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103 Cards in this Set

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Assault
Intentional tort, a threat or attempt to make bodily contact withanother person or without that person's consent
Credentialling
the process of determining and maintaining competence in practice; includes licensure, registration, certification, and accreditation
Defamation
Intentional Tort, which one party makes derogatory remarks about another that diminish the other parties reputation/ Slander
Ethics
study of good conduct, character, and motives
right and wrong
system for deciding what should be done
Governs conduct
Ethical Dilemma
approaches Priciple Based which is combing of two, and Care Based looks at pt
DNR
Do not resuscitate
an order
Felony
a crime of a serious nature, such as murder, punishable by a term in prison
criminal law ( crime)
Good Samaritan Act
Act as laws to health care providers that act in the event of an emergency, covers nurses. You cannot diagnose.
(protect)covers nursing student
Informed Consent
a client's agreement to accept a course of treatment or a procedure after receiving complete information, including the risks
Libel
Intentional Tort
defamation by means of print, writing, or pictures ( Libel)
Malpractice
the negligent acts of health care persons, very hard to prove
Misdemeanor
a legal offense usually punishable by a fine or a short-term jail sentence, or both, criminal law (crime)
Morality
A doctrine or system denoting what is right or wrong in conduct, character,or attitude
Negligence
failure to behave in a reasonable and prudent manner; an unintentional tort
ex. medication error, malpractice
Slander
defamation by the spoken word, stating unprivileged (not legally protected) or false words by which a reputation is damaged
Standards of Care
detailed guidelines describing the minimal nursing care that can reasonably be expected to ensure high quality care in a defined situation (eg, a medical diagnosis or a diagnostic test)
Civil Tort
wrong committed against a person or a person's property, a tort is subject to action in a civil court, invasion
Value
values differ, beliefs or attitudes about the worth of person object, idea, or action
freely chosen, personal belief, often taken for granted
Value Clarification
Process by which people identify, examine,and develop their own individual values.
Identify 4 professional values for a nurse
1. strong commitment to service
2.Belief in dignity and worth of each person
3.Commitment to Education
4.Professional autonomy
Discuss how values calrification promotes personal growth:
Values clarification promotes personal health by fostering awareness , empathy, and insight. Therefore it is an important step for the nurse to take in dealing with ethical problems
Function of the laws in Nursing:

Constitutional law
Federal and state constitutions indicate hoe the federal and state governments are created and given authority and state principles and provisions for establishing laws, serves guidelines for legislative bodies
Statuatory Law
-nurse practice acts
-Good Sama. Act
Child and adult abuse laws
living wills
Sexual Harrass.
must be in keeping with both federal consti. and state consti.
American Disability Act
Administrative laws
Executive officers (Ex. The President Of the United States, governors, or mayors of the city) administer agencies that are responsible for law enforcement ( Board of Nursing are admin. at a state level)
Commom laws
laws evolving from court decisions
blue laws ( court made law) Most law involving malpractices are common made law
Purpose of Nurse Practice Act
Each state has a nurse practice act which protects the public by legally defining and describing the scope of nursing practice. They also act legally to control nursing practice through licensing requirements, is the most important law affecting your nursing practice
Purpose of a license
legal permit the gov. agency grants to an indidvidual to practice of a profession or to use a particular title. Must meet criteria
1. protect the publics safety and wealfare
2.occupation is clearly defined as a seperate or distinct area of work
3. Proper authority to assume the obligations of the licensing process" Nursing State Boards"
Internal Standards of Care
includes nurse description, education, and expertise as well as an individuals policies and procedures
External Standards of Care
Nurse Practice Acts, professional organizations, nursing specialty practice organizations, federal organizations, and federal guidelines
3 Independant legal roles of the nurse
1.provider of service
2.Employee or contractor for service
3.Citizen
Nurses role in obtaining informwd consent
the nurse is not responsible for explaining the procedure, but for witnessing the clients signature on the form
"sullivan 98 states the nurse's signature confirms 3 things
clients gave consent voluntarily
Signature is authentic
Client appears competent to give cnsent
Nurses role in reporting crime
nurse can identify acess cases of violence against others. As a result they are often included in mandated reportes
6 elements that must be present for a case of nursing negligence or malpractice to be proven:
1.Duty
2.Breach of Duty
3. Foreseability
4.Caucasion
5.Harmor
6. Injury
Identify basic nursing errors that may result in a malpractice.
Assessment Errors
Planning Errors
Intervention Errors
Unintential torts
do not require intent but do reqiure the element of harm
Intential torts
the act on purpose with no intent
-no harm need by caused by intential torts for liability to exist
Good Smaritan Act
laws designed to protect health care providers on scene of emergency
Incident Report and information it may contain
record of the accident or unusual occurrence
Identify:
client name, date, time, palce of accident, facts,witnesses...
Legal responsibilities of a student nurse
responsible for own actions and liable for their own actions of neglience committed during the couse of clinical experiences ( Same as RN)
Pateint Bill of rights
"knock on door" (AHA"
Health Care Proxy
See handout
for someone who is uncable of speaking forthemselves the person makes the decisions for the client who cannot
-living will for someone who does not want extreme measures to be taken
HIPPA
-If pt stated going to sue, get risk management involved immed.
-have 2yrs from time of discovery to prove can sue forever (statue of limitations) if it is not written NOT done
No personal opinion, no blaming write what you see
Advanced Directives
Health Care Proxy
Restraints
can not restrain against own will
Nurses Role In Reporting
-write description -Be accurate
-Be creditable -get support
Report-sign Assume responsibility
follow through
Importance of Incident Report
(variance, occurrence report)
Uncured event, document the occurrence of anything out of the ordinary that results in or has potential to harm a pt, employee, or visitor
Basic Nursing Errors resulting in
negligence
liable for own actions
Mode of value transmission

Modeling
parents, teachers, clergy, co-workers
Mode of value transmission

Moralizing
are taught a complete value system by parents or a institution ex. church or school that allows little opportunity for them to weigh different values.
Mode of value transmission

Laissez- fare
whatever goes, lazy
Mode of value transmission

Rewarding + Punishing
children are rewarded for demonstrating values held by parents and punished for demonstrating unacceptable values
Mode of value transmission

Responsible Choice
encourage children to explore competing values and to way their consequences . Support and guidance are offered as children develop a personal value system
1. Valuing Process
Theorists say to have 7 steps focusing on three main activities 1. choosing, 2. Prizing, 3. Acting
Valuing Process

Choosing
1. Freely to believe in the worth and uniqueness of each indiv. to realize you have other options, belive in respecting their dignity 2. Alternatives ex. comply, refuse 3. After consideration of consequences
Valuing Process

Prizing
You will also prize your choice
4. with pride and happiness 5. with public affirmation
Valuing Process

Acting
6. With Incooperation of the choice into one's behavior 7. with Consistence, and regularity
Clarification strategies
Clarifying this value of respect for human dignity will motivate you in corporate this value into your practice
Value clarifiaction
(Look at own values)
Process of identity , examine, +develop own individuals values
-promotes growth fostering awareness, empathy, and insight
Acts as your standard guide behavior
Principle care bases Approach
are doing ethics combined elements combines both utilitarian and deontology are acting specific guides for practice, combining of 2
Care Based
looks at pt. , Directs attention to the specific situations of the indiv. patients viewed as within the context of their life narrative
Utilitarian
The end justifies mean (Ex. sex ed in school)
Deontology
The act itself is wright or wrong in your belief (Ex. abortion)
Code of ethics
Formalized guidelines, Accountability, Responsibility
Advocacy, Confidentially, Veracity
Bill of Rights for Nurses
Advocacy of behalf of nurses and the profession has resulted in a tangible tool, Bill of Rights for nurses , to aid in providing workplaces and ensuring nurses ability to provide safe quality pt care
Examples of Ethical Problems
Paternalism, Deception, Confidentiality, Allocation of Scarce Nursing Resources, Advocay in market Driven Environment,Valid consent or refusal
Ethical Decision Making
Ethical Committees- for ethical dilemmas
Example of ethical Problems
Nurses who value pt advocacy
1.
Make sure that their loyalty to an employee or institution or colleague does not compromise their primary commitment to the pt
Nurses who value pt advocacy
2.
Give priority to the good of the indiv.pt rather than the good of the society in general
Nurses who value pt advocacy
3.
Carefully evaluate the claims of the pt.'s autonomy ( self determination) and pt well being
Professional Values

Altrusim
is a concern for the welfare and well being others, demonstrating cultures of theirs, advocates for pt, take risk on behalf f pt, mentors other professionals
Professional Values

Autonomy
freedom, right to self determination, make own choices
Professional Values

Human Dignity
Respect for the inherit worth and uniqueness of individuals and populations, provide culturally competent and sensitive care, pts privacy, Design care with sensitivity to indii. pt needs
Professional Values

Integrity
is acting in accordance with an appropriate code of ethics and accepted standards of practice, provides honest info to pts and public
Professional Values

Social Justice
Fairness, is upholding moral, legal, and humanistic principles, supports non discrimination, promotes universal access to healthcare
Moral Principles

Nonmaleficence
To do know harm
Moral Principles

Autonomy
pt freedom, Respect the rights of patients or their surrogates to make health care decisions
Moral Principles

Beneficence
Benefit the pt, and balance benefits against risks and harms
Moral Principles

Justice
fairness, act fairly
Moral Principles

Fidelity / Veracity
faithfulness, commitment (be careful what you tell pts, keep promises
truth
ANA code of ethics

Standards of Practice
Governed by ANA
ANA code of ethics

Pts Bill of Rights
AHA
Bill of Rights for RN
AHA
Law
Is a standard of rule or conduct established and enforced by the government. Laws are intended chiefly protect the rights of the public
Functions of Law
1. provide framework for legal nursing actions 2. Differentiate nurse responsibilities 3. Establish boundaries 4. Maintains standards
Law and it's 4 sources
constitution
statute
administrative law
common law
Accreditation
process by which an educational program is evaluated and recognized as having met certain standards
Liscensure
process by which a state determines that a candidate meets certain minimal requirements to practice in the professional and grants a license to do so
certification
process by which a person who has met certain criteria established by a nongovernmental associations is granted recognition in a specified area of practice
Invasion of Privacy
4th amendment right of privacy and right to be left alone ( HIPPA)
False Imprisonment (Freud)
A person cannot be legally be forced to remain in a health care agency such as hospital if he or she is of sound mind even if health care providers think they should be treated.
Negligence ( UNINTENTIONAL TORTS)
Unintentional tort performing an act that a reasonably prudent person under similar circumstances would do. Ex. malpractice very hard to prove!
Personal areas of possible liability
Incomplete data, significant errors, omissions, no indication of nursing care plan, wrongful documentation, no notes, wrongful d/c, failure to respond as RN
Nurse as Defendant
should work closely with the attorney while preparing the defense
Nurse as a fact witness
may be called to go under oath, and must base their testimony only on first hand knowledge of the incident and not on assumptions
Nurse as a expert Witness
solid educational background, strong clinical experience comparable to the nurse defendant
Legal Safeguards in Nursing
Informed consent or Refusal
Contracts
Collective Bargaining
Competent Practice
(most import)
Components of Law suit
Litigation - whole process
Plaintiff- accusing, brings complaint
Defendant Defends himself against plaintiff
Burden of Proof- enough evidence to be found guilty beyond a reasonable doubt
Malice
intentional or published
willfull
Battery
actually touching
Elements Essential to prove negligence/ malpractice
ALL must be present!
1. Duty to the pt ( responsible for pt)
2. Negligence
3. Damage- harm to pt
4.Causation -cause of demise or injury
(If one is missing NO case)
Students and the Law
student nurse accountable for their actions
work/liable under their own actions
Basic Care Nursing errors resulting in Negligence
Assessment errors-didn't gather enough info
Planning Error- didn't identify info or accurate info
Intervention Error
Advance Directives
Health Care Proxy, power of attorney