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legal guidelines for defining nursing practice and identifying the minimum acceptable nursing care. reflect values and priorities of the profession:
standards of care
derived from the Nurse Practive Act found in all states, which describes and defines the legal boundaries of nursing practice in eatch state.
defines your duty to report incompetent or unethical nursing conduct to the Board of Nursing
results from judicial decisions concerning individual cases. most revolve around negligence and malpractice.
meant to prevent harm to society and provide punishment for crimes. felony or misdemeanor.
protect the rights of the individual
protects the rights of disabled people including those with HIV and AIDS
American with Disabilities Act (ADA act)
states that hospitals are mandated to treat and stablize clients before transferring or discharging them
Emergency Medical Treatment and Active Labor Act of 1986 (EMTALA)
forbids health care plans from placing lifetime or annual limits on mental health coverage that are less generous than those place on medical or surgical benefits
Mental Health Parity Act of 1996
requires health care institutions to provide written info to clients concerning their rights to make decisions
Patient Self Determination Act of 1991 (PSDA)
written document that direct treatment in accordance with a clients wishes in the event of a terminal illness or condition
legal document that designates a person or persons of one's choosing to make health care decisions when clients can no longer make decisions on their own behalf.
Durable Power of Attorney for Health Care (DPAHC)
18 yo right to donate organ
Uniform anatomical gift act
these laws limit liability and offer legal immunity for nurses who help at the scene of an accident.
Good Samaritan Act
states that state legislatures enact statutes that describe the reporting laws for communicable diseases, school immunizations, neglect/abuse for child or elder
Public Health Laws
states that health care providers can use either cardiopulmonary or whole brain definition to determine death.
Uniform Determination Death Act of 1980
facilitation of cadiopulmonary and whole brain standars
both facilitate recovery of organs for transplantation
states that pt with terminal disease could make oral/written request for meds to end life
Oregon Death with Dignity Act
A civil wrong made against a person or property
willful acts that violate another's rights
- intentional torts
- -assault, battery, and false imprisonment
acts where intent is lacking but violational action and direct causations occur.
-invasion of privacy
Defamation of character:
person publishing info knows it is false and publishes it anyways or with reckless disregard for the truth
defamation of character:
occurs when one makes a false statement verbally
defamation of character:
written defamation of character
consists of negligence and malpractice; conduct that falls below the standard of care
a person's agreement to allow something to happen, such as surgery or an invasive diagnostic procedure, based on full disclosure of risks, benefits, alternatives, and consequences of refusal.
US supreme court ruling including a woman's right to have an abortion
Roe v. Wade
some states require viability tests if the fetus is more than 28 weeks gestational age
webster v. repoductive health services
a contract between the nurse and the insurance company, which provides defense when a nurse is in a lawsuit involving negligence or malpractice
used when a nurse believes he/she is being asked to accept an unsafe assignment, engage in conduct beyond scope of practice
protection from employers for reporting improper quality of patient care.
Physician's responsible for writting all orders. nurses are responsible for transcribing orders correctly. if verbal is written, it must be signed by the physician within 24hrs
system of ensuring appropriate nursing care that attempts to identify potential hazards and eliminate them before harm occures
the committment to include clients in decisions about all aspects of care
taking positive actions to help others, including clients in decisions
avoidance of harm or hurt, do good but equal do no harm.
commitement to keep promises and follow through with care with pt
says that the value of something is determined by its usefulness
defines actions as right or wrong. doesn't look at consequences
looks to the nature of relationships for guidance in the processing of ethical dilemmas
emphasizes the importance of understanding relationships
ethics of care
7 steps to process an ethical dilemma
- 1. Ask if it is an ethical dilemma
- 2. Gather info (client, family, instutional)
- 3. Clarify values (between fact, opinion, and values)
- 4. Verbalize the problem
- 5. Identify possibilities
- 6. Negotiate a plan
- 7. Evaluate the plan
central to discussions about futile care, cancer therapy, physician-assisted suicide, and DNR
Quality of Life
interventions unlikely to produce benefit for the client
Ensure adult patients are informed of their rights
report of any deviation or unusual event that has occurred and has affected the patient, visitor or others, within 24 hrs
an unexpected occurance
moniter at least every two hours:
- skin for circulation
- mental status
Health insurance portablity and accountability act.
any info, verbal or recorded, relating to the health, healthcare or payment for healthcare. includes any info that can identify the patient as well.
PHI. Protected health information
HIPPA Patient rights
- rights to:
- acces PHI
- request restrictions
- an accounting of PHI disclosures
- confidential communications
- file a complaint
a lifelong process used in nursing practice
the foundation of communication is the internal enviroment for conversation and interpretation of messages. a communication from within, it is a personal translation of experiences
a caring relationship between a nurse and a patient, the ability to relate to others is developed
interaction that occurs within an individuals spiritual domain
0-18 inches away; touching pt
18 inches-4 feet, interviewing pt
4-12 feet; no permission needed; making rounds with physician
12 feet and greater; lecturing to public
what are the non verbal skills you can use to facilitate attentive listening (SOLER)
- S-sit facing pt
- O-observe an open posture
- L-lean towards pt
- E-establish and maintain eye contact