Unit 9

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Unit 9
2012-03-13 08:41:50
Legal Issues

Legal Issues
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  1. Where does statutory law come from?
    US Congress or elected legislative bodies
  2. Explain the Nurse Practice Acts
    An example of a state statute, defines the legal boundaries of nursing practice within each state
  3. What does regulatory or administrative law deal with
    reflects decisions made by administrative bodies such as State Boards of Nursing when they pass rules and regulations. Example of a regulatory law is the duty to report incompetent or unethical nursing conduct to the State Board of Nursing
  4. What can statuatory law be defined as?
    Either civil or criminal
  5. Explain criminal laws
    prevents harm to society and provides punishment for crimes
  6. What are the two classifications of crimes?
    • Felony-crime of serious nature that has a penalty of imprisonment for greater than one year or even death
    • Misdemeanor-less serious crime that has a penalty of a fine or imprisonment for less than one year
  7. What do civil laws do?
    Protects the rights of individual persons within our society and encourages fair and equitable treatment amoung people
  8. What are standards of care?
    Legal guidelines for nursing practice and provide the minimum acceptable nursing care
  9. What has the American Nurses Association done?
    Developed stadards for nursing practice policy statements, and similar resolutions. The standards outline the scope, function, and role of the nurse in practice
  10. What does the joint commission do?
    Requires that accredited hospitals have written nursing policies and procedures. Very specific and need to be accessible on all nursing units
  11. Define the Americans with Disabilities Act
    Broad civil rights statute. Protects rights of disable people. Extensive law on how employers must treat health care workers and clients infected with HIV.
  12. What is the Emergency Medical Treatment and Active Labor Act?
    EMTALA-Any client that comes to the ER must get an appropriate medical screening.
  13. What is the Mental Health Parity Act?
    Forbids health plans from placing lifetime or annual limits on mental health coverage that are less generous than those placed on medical or surgical benefits
  14. What are advance directives?
    Living wills and durable powers of attorney for health care. Based on values of informed consent, client autonomy over end-of-life decsions
  15. What is the Patient Self-Determination Act?
    Requires health care institutions to provide written information to clients concerning the clients' rights under state law to make decisons, including th right to refuse treatment and formulate advance directives
  16. What is a living will?
    Represents written documents that direct treatment in accordance witha client's wishes in the event of a terminal illness or condition.
  17. What is a durable power or attorney for health care?
    Legal document hat designates a person or persons of one's choosing to make health care decisons when the client is no longer able to make decsions on his or her own behalf.
  18. What is HIPAA and what does it entail?
    • Provides rights to clients and protects employees. Protects individuals from losing their health insurance when changing jobs by providing portability.
    • Privacy-right of clients to keep information about themselve from being disclosed
    • Confidentiality-how health care providers treat client private information once it has been disclosed to others. Nurses help organizations protect clients' rights to confidentiality
  19. Explain restraints and The Federal Home Reform Act
    • gives residents in certified nursing homes the right to be free of unnecessary and inappropriate restraints.
    • The joint commission set forth guidelines that health care providers can use restraints
    • 1. only to ensure the physical safety of the resident or other residents
    • 2. When less restrictive interventions are not successful
    • 3. Only on the written order of a physician or health care provider with a specific episode with start and end times
  20. Explain licensure
    The State Board of Nursing licenses all registered nurses in the state in which they practice. Requirements vary among states but most states have minimum education requirements and require a licensure examination. All states use NCLEX
  21. What are Good Samaritan Laws?
    Encourage health care providers to assist in emergencies at an accident scene and will limit liability and offer legal immunity for nurses who help
  22. What are Public Health Laws?
    State legislatures enact statutes under the health code, which describes the reporting laws for communicable diseases, school immunizations, and laws intended to promote health and reduce health risks in the communities
  23. What is the Uniform Determination of Death Act?
    • Two standards for the determination of death
    • 1. The cardiopulmonary standard requires irreversible cessation of circulatory and respiratory functions
    • 2. The whole-brain standard requires irreversible cessation of all functions of the entire brain, including the brain stem
  24. What is Physician Assisted Suicide?
    • Physician or health care provider-assisted suicide, the statue states that a competent individual with a terminal disease could make an oral and written requst for medication to end his or her life in a human and dignified manner.
    • A terminal disease is an "incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgement, produce death within 6 montsh
  25. What is a tort?
    civil wrong made against a person or property
  26. What are intentional torts?
    willful acts that violate another's rights, such as assault, battery, and false imprisonment.
  27. What are quasi-intentional torts?
    are acts where intent is lacking but volitional action and direct causation occur, such as found with invasion of privacy and defamation of character
  28. What are intentional torts?
    Includes assault, battery, false imprisonment
  29. Define Assault and what type of tort is it
    • Intentional threat to bring about harmful or offensive contact. No actual contact is necessary. RN cannot threaten to give a client an injection if the client has refused consent.
    • Intentional Tort
  30. Define battery and what type of tort is it?
    • Intentional touching without consent. The contact can be harmful to the client and cause an injury, or it can be merely offensive to the client's personal dignity. If an injection is actually given, it is battery.
    • Intentional Tort
  31. Define false imprisonment and what type of tort is it?
    • Unjustified restraining of a person without legal warrant, a nusre restrains a clien inn a bounded area to keep the person from freedom.
    • Intentional Tort
  32. Define invasion of privacy and what type of tort is it?
    • Four types: Intrusion on seclusion, appropriation of name or likeness, publication of private or embarrassing facts, publicity placing one in a false light in the public's eye, and release of a client's medical information to an unauthorized person
    • Quasi-Intentional Tort
  33. Define defamation of character and what type of tort is it?
    • Publication of false statements that results in damage to a person's reputation.
    • Quasi-Intentional
  34. What is negligence and what type of tort is it?
    • Conduct that falls below a standard of care. Examples such as hanging the wrong IV solution or allowing a CNA to administer meds
    • Unintentional Tort
  35. What is malpractice and what type of tort is it?
    • Type of negligence referred to as professional negligence. When nursing care falls below a standard of care, nursing malpractice results. The criteria are: 1. The nurse owed a duty to the client 2. The nurse did not carry out that duty 3. The client was injured 4. The nurse's failure to carry out the duty caused injury
    • Unintentional Tort
  36. What is informed consent?
    A person's agreement to allow something to happen, such as sugery or an invasive diagnostic procedure, based on a full disclosure of risks, benefits, alternatives and consequences or refusal
  37. Explain risk management?
    system of ensuring appropriate nursing care that attempts to identify potential hazards and eliminate them before harm occurs
  38. What is the American Nurses Association?
    • Standards for nursing practice, policy statements & resolutions
    • ANA code of ethics for Nurses
    • ANA principles for nursing practice
    • Nursing: scopes and standards for practice
  39. What is nursing care quality assurance commission?
    • Assures safe/quality nursing care for people of Washington State
    • Defines the scope and standards of practice
    • Determines the necessary qualifications for competency assurance while authorizing individuals the right to practice nursing
    • Limits the practice of those individuals from practicing below minimum safe competent levels
  40. What is the nurse practice act and who makes it?
    • Defines scope of practice
    • provided through the Washington State Legislature
    • Practical and registered Nursing licensure and education requirements
  41. What is WAC 246-840-700?
    • Standards of nursing conduct or practice
    • Defines the standards for initiating the nursing process
  42. What is WAC 246-840-705?
    Defines functions of a registered nurse
  43. What is WAC 246-840-710?
    Violations of standards of nursing conduct or practice
  44. What is WAC 246-840-730?
    Mandatory reporting
  45. What is WAC 246-16?
    Standards of professional conduct (sexual misconduct-mandatory reporting & sanctions)
  46. What is the complaint process?
    • RCW 34.05 Administrative procedure act
    • Complaint filed
    • Determination of complaint merit
    • Investigation conducted (if merit) if no supporting evidence complaint is closed
    • If supported-presented to DOH panel of members to approval to take action
    • Actions include but not limited to fines, counseling, re-training, practice limitations, or suspension from practice
  47. What standards are nursing students held too?
    • Liable for actions or lack of actions that harm clients
    • In this case instructor, hospital, health care facility, and college or university usually share liability
    • Expected to perform as professional nurses in providing safe client care
    • Perform within your role
  48. What does statutory law entail?
    • Nurse practice acts
    • criminal law
    • civil law
  49. What does regulatory law entail?
    state board of nursing regulations
  50. What does common law entail?
    • Informed consent
    • Right to refuse treatment
  51. Explain statutory law?
    • Created by elected and appointed officials
    • Nurse practice act is state statute (RCW's only)
    • WAC's are developed by Washington State Nursing Care Quality Assurance Commission
  52. What are some STATE statutes affecting nursing?
    • Good Samaratin Law
    • Public Health
    • Uniform Determination of Death Act
    • The Washington Death with Dignity Act
  53. What are FEDERAL statutes in Nursing?
    • American with Disabilities act
    • EMTALA
    • Mental Health Parity Act
    • Advance Directives
    • Uniform Anatomical Donor Gift Act
    • HIPAA
    • Federal Nursing Home Reform Act
  54. What is common law?
    Case law created by judicial decisions such as Roe v. Wade
  55. What is informed consent?
    • Healthcare provider is responsible for informed consent
    • nurses usually witness consent forms
    • nurses are responsible to notify health care provider or supervisor if client does not understand procedure to take place so tht proper education can be done
  56. What is the abortion law?
    • Roe v. Wade estabished a right to privacy which included a woman's decision to have an abortion
    • 1st trimester-no state regulation
    • 2nd trimester-state had an interest in protecting maternal health
    • 3rd trimester-states interest is to protect the fetus
    • 1989-further narrowed-parental consent & viability tests
  57. What is civil law?
    Protection of a person's rights, not society as a whole
  58. What is civil law in nursing?
    • Unintentional torts
    • negligence
    • malpractice
  59. Define negligence
    Conduct that falls below standard of care characterized by inadvertence, thoughtlessness, inattention, or carelessness
  60. Describe malpractice
    • The nurse owed a duty to the client
    • The nurse did not carry out that duty
    • The client was injured
    • The nurses failure to carry out the duty caused injury
  61. What is the leading cause of malpractice?
    • Poor client relations
    • Documentation
    • Risk manager
  62. What is RCW 18.79.260?
    • Delegation
    • Right task, circumstance, person, direction/communication, supervision
  63. What is risk management for?
    • System of looking at care for appropriateness and idnetification of potential errors before they happen
    • Identifying possible risks
    • Analyzing risks
    • Acting to reduce risks
    • Evaluating steps taken
  64. What is the patient's bill of rights?
    • Assessing providers
    • Protecting the patient privacy
    • Receiving the benefits
    • Appealing a denial or filing a grievance
    • Getting an independent 3rd party review of appeal
    • Seeing damages that result from denial of care
  65. Explain criminal law
    • Acts that threaten society and its order
    • Criminal acts are prosecuted
    • Felony=serious crime
    • Misdemeanor=less serious crime
  66. What is a tort?
    Civil wrong
  67. What are notifiable conditions?
    • Principal health care providers shall notify public health authorities of conditions identified in Table HC-1
    • Health care facilities shll notify public health authorities of cases that occur in their facilities of the conditions listed in Table HF-1
  68. What is slander?
    Verbal tort
  69. What is libel?
    Written tort
  70. What is patient abandonment?
    Involves the nurse leaving her assignment without transferring patient care and reporting off to an appropriate care giver