Week 2 - documentation and legal issues Flashcards
What are the 5 foundations of legal and ethical responsibilities of the nurse?
- follow laws and guiding docs
- meet entry level compentencies and standards of practice
- gain competence in specific areas
- Maintain fitness to practice
- continuous learning
What are the three formal things nurses must follow in their practice?
- law
- regulation
- code of ethics
What is CRNM guided by?
the RHPA- regulated health professions act
What document do nurses follow for ethics?
CNA code of ethics for registered nurses
What is the RHPA?
-umbrella law
- statute law
- governs the practice of 21 diff health professions
- defines reserved acts
- only HCPs can perform acts under RHPA
- defines how a profession registers its members
- defines how professions are designated and governed
- title protection
- sets requirements for standards of practice, code of ethics, practice directions, PD, conduct and managing complaints
- how to become a regulated profession
What are reserved acts?
- need special training and show compentency
- not exclusive to any one health profession. encourages IPC
When did RNs come under RHPA?
May 31 2018
What CRNM regulations govern nursing practice and expand on the RHPA?
- practice of registered nursing regulation
- College of registered nurses of Manitoba general regulation
what is the practice of registered nursing regulation under CRNM?
- scope of practice- which reserved acts can be done by RN
What is the college of registered nurses of manitoba general regulation under CRNM?
- how to become an RN, title protection, reserved acts, standards of practice
What are CRNM practice directions?
-written statements about RN practice
- more detailed than regulations
- minimum nurses should practice
- manage public’s expectations
- legal reference to describe reasonable and prudent nursing practice
- compliance with practice directions is required
Which is more detailed, regulations or CRNM practice directions?
CRNM practice directions
What are the 10 CRNM practice expectations for RNs?
- professional practice
- competent practice
- ethical practice
- professional communication
- cultural safety, cultural humility and anti-racism
- Client centered practice
- collaborative practice
- Follow up to diagnosis and tests results
- practice environment
- client records
what 3 things does the CRNM do ?
- protect the public
- set standards for RN education and practice
- take action when standards are not met
what are the 5 components of the CCP (continuing compentency program)?
- self assessent
- learning goals and plan
- documentation of learning activities to meet goals
- jurisprudence learning module online
- report actual practice hours
when complaints are made and inquiries, what two things do they make their determinations on?
- standards of practice
- code of ethics
what is professional misconduct?
act or omission that falls short of what would be considered proper in the same circumstances
what are 4 foundations of professional misconduct?
- abuse of a client or staff
- falsification of record
- abandonment
- breaking the law
What is the main role of CRNM?
protect the public
What is the role of the college/educational insitutution such as UofM?
advance nursing education
What is the role of a union (MNU)?
to support the nurse and strengthen working conditions
WHat is the role of an association like ARNM?
advance profession and improve health of the public
What is the role of liability protection (CNPS) ?
provide protection for nurses in legal situations
What is civil tort of negligence?
- Civil wrong occurs
- the harmed party seeks compensation
-when standards of practice are not met - negligence lawsuit or civil suit (care not reasonable or prudent)
what is negligence ?
conduct that is below the standard that is expected as a nurse
What 5 elements MUST be PROVEN before someone can be found guilty of neglegence?
- duty of care
- breach of duty
- Forseeable harm caused by breach (presence of injury/damage)
- causation
- patient did not contribute to negligence and or/accept risk voluntarily
What does duty of care mean?
“duty to exercise a reasonable degree of skill, knowledge and care in the treatment of a patient”
- patient was assigned to the nurse
- nurse was suppose to follow EIP protocols
- act in a manner that meets or exceeds prudent caregiver standards
- you must see and examine your patient
- record keeping
- give proper report/handoff
- supervise colleagues with less experience
how do we know there was Breach of duty?
there was neglegence based on evidence from:
- documentation
- organizational policies
- staffing levels and workload
- experts
What does it mean when there’s a breach of duty to care when injury or harm is invovled?
- financial, property damage, injury, death or disability
- degree of harm determines the size of award $
What does Causation mean?
injury or harm is direct result of nurse’s action or inaction
- must be a clear link
Can negligence reach a level that warrants criminal charges?
yes
Manianatha case:
1. criminal code - neglegence
2. civil tort - family sued
3. CPSS - 6 month suspension and upgrade skills
What are the 3 diff outcomes an RN who does not uphold their legal and ethical duties could be subject to?
- Violation of statute law (criminal negligence)
- Violation of civil/tort law
- CRNM investigation and discipline
What is the Manitoba Fatality Inquiries Act?
-cheif medical examiner in MB oversees investigation of all unexpected and violent deaths
What is an inquest?
a court hearing
before a judge
examines facts around cause and manner of someone’s death
- goal is not to blame but understand why - prevention
- judge makes recommendations to change policy
- inquest reports are public
What are reportable deaths?
CME - chief medical examiner must be notified of deaths that are unexpected/sudden or a child
- don’t move the body if medical examiner is involved
what is the purpose of nursing documentation?
- communicate with care team
- continuity of care
- proves care = standards
- compliance with professional standards of care
- QA-chart audits + accreditation
- facilitates research
what are some errors in documentation?
- care & treatment is omitted from the record
- incorrect/inaccurate/vague info in the chart
- HCP don’t read the chart - info is there but they don’t do anything
