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80 Cards in this Set

  • Front
  • Back
Nurse Practice Act
describe and define the legal boundaries of nursing practice within each state
Regulatory law, or administrative law
is created by administrative bodies such as State Boards of Nursing when they pass rules and regulations
Common law
is created by judicial decisions made in courts when individual legal cases are decided
Criminal laws
prevent harm to society and provide punishment from crimes
Two classifications of crimes: Felony
is a crime of a serious nature that has a penalty of imprisonment for greater than 1 year or even death
Two classifications of crimes: Misdemeanor
is a less serious crime that has a penalty of a fine or imprisonment for less than a year
Civil laws
protect the rights of individual persons within our society and encourage fair and equitable treatment among people
The damages for civil laws involve
the payment of money, unlike criminal laws, which are punished by imprisonment
Standards of care
are the legal guidelines for nursing practice.
Nursing standards of care are defined in the
Nurse Practice Acts and by the State Board of Nursing of each state, by the federal and state laws regulating hospitals and other health care institutions, and by the written policies and procedures of employing institutions
In a malpractice lawsuit, nursing standards of care are used to
measure nursing conduct and to determine whether the nurse acted as any reasonably prudent nurse would act under the same or similar circumstances
Nurse Practice Acts established
educational requirements for nurses, distinguish between nursing and medical practice, and generally define the scope of nursing practice
American Nurses Association
has developed standards for nursing practice, policy statements, and similar resolutions
Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
requires that accredited hospitals have written nursing policies and procedures
Institutional policies and procedures must
conform to state and federal laws, as well as community standards, and cannot conflict with legal guidelines that define acceptable standards of care
In a lawsuit for malpractice or nursing negligence, a _ _ is called to testify to the jury about the standards of nursing care as applied to the facts of the case
nursing expert
Nurse experts must base their opinions on
existing standards of practice established by Nurse Practice Acts, professional organizations, institutional policies and procedures, federal and state hospital licensing laws, and current nursing research literature
The nurse is obligated to seek appropriate treatment for the client both
ethically and legally
fiduciary relationship
is one in which a professional, the nurse, provides services which by nature cause the recipient, the client, to trust in the specialized knowledge, the integrity, and the fidelity of the professional
Emergency Medical Treatment and Active Labor Act (EMTALA)
This act provides that when a client comes to the emergency department or the hospital, an appropriate medical screening must be done within the hospital's capacity
Under EMTALA a transfer to another hospital can be performed if
1. Receiving facility agrees to the transfer, has space for the client, and has qualified personnel to receive the client; 2. the medical records must be forwarded to the receiving hospital; 3. the client must be transported by qualified personnel and transportation equipment
Mental Health Parity Act of 1996
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
A petition for involuntary detention must be filed with the court within _ hours of the client's initial detention. A hearing must be conducted within _ days of the filing of the involuntary petition
96 hours; 2 days
If the judge determines that the client is a danger to self or others, the client can be detained for _ more days for psychiatric treatment
21 days
Two basic advance directives:
living wills and durable powers of attorney
Patient Self-Determination Act (PSDA)
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 directive
Under PSDA, it must be documented in the client's _ whether the client has signed an advance directive
In order for living wills or durable powers of attorney for health care to be enforceable, the client must
be legally incompetent or lack decisional capacity to make decisions regarding health care treatment.
The determination of legal competency is made by a
The determination of decisional capacity is usually made by the
physician and family
Living wills
are written documents that direct treatment in accordance with a client's wishes in the event of a terminal illness or condition
Generally, _ witnesses, neither of whom can be a relative or physician, are needed when the client signs a living will
Durable power of attorney
designates an agent, surrogate, or proxy to make health care decisions if and when the client is no longer able to make decisions on his/her own behalf
Ethical doctrine of autonomy ensure the client
the right to refuse medical treatment
Every state now requires "_ and _" evidence of the client's choice, but individual states differ as to what standard satisfies the amount of evidence required
"clear and convincing"
A DNR order should be
written, not given verbally
"_ _" or "_ _" may be defined differently by various institutions and may be interpreted as not performing resuscitative procedures as a competent person would
"slow codes" or "partial"
_ is a procedure that is performed on an appropriate client unless a _ order is written in the client's chart
Legally competent adult clients may consent to a DNR order either
verbally or in writing after being given the appropriate information by the physician.
A verbal consent for a DNR requires
two witnesses, one of whom must be a physician affiliated with the hospital.
A written consent for a DNR requires
two adult witnesses
If no surrogate is available to give consent, the DNR order can still be written but
only if the physician is reasonably medically certain that the resuscitation would be futile
The statutes provide that the attending physician must review the DNR orders every
3 days fro hospitalized clients or every 60 days for clients in residential health facilities
An individual who is at least _ years of age may make an anatomical gift or organ donation
anatomical gift is defined as a "donation of all or part of a human body to take effect upon or after death"
The anatomical gift must be made in
writing and signed by the donor
Uniform Anatomical Gift Act of 1987
unless the gift is revoked by the donor before death, no further consent is required after the donor's death.
In most states Required Request laws mandate that at the time of admission to a hospital,
a qualified health care provider must ask each client over 18 whether they are an organ or tissue donor
Required Request laws are also part of the _ _ _ _, which addresses many issues involving organ donation, including the rights and duties at death.
Uniform Anatomical Gift Act
The physician who certifies death
shall not be involved in the removal or transplantation of organs
National Organ Transplant Act of 1984
prohibits the purchase or sale of organs. The act also provides civil and criminal immunity to the hospital and physician who acts in accordance with the act. The act also protects the donor's estate from liability for injury or damage that may result from the use of the gift.
Health Insurance Portability and Accountability Act
limits the extent to which health plans may impose preexisting condition limitations and prohibits discrimination in health plans against individuals participants and beneficiaries based on health status.
One of the ways that insurance companies keep costs down is
by not insuring certain preexisting conditions that clients have when they obtain group health insurance coverage.
HIPPA requires insurers to only limit coverage for a preexisting condition for
12 months in most cases
The advantages of HIPPA are
that employees can change jobs without losing coverage as a result of preexisting coverage exclusion as long as they have had 12 months of continuous group health insurance coverage
Privacy Standards
these rules 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
HIPPA requires that nurses and all health care providers avoid
discussing clients in public hallways and should provide reasonable levels of privacy in communicating with and about clients in any manner
FDA has set forth guidelines for the use of restraints
1. only to ensure the physical safety of the resident or other residents 2. only on the written order of a physical that specifies the duration (usually 24 hours) and circumstances under which the restraints are to be used
The most frequent indications for restraints are
1. unanticipated risk of injury to self (falls) or others; 2. interference with treatment 3. clinically disruptive or disturbing behavior
A license can be _ or _ by the State Board of Nursing if a nurse's conduct violates provisions in the licensing statue based on administrative law rules that implement and enforce the statue
suspended or revoked
Because a license is viewed as a _ right, due process must be followed before a license can be suspended or revoked.
Due process means
that nurses must be notified of the charges brought against them and that the nurses have an opportunity to defend against the charges in a hearing
Good Samaritan Law
These laws limit liability and offer legal immunity for nurses who help at the scene of an accident. They also provide that a nurse can assist a minor in an emergency at the scene of an accident or competitive sports event before obtaining the parent's consent
Nurses should check their own state's Good Samaritan statue because
some states (Minnesota and Vermont) require nurses to stop and help in an emergency
The purpose of public health laws are
protection of the public's health, advocating for the rights of people, regulating health care and health care financing, and ensuring professional accountability for the care provided
Public Health Laws may include
reporting suspected abuse and neglect, such as child abuse, elder abuse, or domestic violence, reporting communicable diseases, ensuring that required immunizations have been received by clients in the community, and reporting of other health-related issues enacted to protect the public's health
Every state with child abuse legislation requires that
suspected child abuse or neglect must be reported
Health care professions who do not report suspected child abuse or neglect may be
held liable for civil or criminal legal action
There are two standards for the determination of death
1. The cardiopulmonary standard requires irreversible cessation of circulatory and respiratory functions. 2. The whole-brain standard requires irreversible cessation of all functions of the entire brain, including the brain stem
Uniform Determination of Death Act
has been adopted in most states and provides that either the cardiopulmonary definition or the whole-brain definition may be used to determine death
In many states there is an order of priority for the giving of consent for autopsies
1. decedent, in writing; 2. durable power of attorney; 3. surviving spouse; 4. surviving child, parent, brother, or sister in the order named
Oregon Death with Dignity Act
the statute provided that a competent individual with a terminal disease defined as an "incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment, produce death within 6 months" could make an oral and written request for medication to end his/her life in a humane and dignified manner
There was a _-day waiting period between the initial oral request and the writing prescription and no less than a _-hour waiting period between the written request and the writing of the prescription
15 day; 48 hour
is a civil wrong made against a person or property
A tort can either be
unintentional or intentional
is negligence committed by a professional such as a nurse or physician
Intentional tort
are willful acts that violate another's rights.
Examples of Intentional torts
1. Assault 2. Battery 3. Invasion of privacy 4. Defamation of character
is any intentional threat to bring about harmful or offensive contact
Example: a nurse threatening to give a client an injection without the client's consent
is any intentional touching without consent
Example: if the nurse actually gives the injection without consent
A battery always includes an
assault, which is why the terms assault and battery are commonly combined