The flashcards below were created by user
foxyt14
on FreezingBlue Flashcards.
-
to have the freedom and the right to make decisions for yourself.
autonomy
-
to do good for others, promoting goodness, kindness and charity
help heal, dont hurt
beneficence
-
the duty not to inflict harm.....dont do it if it will hurt somebody
nonmaleficience
-
the principle of truth telling
veracity
-
Abortion law in CA...cuz it is state spefific
cant have abortion after 26 weeks
-
States that allow assisted suicide/euthanasia
-
What act allows 2 Dr.'s to make the choice of sustaining a persons life or letting them die when they cant speak and dont have family present
Natural Death Act
-
Laws that are written and enacted by legislative bodies, where violations are criminal offenses and are punishable by fines or improsonment
Statutory Law
-
What statutes mandate a minimum standard of care in all settings that receive federal funds....(Medicare, Medicaid)
Federal statutes related to nursing and health care
-
Emergency Medical Treatment and Active Labor Law (EMTALA)
- prohibits the refusal of care to indigent/uninsured in the ED
- prohibits the transfer of unstable patients, including women in active labor from one facility to another
-
Americans with Disabilities Act of 1990
prohibits discrimination against persons with disabilities by removing barriers that might prevent the same opportunities available to persons without disabilities....language/wheelchairs
-
This requires all federally funded hospitals (Medicare, Medicaid) to inform their adult patients in writing about their right to make treatment choices
and
ask patients whether they have a living will or a durable power of attorney for health care
Patient Self Determination Act
-
Durable Power of Attorney
- all patients have the right to choose care or end of life decisions
- assignment of a person to make these decisions for them should they become incapacitated
**they have the knowledge and legal right
-
What supercedes all hospital policies?
Board of nursing for the state I am licensed/practicing in
-
3 things to know about the Nursing Practice Act
- it is revised every year
- my responsibility to look at and know changes
- can be found on www.rn.ca.gov.regulations
-
6 Standards of competence for nursing
- diagnosis
- how to form a plan of care
- how to perform and teach skills
- delegation of tasks
- evaluation effectiveness of care plan
- act as an advocate
-
-
Why are nurse patient ratios important?
research indicates that improved nurse-patient ratios are associated with lower "failure to rescue" rates and lower inpatient mortality rates
-
These things can only be done by an RN...cant be delegated to LPN or CNA
ADPIE
-
Under Child Abuse Prevention and Treatment Act we are obligated to....
report the following or be fined or imprisoned
- infant/child/elder abuse
- specified communicable diseases
-
Details of dependent elder abuse
Neglect...physical or financial should be reported to social services
must be reported within 36 hours
dont report....$1000 fine or 6 mo. in jail
-
If I am not comfy with a patient I have been assigned to or a circumstance...what do I do?
report it up the chain of command and decrease my liability
-
How do you become a preceptor?
one year of experience on that unit
-
What are standards of care?
- policies and procedures for the population I am taking care of
- would any reasonable nurse have acted in the same matter for this patient
-
Nursing case law
body of written opinions about nursing practice
-
An important nursing case law is Affirmative Duty...what is this?
the duty that nurses will exercise independent judgment to prevent harm to her patients
-
What 2 laws provide precedence and guidelines for deciding future cases
-
Negligence
failure to act in a reasonable and prudent manner
-
Malpractice
the failure of a PROFESSIONAL, or a person with a specialized education and training, to act in a reasonable and prudent manner
-
4 elements essential to prove negligence or malpractice
- breached duty of care
- breached standard of care
- suffering of harm/damage
- connection established between the standard of care given by the nurse and the patients injury
-
Example of breached duty of care
didnt give/get report
-
How do you make sure you dont breach the standard of care to your patients?
document the time you received report from the previous shift....that is when you are liable
-
Most frequent allegations of nursing negligence
- patient safety...meds, side rails, skills
- improper treatment/negligent perfromance of treatment
- failure to monitor/report significant findings
- medication errors
-
Res Ipsa Loquitur
- a doctrine that applies when the negligent act clearly lies within the range of a jury's common knowledge and experience to determine the standard of care ....
- "the thing speaks for itself"
doesnt take an expert witness to determine that an error happened....2x2 left in patients body after surgery
-
Why are incident reports important to file?
shows the hospitals flaws in the system....so they can be improved upon
-
gross negligence
reckless act that reflects a CONSCIOUS disregard for the patient s welfare
-
damages awarded to the injured patient from a grossly negligent nurse
punitive damages
-
Who's the 2nd victim?
the person that made the error
-
Criminal negligence
a negligent act that also constitutes a crime...the act is deemed so reckless that the action also results in serious injury or death to the patient
-
3 defenses again claims of negligence for nurses and 1 that will never work
- Emergency situation
- Governmental immunity-VA/Jail employees
- Good samaritan....even as a nurse as long as care you provided wasnt negligent
"I was following physicians orders" will never work!!
-
What is the statute of limitations for filing a malpractice claim
until they are 18 years old
-
Transparency and disclosure of Error
- best to tell the patient about our error
- if they like you they are less likely to sue
- institutions must have a process in place to disclose these unanticipated outcomes to the patients/family
-
Why nurses need malpractice insurance
- can be named in civil suits
- floating/cross training is more common
- some employers dont initiate an adequate defense for nurses....so need extra council provided thru my malpractice insurance
-
every person is responsible for the wrong or injury done to another as the result of carelessness
Liability
-
a nurse cant be relieved of liability by another professional, such as a physician or nurse manage
personal liability
-
Personal liability with floating and cross training
- in no case is a nurse permitted to render services if the requisite knowledge to act competently is lacking
- nurses have a legal duty to refuse specific tasks they cant perform safely and completently
- no hospital shall assign a licensed nurse to a unit or area unless they are determined competent in that area
-
Personal liability for team leaders/managers
duty assignments are given to competent nurses who can provide quality care
triage of patients and allocation of staff and equipment
-
What type of nurses allow the proper ratios to be maintained during breaks/meals?
resource nurses
-
Nurse managers and administrators may be held liable for the following:
- inadequate training
- failure to periodically reevaluate staff competencies
- failure to terminate/discipline unsafe workers
- failure to uphold institutional licensing laws and state and federal statutes
- negligence in developing appropriate policies and procedures
-
an unexpected occurrence involving death or serious physical or psychological injury....specifically including loss of limb or function
requires immediate investigation or response
sentinel event
-
the analysis of the sentinel event.... and examples
- root cause
- what happened
- why
- how do we make sure it doesnt happen again
-
threat of harm....causing a person to fear that he or she will be touched without consent
assault
-
the unauthorized touching or the actual harmful or offensive touching of a person and may rise to the level of a crime
battery
-
What is the simple way to prevent battery?
always ask the patients permission before initiating any procedure and should document permission was granted
-
defamation caused by written word
lible
-
defamation caused by spoken word
slander
-
unlawful restrain or detention of another person against his or her wishes...nurses has no authority to detain a patient even with the likelihood of harm or injury
false imprisonment
-
rules of leather vs. regular restraints
- leather evaluate q 15min
- regulpar q 2 hr
csm, toileting,skin
-
Define misdemeanor offense....and give examples
minor criminal offenses
- illegal practice of medicine
- failing to report child/elder abuse
- falsification of the patients medical records
- assault and battery
-
Main 4 student learning objectives
- nursing process
- safety
- communication
- taking on the professional role
-
Define felony offense and give examples
major criminal offenses
- drug trafficking
- fraud in billing services for Medicare patients
- theft, rape, murder
-
Advance Directives legality details
- signed by 2
- 1 is a witness not related by blood.
1 is a notary
-
DNR orders
written by the physician on the basis of the directives by the patient
-
What gives a person, other than the ill person, to make decisions for them?
Durable power of Attorney for healthcare
-
Physician or advanced practice nurse has a duty to disclose information so the patient can make intelligent choices
informed consent
-
What must be explained by the doctor when getting an informed consent
- nature of the therapy or procedure
- expected benefits and outcomes
- potential risks....and alternative procedures, and what will happen if they dont do it
-
RN's job when getting an informed consent
getting the signature and making sure they dont have any questions
-
The right to refuse diagnostic testing, treatment and care
an adult of sound mind has a right to refuse any treatment that has previously been agreed to.
nurse must notify the MD of the change
-
What do I do if a patient is leaving against medical advice
- tell them insurance wont pay for any treatments rendered
- tell the doctor
- clearly articulate the dangers of them leaving
- TRY to get them to sign AMA papers
- document
-
Charges that can be filed when restraints are used immproperly
- assault and battery
- false imprisonment
-
When can a nurse apply restraints without an order?
when it is an emergency and in their independent judgment, no other strategies are effective in protecting the patient from harm
**careful and detailed documentation is crucial
|
|