Legal Implications Nursing
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Describes and defines legal boundaries of nursing practice w/in each state?
Nursing Practice Acts
Also called "administratice law" reflects decisions made by administrative bodies such as STate Boards of Nursing when they pass rules and regulations/
Regulatory law or administrative law
Results from judicial decisions made in courts when individual legal cases are decided (e.g., a client's right to refuse treatment) is called?
Statuatory law that prevents harm done to society and provides punishment for crimes? There are two types?
- Criminal law
A crime of a serious nature that has a penalty of imprisonment for greater than 1 year or even death?
What is a felony?
A crime of a serious nature that has a penalty of imprisonment for greater than 1 year or even death
A less serous crime that has a punishment of penalty of a fine or imprisonment for less than one year is called a?
What is a misdemeanor?
A less serous crime that has a punishment of penalty of a fine or imprisonment for less than one year
These laws protect individuals in our society and encourage fair and equitable treatment among people. Damages for these laws involve the payment of money?
These are legal guidelines for nursing practice and provide the minimum acceptable nursing care? Thes reflect the values and priorities of the profession?
Nursing Standard of Care
This federad statutory issues in nursing practice protects the rights of disabled people including clients infected with HIV?
American with disabilities act
This federad statutory issues in nursing practice provides that when a client comes to the emergency department or the hospital, and appropriate medical screening occurs within the hospital’s capacity. If an emergency situation exists, the hospital cannot discharge the client until his condition stabilizes is called?
Emergency Medical Treatment and Active Labor Act (EMTALA)
This federad statutory issues in nursing practice 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?
Mental Health Parity act
This advance directive requires health care institutions to provide written information to clients concerning the clients’ rights under state law to make decisions, including the right to refuse treatment and formulate advance directives. Clients’ record must contain documentation whether the client has signed an advance directive?
Patient self-determination act
This advance directive is a written documents that direct treatment in accordance with a client’s wishes in the event of a terminal illness or condition. The client is able to declare which medical procedures he or she wants or does not want when terminally ill or in a persistent vegetative state. If health care workers follow the terms of the living will, they are usually immune from liability?
This advance directive is a legal document that designates a person or persons of one’s choosing to make health care decisions when the client is no longer able to make health care decisions on his or her own behalf. This individual makes decisions based on client’s wishes; also upholds the right of a legally competent client to refuse medical treatment for religious reasons?
Durable power of attorney
This advance directive literally means "do not resucitate" or "no-code", this order was first developed in 1976 and marks and important change in health care because it was the first order to withhold treatement instead of deliver treatment?
Can CPR be performed without consent? What about if client has DNR?
CPR does not require consent UNLESS a patient has a DNR
provides rights to clients and protects employees. Protects individuals from losing their health insurance when changing jobs by providing portability. Allows employees to change jobs without losing coverage as a result of preexisting coverage exclusion as long as they have had 23 months of continuous group health insurance coverage.
A standard regarding accountability in a health care setting. Rules that create client rights to consent to use and disclose protected health information, to inspect and copy one’s medical record and to amend mistaken or incomplete information is called?
Is the right of a client to keep information about themselves from being disclosed?
Is how health care providers treat private information once it has been disclosed to others?
What are the TJC guidelins regarding the use of restraints?
- only to ensure the physical safety of the resident or other residents
- when less restrictive interventions are not successful
- Only on the written order of a physician or health care provider.
All registered nurses in the state in which they practice are required to be liscensed in order to practice, this is called ______________?
Laws that encourage health care providers to act in emergencies, but limits the nurse against liability and offers legal immunity for nurses who help at the scene of an accident is called?
The Good Samaritian law
Statutes under health code, enacted by state legislatures, which describe the reporting laws for communicable diseases, school immunizations and laws intended to promote health and reduce health risks in communities. CDC and OSHA provide guidelines for safe and healthy communities and work environments (national level)?
Public Health Laws
This act sets forth the two standards for the determination of death? Name these two standards?
- The Uniform Determination of Death Act
- The cardiopulmonary standard
- The whole brain standard
This standard to determine death requires irreversible cessation of circulatory and respiratory functions?
The cardiopulmonary standard
This standard requires irreversible cessation of all functions of the entire brain including the brain stem?
The whole brain standard
A civil wrong made against a person or property? Classification include intentional, quasi-intentional or unintentional?
This intentional tort is any intentional threat to bring about harm or offensive contact. No actual contact is necessary/
This intentional tort is any intentional touching without consent?
If a nurse threatens to give a client an injection this is called an __________; however, if she actually gives the patient the injection just to shut him up, without his consent, this is called _________?
Unjustified restraining of a person without legal warrant. Ex: when nurses restrain a client in a bounded area to keep the person from freedom?
This quasi-intentional tort protects the client's right to be free from unwanted intrusion into his/her private affairs. Name the for types of invasion?
- INvasion of privacy
- 1. seclusion
- 2. appropriation of name or likeness
- 3. publication of private or embarrassing facts
- 4. publicity placing one in a false light in the public's eye
This quasi-intentional tort is a publication of false statment(s) that result in damage to a person's reputation and include: malice, slander, libel?
Defamation of character
When a person publishes information knowing that this information is false, yet publishes it anyway is called?
When a person verbalizes the false statement of a client, knowing the information is false yet announces it/states it anyway is called?
When written defamation of character is committed, to include documenting in the client's M.A.R. false information, the nurse is ________ for false information?
Conduct that falls below a standard of care is called?
Examples of negligence include?
- If a nurse fails to:
- assess/monitor a client
- fails to notify the HCP of problems
- fails to follow orders
- fails to follw 6 rights of med admin
- fails to convey discharge instructions
- fails to ensure client safety
- fails to follow policy and procedure
- fails to properly delgate and supervise
One type of negligence, and often referred to as professional negligence, is called?
This is requried for all routine treatement, hazardous procedures like surgery, treatment programs like chemo, and research...if the client is deaf, illiterate, or speaks a foreign language someone/something needs to be found in order for client to give this before ANYTHING can be performed on that client?
This type of consent is a person's agreement to allow something to happen (like surgery or a diagnostic procedure) based on full disclosure of risks, benefits, consequences of refusal?
This consent needs to be obtained and witnessed only when the client is NOT under the influence of medication?
What must a nurse be sure the client understands when providing them with the consent form?
- That the client:
- knows the procedure they are there for
- that if client is not in the know, the physician, HCP or nurse supervisor is notified
- if client rejects, must be documented
- nursing students cannot be responsible for and should not obtain the written consent
At this point in the pregnancy a women can abort her pregnancy without state regulation?
At this point in the pregnancy the state has an interest in protecting the maternal health, and enforces regulations on the person performing the abortion and abortion facility?
At this stage in the pregnancy the fetus is viable so it is in the state's interest to protect the fetus; the state prohibits abortion except when necessary to save the mother?
When are nursing students liable?
- if action causes harm to client
- if lack of action causes harm to client
This is professional liablity insurance; is a contract between the nurse and the insurance company and provides a defense for a nurse who is involved in a malpractice lawsuit?
If you are required to care for more clients than reasonable "short staffing" what should you do?
- bring the matter to the attention of the nurse supervisor
- make a written protest, if you accept the assignment; however, if a client is injured due to overload, this will not relieve the nurse of injury caused
- never walk off the job due to work overload - considered abandonment
- never refuse an assignment - this is considered insubordinate
What should you do if you suspect the physician's order is inappropriate?
- obtain further clarification from the physician
- inform a supervision nurse and follow chain of command - if you still feel is wrong after getting clarification
- you are responsible IF you still carry out the order you feel could cause harm to the client
- ALWAYS document that you performed a competent assessment and followed all interventions - this will cover you in case the matter becomes litigated
Ensuring appropriate nursing care by attempt to identify potential hazards and eliminating them before they occur is called?
What is the process of risk management?
- identify possible risks
- analyze possible risks
- act to reduce possible risks
- evaluate the steps taken to avoid risks
Provides a database for further investigation in an attempt to establish deviations from standars of care is called?
incidence or occurrence report
Deviations from standards of care include?
- visitor falls or is injured
- failure to follow physician or HCP order(s)
- significant complaint by client, family physician or HCP
- error in technique or procedure
- malfunction of device or product
DOCUMENT ANY INCIDENT THAT HAS OCCURED
What are the legal limits of nursing?
- Sources of law: legal guidelines that come from statuatory, regulatory and common law
- Standards of care: legal guidelines for defining nursing practice and identifying the minimum acceptable nursing care
Documentation precautions against suicide is essential in regards to this federal statutory issue in nursing practice?
a. Amer. Disabilities Act
b. Mental Health Parity Act
Mental Healthy Parity Act
An example of this law is the duty to report incompetent or unethical nursing conduct to the State Board of Nursing?
1. Common Law
2. Statutory Law
3. Regulatory Law
Regulatory Law - decisions/rules/regulations made by administrative bodies e.g., State Board of Nursing
Examples of this law include informed consent and the client's right to refuse treament; however the nurse more frequently encounters this law involving negligence and malpractice?
1. Common Law
2. Regulatory Law
3. Satutory Law
Common Law - judicial decisions made in courts when individual legal cases are decided
This law is either civil or criminal_____?
_____ prevents harm to society and provided punishment for crime?
____ protects the rights of individual persons within our society and encourage fair and equitable treatement among people?
- Criminal - punished
- Civil - protects
What is the nurse practice act?
It is a law that defines the standards of care for all nurses to practice in all 50 states - "STandards of Care"
Patient dumping would not be tolerated unter this Satutory issue in nursing practice?
EMTALA - Emergency Medical Transfer and Active Labor Act
All individuals, be they disabled or have HIV, will be treated equal according to this Federal staturtory issue in Nursing Practice law?
American With Disabilities Act
This acts places forbids health insurance plans from placing lifetime limits on any mental health plan care according to the statutory issues in nursing practice?
Mental Health Parity Act
Living Wills and Durable Powers of Attorneys are two examples of this statutory issue in nursing practice?
Living will = written documentation of care requested according to patient wishes
Durable Power of Attorney = legal document designating a member of client's wishing to make medical decisions for them should they not be able to make those decisions on their own
A written documentation of care requrested by the HCT, according and based on the wishes of the patient, is calle what kind of advance directive?
A living will
A designated individual who is allowed to make medical decisions on behalf of the client, should the client be unable to make their own health-related decisions is what kind of advance directive?
A Durable power of Attorney
What is the best way for nurses to avoid negligence?
- follow standards of care
- provide competent healthcare
- communicate with other HCP
Hanging a wrong IV, not checking a patients wrist band and administering the wrong medication, and/or allowing a CNA to administer medication are all examples of _________ according to Common/Civil Laws?
- The protection of the patient (Civil) and the decision of the court based on the crime (Common) are the laws addressed in negligence
There are certain criteria that need to be met in order for nursing malpractice to be established - what are these criteria?
- 1. A nurse (defendant) owed duty to a client (plantiff)
- 2. the nurse did not carry out duty
- 3. the client got hurt
- 4. the nurse's failure to carry out duty caused injury to client
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