Week 7 Flashcards
Liability
person is financially or legally responsible for something. Nurses are legally responsible for their own actions, and this responsibility cannot be delegated—this is the basis for liability in nursing practice
malpractice
one source of legal liability. It means that a professional person has failed to act in a reasonable and prudent manner.
The Patient Self-Determination Act (PSDA) of 1991
the patient’s right to make decisions regarding their own healthcare. The healthcare provider must inform the patient about available medical or surgical treatment options and benefits, risks, and alternatives
The Patient Self-Determination Act requires healthcare facilities to:
Provide written information to each patient regarding the right to make decisions, including the right to accept or to refuse medical treatment and the right to make advance directives.
Document in the patient’s medical record the presence or absence of advance directives.
Provide education to the staff, healthcare providers, and community on advance directives.
Follow state law as it relates to advance directives.
Treat everyone the same regardless of the presence or absence of advance directives (facilities may not discriminate).
The HIPAA was passed by Congress in 1996
Protect health insurance benefits for workers who lose or change their jobs
Protect coverage to persons with preexisting medical conditions
Establish standards to protect the privacy of personal health information
Emergency Medical Treatment and Labor Act (EMTALA)
requires healthcare facilities to provide emergency medical treatment to patients (including those in labor) who seek healthcare in the emergency department (ED), regardless of their ability to pay, legal status, or citizenship status.
Mandatory Reporting Laws
You also have a duty to report physical, sexual, or emotional abuse or neglect of vulnerable individuals (e.g., children, older adults, the mentally ill), whether you suspect it or have actual evidence of it and to protect society against the spread of communicable diseases.
Good Samaritan Laws
must be provided in an emergency situation,
in a reasonably competent manner,
was voluntary and not payable,
the person receiving did not protest,
for nurse have someone call 911, do not leave until transfer to someone of equal care, place under emergency care of other as soon as possible
Nurse Practice Acts
statutory laws passed by each state’s legislative body that define the practice of nursing. NPAs are designed to:
Regulate nursing practice to protect the health, safety, and welfare of the general public.
Define the scope of nursing practice.
Approve programs providing prelicensure nursing education to students.
Medical Malpractice Statutes
refers to a lawsuit brought against a healthcare provider for damages (e.g., money) when there has been death of, injury to, or other loss to the person being treated.
ANA Code of Ethics for Nurses
describes nurses’ obligations for safe, compassionate, nondiscriminatory, and quality care while defining commitments to self, the patient, the employer, and the profession. The Code of Ethics is not a law
American Nurses Association Nurses’ Bill of Rights
Practice in a manner that fulfills their obligations to society and to those who receive nursing care
Practice in environments that allow them to act in accordance with professional standards and legally authorized scopes of practice
A work environment that supports and facilitates ethical practice as defined by the Code of Ethics for Nurses
Freely and openly advocate for themselves and their patients, without fear of retribution
Fair compensation for their work, consistent with their knowledge, experience, and professional responsibilities
A work environment that is safe for themselves and for their patients
Negotiate the conditions of their employment, either as individuals or collectively, in all practice settings
A state’s NPA usually includes the following:
The authority of the board of nursing, its composition, and powers
A definition of nursing and the boundaries of nursing practice
Standards for the approval of nursing education programs
The requirements for licensure of nurses
Grounds for disciplinary action against a nurse’s license
Malpractice/Negligence Liability
4 elements
duty, breach of duty, causation, and damages
duty- forms when the patient is assigned to the nurse or seeks treatment from the nurse, or when the nurse observes another person doing something that could harm the patient.
causation- shows a connection to the failed breach of duty and direct and proximate cause of injury.
Vicarious Liability
Captain of the ship- used to sue physicians for those under his employee
Borrowed servant doctrine- nursing agencies are not sued but the hospital temporary employer is.
respondeat superior- employer is sued based on employee working within scope of practice when mistake is made.
stages of the litigation process
pleading and pretrial motions-
filing a complaint and beginning the process
Discovery Phase- gather information and interviews
Alternative dispute resolution-
negotiation, mediation, arbitration
Trial process
Appeal
common malpractice lawsuits
failure to respond.
failure to educate.
failure to follow standards of care and policies and procedures.
failure to communicate (Providers)
failure to document
failure to advocate for patient
when documenting keep information FACTUAL
F- factual no opinion
A- accurate
C- complete
T- timely
U- an unusual occurrence
A- assessment data and responses
L- its a legal document
elements of informed consent
completeness
clarity and comprehension
Voluntariness
Competence
The 5 rights of delegation
delegating to the right person, under the right circumstances, using the right directions and communication, and practicing the right supervision and evaluation
To do this safely, you (the delegator) must know the education background, knowledge, experience, and physical and emotional capability of those to whom you delegate (delegatee)
types of malpractice insurance
Occurrence-type insurance- cover incidents that occur during policy, despite when claim takes place.
Claims-made insurance- only covers when it is active and stops when canceled
Autonomy
Autonomy refers to a person’s right to choose and ability to act on that choice. It is based on respect for human dignity.
Nonmaleficence
The principle of nonmaleficence is the twofold duty to (1) do no harm and (2) prevent harm. It encompasses actual harm, risk of harm, and intentional and unintentional harm.
Beneficence
Beneficence is the duty to do or promote good. At one end of the continuum is beneficence, the duty to bring about positive good; at the other end is the duty to do no harm.
Paternalism
Although viewed by some as beneficence, paternalism (treating others like children) can have negative consequences. negative to autonomy
Fidelity
Fidelity (faithfulness) is the duty to keep promises.
Veracity
the duty to tell the truth.
Justice
the obligation to be fair. It implies equal treatment of all patients.
VALUES CLARIFICATION
refers to the process of becoming conscious of and naming one’s values (Burkhardt & Nathaniel, 2014). If you are clear about your values, you will be more able to make good decisions and avoid imposing your values on others.
problem solving using the MORAL model
M-massage the dilemma
O- outline the options
R- resolve the dilemma
(using autonomy, nonmaleficence, beneficence, and fidelity/veracity)
A- act by applying the option
L- look back and evaluate
how providers utilize documentation
communication between staff,
continuity of care,
quality improvement,
planning and evaluating of outcomes,
legal record,
professional standards of care,
education and research,
reimbursement purposes,
data collection for research
how are health records system organized
source-oriented- members of each discipline record findings in a separate section of the record (admission data, history and physical summary, laboratory data etc…)
Problem-oriented- each section revolves around an individual issue being followed
chart by exception- flowsheet with standard routine care is only filled in when outside the normal ranges
Electronic health record- combines problem and source, but mostly follows source oriented.
Common Formats for nursing notes
