or support a union Military service (past, present or future obligations) Accents
what happened in June 2020 with the US Supreme Court?
ruled that federal law bans employment discrimination based on sexual orientation and gender identify.
What was happening up until the ruling in June 2020?
Up until that ruling, it was up to individual states to ban employment discrimination of this population.
What is employment harassment?
Offensive conduct based on race, color, religion, sex (including pregnancy), national origin, age (40+), disability and genetic information
What does offensive conduct include?
offensive jokes, slurs, epithets or name calling, threats, intimidation, ridicule or mockery, insults or put-downs, offensive objects or pictures,
When is employment harassment illegal?
- Enduring the behavior becomes condition of continued employment
Is severe or pervasive - Creates a hostile work environment
- Does not need to be the supervisor
What is the Arizona Medical Marijuana Act?
Unless a failure to do so would cause an employer to lose a monetary or licensing related benefit under federal law or regulations, an employer may not discriminate against a person in hiring, termination or imposing any term or condition of employment or otherwise penalize a person based upon either:
- The person’s status as a cardholder.
- A registered qualifying patient’s positive drug test for marijuana components or metabolites, unless the patient used, possessed or was impaired by marijuana on the premises of the place of employment or during the hours of employment.
Who can also not get in trouble int he Arizona Medical Marijuana Act?
A registered qualifying patient or registered designated caregiver is not subject to arrest, prosecution or penalty in any manner, or denial of any right or privilege, including any civil penalty or disciplinary action by a court or occupational or professional licensing board or bureau.
what are 4 federal laws regarding drugs that impact nurses and health care?
- 1970 Controlled Substances Act
- 1988 Drug-Free Workplace Act
- 1989 Drug-Free Schools and Community’s Act
- 2018 Farm Bill legalizing production, sale, possession and use of Hemp/CBD
What are 3 state laws that impact nurses and health care?
- Arizona Medical Marijuana Act 2010 (ARS 36-2811)
- Drug Testing of Employees Act (2011)
- Smart and Safe Act (Approved by voters Nov 2020)
What is 1 policy that impacts nurses and health care?
AZBON
What did the 1970 controlled substances act criminalize?
Criminalized the possession, manufacture, distribution and sale of schedule 1 drugs
What are schedule 1 drugs under the controlled substances act?
Criminalized the possession, manufacture, distribution and sale of schedule 1 drugs. With Heroin, LSD, Ecstasy, Peyote
What are schedule 2 drugs under the controlled substances act?
Oxycontin, morphine, Dilaudid, methadone, opium
What does the 1970 controlled substances act prevent?
Prevents providers from prescribing marijuana (or advising doses)
What did the 1970 controlled substances act complicate?
access for hospitalized patients
What does the Arizona Medical Marijuana Act 2010 prevent?
Prevents employers from discrimination of an employee or prospective employee:
- who is a qualified AMMA patient for a positive drug test for marijuana components or metabolites
- Unless employer would loose employer to lose a monetary or licensing related benefit under federal law
What does the Arizona Medical Marijuana Act 2010 prohibit?
Prohibits professional regulatory boards from disciplining individuals simply for having a medical marijuana card, using marijuana, or being a designated caregiver as permitted by law
Who cannot certify their patient for marijuana?
AZ APN
Who can certify their patients for marijuana?
only MDs, DOs, ND/NMDs in Arizona
What is HB 2541 say?
says an employer can fire someone without fear of retribution if the employee is in a “safety-sensitive” role and the employer has a “good faith belief” the staffer has been impaired during work hours.
what did the 2019 new medical marijuana law added?
added quality and cost controls
What did the 2020 smart and safe act do?
legalize recreational marijuana
Which much be reported to the AZSBN within 10 working days?
a. felony charges
b. felony convictions
c. misdemeanor criminal charges involving conduct that may affect patient/public safety
d. misdemeanor criminal convictions involving conduct that may affect patient/public safety.
A, B, C, D.
According to the AZNPA, who must report a criminal charge or conviction against a licensed nurse?
- The applicant or licensed offender (self-reporting) BEST
- Licensees, certificate holders, and health care institutions (36-401) who have any information that a licensee was or may be a threat to public health or safety
Failure to report a criminal charge or conviction against a licensed nurse could result in what?
could be disciplinary action by AZSBON for unprofessional conduct
According to the Arizona Nurse Practice Act, which misdemeanors must be reported to AZSBON? (Select all that apply)
a. domestic violence
b. credit card or insurance fraud
c. speeding ticket
d. DUI
e. barking dog
f. buying known stolen property
g. harassing 65+ faculty
h. burning your APA book at graduation
i. assaulting a co-worker
A, B, D, F, I
What are reportable misdemeanors?
Assault and related offenses
Theft and related offenses
Fraud, deceit and related offices
Abuse, neglect, exploitation of a child or vulnerable adult and related offenses
Sexual assault and related offenses
Drug and/or alcohol and related offenses (including a DUI)
Arson and related offenses
Animal abuse, cruelty and related offenses
Per AZ NPA what must happen with misdemeanors?
RNs must report these charges if they know or suspect that another nurse has not self reported
What are good reasons why nurses might want to avoid purchasing professional liability (malpractice) insurance?
- employer’s coverage will protect the nurse
- many employers advise against it.
- chance of getting sued is minimal.
- time and money
- could keep you in a lawsuit.
What are good reasons nurses should carry professional liability insurance?
- nurses should have their own legal rep.
- SBON complaints
- Practice outside of employment.
- Cost
- Employer may not cover the damages
What is legal principle which allows minors to make decisions if they can show they are mature enough to make a decision?
mature minor doctrines.
What is Title X of the Public Health Service Act and HIPPA?
Federal law
