legal ethical considerations for family health

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legal ethical considerations for family health
2014-10-13 14:12:19

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  1. What are Negligence and Malpractice?
    Negliance- failure to use such care as a reasonable prudent and careful person would use under similar circumstances

    malpractice- improper or unethical conduct or unreasonable lack of skill by a holder of a professional or official position- resulting in harm to a client

    breach of duty- failure to fulflill a duty
  2. Negligence
    • a charge of neligence against a nurse can arise from almost any action or failure to act that results in patient injury
    •  - most often due to an unintentional failure to adhere to a standard of clinical practice
    • - may lead to a malpractice law suit
  3. Malpractice
    • Professional negligence
    • failure to provide professional services with the skill usually exhibited by responsible and careful members of the profession, resulting in injury, loss, damage to the party contracting for those services

    standard of care: treatment process a clinician should follow for certain patient, illness or circumstances (procedure, treatment, meds)
  4. For a count to recognize as malpractice four legal elements must be present
    • 1. there must be a professional duty owed to the client by nurse
    • 2. the nurse must breach the duty
    • 3. the breach of duty must be the cause of damage
    •  commission- doing what should not have been done
    •  omission- failure to do what should have been done
    • 4. there must be an actual damage or harm to the client

    pt can sue for damages- money
  5. 5 rights to medication
    Dr. Tim- help u not breach duty to client
  6. Prevent malpractice suits by
    • build trusting relationships and be honest (excellent communication and allow time to ask questions)
    • maintaining excellent standards of care- keep up with ceu
    • self awareness and life long learning- identify ur strengths and weakness- get training
    • adapting proposed assignments- assist and be honest about what u can do, u can help
    • following policy, procedures and protocols
    • changing policy, procedures and protocols- bring this to ur supervisor's attention
    • proper documentation- if it is documented it is not done
  7. who is a mandated reported
    • physicians, hospital personnel involved in examination, medical examiners, nurses, emt, chiropracter, podiatrists, osteopath's 
    • school teachers, admins etc social workers, police, fire fighter etc, counselors, clergy. 

    anyone who is involved with working with children, elder, mental health, prisoner, disable

    report to state agency- when violence or neglect occurs on this population
  8. Nurse as Mandated reporter
    Most reporting statues include

    reporter has a good faith belief or reasonable suspicion

    reporter will be immune from civil, criminal or professional licensure actions (protected)

    reported identity is confidential 

    STI, domestic violence, abuse,
  9. Mandated reporting
    child abuse prevention and treatment act and reporting statues

    • as long as we suspect or confirm abuse it should be reported
    • state agency

    • child abuse
    • elder abuse
    • specified communiable disease
  10. Mass what if I fail to report?
    • any manadated reporter who fails to make a required oral or written report can be punished by
    • - a fine of up to $1,000

    any mandated reporter and u fail to report and injury or death involved- fine up to 5000 bucks and up to 2 1/2 years of prison
  11. How do I report
    • if a nurse suspects a child is being abused or neglected
    •  immediately discuss with the HCP
    • otherwise immediately make an oral report to dcf
    • after hours child at risk hotline
    • a written report 51a is submitted within 48hrs
  12. What is informed consent
    nurses cannot provide informed consent for procedure but can for a vaccine

    nurse witness- and make sure paper work filled out and in chart

    every client has to right to say what should be done to his or her body.

    IC- duty of a health care provide to discuss the risks and benefits of a treatment or procedure with a client prior to giving care
  13. IC must include the following
    • what the procedure is? 
    • risk and hazards of the procedure- complications that can arise
    • alternatives to the procedure- is there something else that can be done
    • benefits of procedure
  14. when IC is not required
    • emergency medical procedure for a minor adult
    • no consent required 
    • we would try to get parents consent- 
    • Life v death situation

    minor any person under the 18 years of age
  15. when is IC is not required
    evaluation and treatment- suspected of physical or sexual abuse- bc parents might be the abuser

    forensic (crime) the examiner must not force child to perform genital and rectal examine
  16. emanicipation
    when a child goes to court to get away from parent and be 

    • legal recognization that minor can be responsible for themselves- can occur thru court preceedings 
    • other ways it happens- marrying, joining the military, becoming a parnt 

    some states do not officially recognize any form of emancipation
  17. Minor consent for care
    some children are mature or been thru so much that they are deemed competent to identity risk and benefits of treatment
  18. Parental consent after divorce
    legal custody v physical custody
  19. refusal of medical care by parent or child
    • religious belief- state can make legal decision for the child
    • parens patriae- legal rule that allows the state to make decisions in place of the parents when they are unable or unwilling to provide for the best interest of the child
  20. refusal of medical care by parent or child 2
    some states use child abuse statues that make medical neglect a form of abuse as legal justification to take custody of a child who needs medical care

    the religious exemption clause only prevent the parents from being prosecuted for medical neglect
  21. Confidentiality
    the right to confidential health care is protected by the US constitution, federal and state law and the ethical codes of health care professionals 


    good for the relationship between provider and client

    nurse has a duty for confidentiality
  22. Confidentiality and the adolescent
    • independence from parents
    • assuming responsiblity- personal health, health behaviors, and medical decisions

    more likely to seek health care if believe provider will maintain confidentiality
  23. When can a minor receive confidential care
    • HIV testing and treatment
    • contraception, treatment of other STD's 
    • drug and alcohol treatment children as young as 12 years of age
    • mental health care
    • depending on state law
  24. When a health care provider can breach confidentiality
    • exceptions to confidentiality:
    •  1. child abuse/neglect- mandated reported
    • 2. suicidal or homicidal ideation- due to warn 3rd party
    • 3. violent injuries- required to report all gunshots and stab wounds- report to local authorities
    • 4. STI- reported to infectious disease to the local health department
    • 5. mental health care- break confidentiality if threaten harm to self or others