WK 2 Legal & Ethical Issues in Nursing Flashcards
scope of nursing practice
defines nursing and reflects the values of the nursing profession
important legal acts
american nurses association (ANA), evidence-based practice, the joint commission (TJC), nurse practice act, compact licensure
American Nurses Association (ANA)
defines what nurses can do and what they are taught in school
The Joint Commission
requires institutions to have all policies written and accessible by all nurses = what nurses are expected to know
nurse practice act
state laws related to licensure
all nurses myst be licensed in each state they work in
compact licensure
groups say you can be licensed in one state and work in another without retaking any tests or filling out other paperwork
patient protection and affordable care act
a legal act approved by congress that makes sure all Americans have access and ability to get healthcare insurance
4 components of the affordable care act
- consumer rights and protections
- affordable health care coverage
- increased access to care
- quality of care that meets the needs of patients
patient bill of rights
protection for people with pre-existing conditions
can increase insurance rates, but cannot deny insurance coverage
health insurance portability and accountability act (HIPPA)
establishes patient rights regarding privacy of their health care info and records
allows patient the right to their OWN medical record
limits who can have access to the chart
protected health information (PHI)
name, address, DOB, SSN, photographs, fingerprints, medical record #, phone #, driver’s license #, email, URL, IP address, Admit/discharge dates, any other unique ID #
if there are two or more items listed, this is considered PHI and is considered a HIPPA violation if shared
what is HIPPA comliant?
privacy rule, security rule, breach notification rule, safety rule
privacy rule of HIPPA compliance
should be responsible to keep personal health records private
security rule of HIPPA compliance
must keep patient files safe from any unauthorized access during transit and storage
breach notification rule of HIPPA compliance
have to inform affected individual in case of breach of unsecured patient info
safety rule of HIPPA compliance
it should protect identifiable protected health info that can be used to analyze and improve the safety of the patient
patient self-determination act
requires health care institutions to provide written info to patients concerning their rights to make decisions about their care, including the right to refuse treatment and to formulate an advance directive
components of the patient self-determination act
patients must be offered info about advance directive
durable power of attorney for health care (DPAHC)
lots of emphasis placed on patient’s decisional capacity
informed consent
an explanation of the procedure or treatment
name and qualifications of people performing and assisting in the procedure
description of serious harm, including health, that may occur as a result of the procedure and anticipated pain and/or discomfort
knows that he or she has the right to refuse the procedure/treatment
advance directives
document developed by the patient that instructs others to do tasks before, during and after their death
related to the patient self-determination act
important consideration for advanced directives
patients must have decision making capacity to sign an advanced directive and if they do NOT, then refer to AD for decision making related to health care
hospitals must ask patients if they have one, obtain a copy and if they do not, ask if they want info about creation of one
living will
type of advanced directive that gives more info about end of life preferences
can include info about DNR, enteral feedings, and other decisions about end of life care
patient must have decision making capacity to make a living will
do not resuscitate (DNR)
does not mean “do not care”
order = do not do CPR and other acts that may or may not be stated on the living will/advanced directive
can be revoked at any time by the patient with decisional capacity
other important legal acts
EMTALA, Americans with Disabilities Act (ADA), mental health parity and addiction equity act, omnibus budget reconciliation act
EMTALA
when a person presents to an ED, the have to be treated NO MATTER WHAT
ADA: Americans with Disabilities Act
protects rights of people with physical or mental disabilities
Mental Health Parity and Addiction Equity Act
requires health insurance coverage for mental health and substance use treatment
Omnibus Budget Reconciliation Act
centered on protection of older adults, legal use of physical and chemical restraints in any setting
state statues impacting nursing practice
good samaritan laws, public health laws, the uniform determination of death act
good samaritan laws
limit liability and offer legal immunity if a nurse helps at the scene of an accident
can do anything in the scope of your practice
public health laws
laws affect individuals, populations and communities that are intended to improve the health of people
the uniform determination of death act
determines actual death
values
deeply held belief about the worth of an idea, attitude, custom, or object that affects choices and behaviors
values clarification
ethical dilemmas almost always occur in the presence of conflicting values
to resolve ethical dilemmas, one needs to distinguish among values, facts and opinion
types of ethical problems
ethical dilemma and moral distress
ethical dilemma
when two opposing courses of action can both be justified by ethical principles
moral distress
instead of competing options for action, the nurse feels the need to take a specific action while believing that action to be wrong
issues in health care ethics
social media, quality of life, care at the end of life, access to health care
list of ethical principles
autonomy, beneficence, non-maleficence, justice, fidelity
autonomy
freedom from external control
beneficence
taking positive actions to help others
non-maleficencce
avoidance of harm or hurt
justice
fairness and distribution of resources
fidelity
faithfulness or agreement to keep promises
professional nursing code of ethics
advocacy, responsibility, accountability, and confidentiality
