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Leadership Term 4 ABSN > Week 5 lecture study > Flashcards

Week 5 lecture study Flashcards

1
Q

What are nurses held to that serves as a guide in their practice?

A

American Nurses Association Code of Ethics

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2
Q

Ethical

A

behaving in a way of respect to ones dignity and the rights of individual people using moral principles

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3
Q

Utilitarianism

A

End goal moral justifies even when the means are not moral

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4
Q

Deontology

A

both the means & end goal must be ethical and moral

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5
Q

What are the most common ethical concerns in healthcare?

A

allocation of scarce resources & end of life issues

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6
Q

Bioethics

A

subcategory of ethics, concerns that occur due to advancing science & technology
–> Stem Cell, cloning, genetic engineering

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7
Q

justice

A

Fairness. RN is fair when distributing care. All clients being cared for must get justly and equitably care.

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8
Q

Beneficence

A

doing good, RN does the right thing for client

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9
Q

Nonmaleficence

A

doing no harm, harm can be classified as intentional and nonintentional

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10
Q

accountability

A

Taking responsibility for one’s own actions. Take responsibility for all professional & personal consequences that occur due to their actions.

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11
Q

Fidelity

A

Keeping one’s promise.

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12
Q

Autonomy

A

Client self-determination. Encourage client to make own decisions w/o judgement or coercion

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13
Q

Veracity

A

Truthful. RN cannot withhold truth from client.

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14
Q

Recognize ethical dilemmas and take appropriate action:

A

RN has responsibility to recognize and ID ethical issues affecting staff or clients

Multidisciplinary ethics committees

Understand and apply ethical guidelines - ANA Code of Ethics. World Medical Association’s Code of Ethics

No automatic guidelines for solving ethical dilemma’s

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15
Q

Recognize ethical dilemmas and take appropriate action: problem definition

A

– clear description of the dilemma & circumstances

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16
Q

Recognize ethical dilemmas and take appropriate action: assessment process

A

gather facts, opinions, perceptions, collect data

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17
Q

Recognize ethical dilemmas and take appropriate action: ID those involved and available resources

A

review ethical codes, evidence based practices

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18
Q

Recognize ethical dilemmas and take appropriate action: data analysis

A

organize and analyze data collected

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19
Q

Recognize ethical dilemmas and take appropriate action: investigate

A

examine rights, duties, values

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20
Q

Recognize ethical dilemmas and take appropriate action: evaluate the results

A

measure in terms of effectiveness

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21
Q

Inform client / staff members of ethical issues affecting client care

A

RN’s responsibility to inform staff and clients of ethical issues that can/do affect care.

Client may ask nurse to do something unethical. RN must inform client they can’t do it for ethical & legal reasons.

Clients may ask for information on ethical actions to choose.

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22
Q

Nurse Practice Act

A

Outline legal scope of practice

Sets educational requirements

Facility policies govern practice in that particular facility

Standards of care-established by federal, state, professional organizations

Each state has own nurse practice act

Your state of work is most important affecting your care

Practicing beyond limits may lead to charges of violating act

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23
Q

Rules of Conduct

A

Legally use skills & knowledge to protect safety & comfort of clients

Laws are binding rules of conduct enforced by authority

Laws & ethics can overlap- you have to identify & examine fine lines that separate them.

If a law is challenged as unjust or unfair, usually reflects underlying ethical principle

Clients who feel they have been treated with disrespect or lack of dignity, or that their rights were ignored/violated –more likely to initiate legal action

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24
Q

Evaluate outcomes of interventions to promote ethical practice: things to ask

A

Is staff knowledgeable about ethics & ethical practice?

Is staff effectively applying ethical principles to their daily practice?

Are clients knowledgeable and informed about ethics & ethical practice?

Were all appropriate professional resources, including code of ethics & professional literature, employed to resolve the ethical dilemmas?

25
Q

Ethical dilemmas carry what

A

a great deal of stress

26
Q

Moral dilemmas call for what

A

Ethical choices in the face of profound uncertainty

27
Q

How can moral dilemmas be further complicated?

A

by psychological pressures and personal emotions

28
Q

What do many moral dilemmas involve?

A

choices about justice or fairness when scant recourses must be divided among clients with equal needs

29
Q

Dilemmas: Beneficence

A

Beneficence-often occur when providers, client or family members disagree about what course of action is in client’s best interest

30
Q

Dilemmas: Autonomy

A

often closely related to beneficence issues especially when family must make decision for what’s best for the client

31
Q

Dilemmas: Justice

A

example limited resources being divided fairly

32
Q

Dilemmas: fidelity

A

– balancing a client’s privacy against society’s right to be informed. Involves a commitment to veracity.

33
Q

Dilemmas: values

A

Encounter many conflicting sets of values. Must establish own ethical belief

Incorporate chosen values into everyday thoughts and actions

34
Q

informed consent

A

Clients have the right to knowledgeably consent to or reject all care and proposed treatments.

35
Q

informed consent: providing the client with what?

A

enough information to know what the client is getting into if they decide to undergo the proposed treatment or procedure as well as anticipated consequences if consent is refused or withdrawn

36
Q

informed consent: responsibility

A

Responsibility for obtaining informed consent rests with the person who will perform the treatment or procedure

37
Q

informed consent: what is client informed of?

A

Client must be fully informed regarding treatment, tests, surgery, and risks & benefits prior to giving informed consent

38
Q

informed consent: refusal

A

Client must be told they have the right to refuse the treatment or procedure without having other care/support withdrawn and that they may withdraw consent after giving it.

39
Q

informed consent: carrying out procedure without informed consent

A

Carrying out a procedure without informed consent may be grounds for charges of assault and battery.

40
Q

Elements of informed consent

A

Description of treatment or procedure

Description of inherent risks and benefits with frequency or regularity

Explanation of potential for death or serious harm or discomforting adverse effects during or after treatment/procedure.

Explanation & description of alternative treatments/procedures

Name & qualifications of person who is going to perform the treatment or procedure
Discussion of possible effects of not undergoing the treatment or procedure

Explanation of alternative treatments or procedures

Must disclose specific consequences that are particularly significant for the client if they exist

41
Q

Who can sign or appropriate person to provide informed consent

A

Must be from an adult client who is mentally competent

42
Q

Informed consent: next of kin

A

Next of kin may sign if adult is deemed incompetent, unconscious, can’t be obtained

  • People who may sign legal guardian, parent, legally appointed representative, clients durable power of attorney
  • Some situations where the above doesn’t exist then courts have guardianship and right to give informed consent if client can’t
43
Q

informed consent: emancipated minor

A

May consent to their own care/treatment

Only minors that are emancipated or married may give their own informed consent

Except in cases of pregnancy or sexually transmitted infections

44
Q

what is the exception to informed consent?

A

emergency situations

45
Q

responsibility of informed consent: nurse

A

Verification & witnessing

May provide information within scope of practice & knowledge base

Cannot substitute their own knowledge for the providers

Witnesses only doesn’t obtain actual consent

46
Q

Nurse: by witnessing informed consent, you attest to…

A

By witnessing you attest to: client voluntarily consented, client’s signature is authentic, client is competent to give consent

47
Q

Responsibility of informed consent: provider

A

Provide complete information, potential risks, benefits, who will perform, possible alternatives including their risks & benefits

48
Q

Responsibility of informed consent: client/representative

A

Must give consent voluntarily & without coercion

Must ask questions & clarify until fully certain

49
Q

Clarification of consent

A

The nurse is not providing informed consent.

The nurse is ensuring that the client/representative signs the form.

Witnessing the consent form is just one of many important tasks for RNs

50
Q

Information technology uses

A

Bar code patient identifiers

Bar codes for billing supplies, medications

Automated provider orders systems

Electronic medical records

Instant access to information i.e. facility policies

Analysis
Current information i.e. standards of care, evidence based practices

51
Q

risks of information technology

A

breaches of privacy, hacking, crashes

52
Q

advantages of information tech

A

Reduce risk of misinterpretation

Record of each person who entered/viewed client record

Offer standardized input, mandatory charting fields, flow charts, care plans

53
Q

Disadvantages of information techn

A

Use of incorrect prompt/phrase can give misleading assessment

Prompt isn’t descriptive then need for typing out assessment

Need for back up records

Ensuring completeness

Need all members to know how to use the system

54
Q

information technology: verification

A

Nurse’s have the responsibility of verifying providers orders.

–> They insure it is complete & appropriate and carried out in a timely manner

–> Nurse’s review an order for completeness, question orders that a client questions, question an order that doesn’t seem appropriate, question orders that aren’t clear.

–>The nurse is responsible for following up on any questionable orders.

55
Q

Why are telephone orders and verbal orders strongly discouraged?

A

may lead to serious error

  • Full documentation is a must including the reason for the phone call.
  • Must read the order back to provider to confirm. Some facilities require two nurses hear & confirm the order.
56
Q

Applying a Knowledge of Facility Regulations When Accessing Client Records

A

Mandated by law for facilities to have policies, procedures & educational activities related to accessing, viewing, and use of medical records & information.

HIPAA mandates safeguards to insure confidentiality, integrity, and availability

57
Q

Applying a Knowledge of Facility Regulations When Accessing Client Records: safegaurds

A

Primary safeguard is the signature code. Limits access to records

Policies for specific information such as HIV status

Software automatically records date & time of every entry and each correction including name of anyone who modifies a record.

58
Q

utilizing online resources

A

Responsible for identifying online resources in a complete and accurate manner before using with a client/staff.

Website that have url with .org, .edu, and .gov are generally reliable and accurate but may not be as current as needed.

Merck Manual, American Cancer Society, American Heart Association, CDC, WHO

Leadership Term 4 ABSN (4 decks)

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