N210 Week 5 Lecture Legal & Ethical Issues
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1. Differentiate between intentional torts (assault, battery, false imprisonment, and invasion of privacy). pg.118-120
- Assault: a threat or attempt to make bodily contact with another person without their consent
- Battery: assault that is carried out and includes willful, angry and violent or negligent touching of another person’s body or clothes or anything attached to or held by that other person.
- Ex: Forcibly removing a patient’s clothing, administering an injection after the patient has refused it and pushing a patient into a chair
- • Threatening to do any of these actions if the patient does not cooperate is assault
- • Just because the treatment is desirable does not mean that they can proceed without the consent of the patient or go beyond the limits to which the patient has consenter.
- • Every individual has the right to be free from invasion of one’s person, and adult patients who are alert and oriented have the right to refuse any treatment
- Defamation of character: is an intentional tort in which one party makes derogatory remarks about another that diminish the other party’s reputation.
- • Slander: spoken defamation of character
- • Libel: is written documentation
- • Nurses who exaggerate statements about patient or coworkers run the risk of being sued for slander or libel
- • Invasion of privacy: patient’s right to have information kept confidential
- • ALL INFORMATION ABOUT PATIENTS IS CONSIDERED PRIVATE OR CONFIDENTIAL
- HIPPA ensures that the person has the right to:
- • To see and copy their heath record
- • To update their heath record
- • To request correction of any mistakes
- • To get a list of the disclosures health care institutions has made independent of disclosures made for the purposes of treatment, payment, and health care operations
- • To request a restriction on certain uses or disclosures
- • To choose how to receive health information
- • If health institutions want to release a patient’s health information for treatment, payment and routine health care operations, the patient must sign an authorization
- • When in doubt about disclosing confidential information, consult the nursing supervisor, ethics committee, or public relations department of the institution
- • False Imprisonment: unjustified retention or prevention of the movement of another person without proper consent can constitute false imprisonment.
- Ex: use realistic amount of restraint
- • a person cannot be legally forced to remain in a health agency
Describe the professional and legal regulation of nursing practice. (pg. 114-117)
- • Nurses who practice safely respect both the voluntary and legal controls of nursing practice. It is designed to ensure quality health care and to protect society from unsafe actions
- Nurse Practice Acts:
- 1. State’s Nurse Practice Act
- • Is the most important law affecting your nursing practice
- • Protects the public by broadly defining the legal scope of nursing practice
- • Practicing beyond those limits makes you vulnerable op charges of violating the state Nurse Practice Act
- • Protects from untrained or unlicensed people
- 2. Standards
- • Professional nursing organizations continually reassess the functions, standards and qualifications of their members. These organizations are guided by their own assessment of society’s need for nursing and by the public’s expectations of nursing
- • ANA accreditation of educational programs and service organizations and standards for the certification of individual nurses in general
- • Legal standards are developed by legislature and are implemented by authority for the education of nurses, set requirements for licensure or registration, and to decide when a nurse’s license may be suspended or revoked
- C. Credentialing
- • Credentialing: refers to ways in which professional competence is ensured and maintained. There are 3 processes for credentialing in nursing which are accreditation, licensure and certification.
- D. Accreditation
- • Is the process by which an educational program is evaluated and recognized as having met certain standards
- • State constitutions give states a responsibility for the public welfare. State legislative bodies have used this principle to enact laws controlling occupational and professional groups.
- • Nursing operates under state laws that promote the general welfare by determining minimum standards of education though accreditation of schools of nursing
- • NLNAC and AACN are voluntary agencies that accredit schools when they meet certain criteria
- • NLNAC and AACN are not a legal requirement for a school to exist; state accreditation is a legal requirement
- E. Licensure
- • Specialized form of credentialing based on laws passed by a state legislature
- • A license is a legal document that permits a person to offer to the public skills and knowledge in a particular jurisdiction, where such practice would otherwise be unlawful without a license
- • nurses must keep up and maintain a license in good standing. There requirements usually include good moral character, English proficiency, continuing clinical competence or continuing education and the absence of criminal records.
- • You must legally reside in an NLC state to be eligible for a multistate license
- • State boards of nursing can revoke or suspend nurse’s license or registration such as drug/alcohol which is the most frequent reason
- • Validates specialty knowledge, experience and clinical judgment
- • Voluntary
- • Certification is one means to demonstrate advanced proficiency and a commitment to ensure competence
3. Explain the purpose, indication and components of consents and the role of the nurse. pg 125
- o Obtaining informed consent is the responsibility of the person who will be performing the dx or tx procedure or the research study.
- o Your role as a nurse is to confirm that a signed consent form is present in the pt chart and to answer any pat questions about the consent.
- o In some cases you might to have a pt sign consent form after the physician had explained the procedure, its risks and benefits and alternative tx to the pt.
Recognize and apply the Health Insurance Portability and Accountability Act (HIPAA) to patient care situations. pg118
- o State courts have also strongly protected a patient’s right to have information kept confidential.
- o All information regarding patients is to kept confidential whether written on paper saved on a computer or spoken aloud.
- • This includes their name and all identifiers such as address, telephone and fax numbers, social security number, and any other personal information.
- • It also includes why the pt Is such or in the hospital, office, or clinic, the treatments the patient receives, and information about past health conditions.
Evaluate personal area of potential liability in nursing (121)
- A. Assessment
- • Incomplete database obtained (occurs frequently when patient is too ill at admission to respond to questions)
- • Significant omissions or errors in recorded database
- • Failure to note in the patient’s plan of care (and to execute) the need for more frequent assessments
- • Failure to recognize and to report significant changes in the patient’s condition
- B. Diagnosis
- • Failure to identify priority nursing diagnosis critical to the patient’s care
- • Nursing diagnosis incorrectly developed and “labels” the patient negatively
- C. Outcome Identification and Planning
- • No indication in nursing care plan that nurses were aware of and sensitive to the patient’s healthcare priorities
- D. Implementation
- • Patient’s record contains no documentation of attempts to teach appropriate self-care measure to patient and family
- • Nursing interventions deviate from usual standard of care (understaffing, indifference on part of nurse, inexperience of nurse, faulty or scarce equipment or resources)
- E. Evaluation
- • No evidence in plan of care and nursing notes that nurses evaluated whether patient achieved goals
- • Patient discharged before key goals were met and without follow-up instruction
o Document the time the physician was called, the time of response or lack of response
- o And subsequent nursing response (ex: nursing supervisor notified)
- Adequate Staffing
- o Understaffing can create negligent care for the patient. If patient claims this, the nurse cannot claim for being overworked. It does not create enough legal defense.
- Whistle Blowing
- o A warning from a present or past member of an organization to the public concern a serious wrongdoing or danger created or masked by the organization
- Good Samaritan Law
- o In many states, No person has a legal obligation to help another
- o Ex: A nurse can give emergency care without fear of a legal suit if such care appears necessary, unless care is given in a grossly negligent manner
Explain the purpose of incident reports
- o It is used by health care agencies to document the occurrence of anything out of the ordinary that results in, or has the potential to result in harm to a patient, employee, or visitor
- They are used for quality improvement and NOT for disciplinary action
- They ID risks, and high-risk patterns
- They may be used for any litigations
- o When document a patient incident, be sure to include a complete account of what happened in the patient’s record as well as in the incident report
Recognize ethical issues as they arise in nursing practice.
Use an ethical framework and decision making process to resolve ethical problems.
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