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36 Cards in this Set
- Front
- Back
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"To Err Is Human"
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Report in 1999 by Institute of Medicine that reported est. of 44,000 to 98,000 Americans die each year due to preventable errors. Inst. called for legal reform in the area of medical malpractice and tort liability.
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Statutory Law
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Created by legislative bodies such as state legislatures and US Congress. EX. NPA - describe and define legal boundaries in ea state.
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Regulatory Law or Administrative Law
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Made by administrative bodies such as State Boards of Nursing when they pass rules and regs. Ex. to report incompetent or unethical nursing conduct to the SB of N.
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Common Law
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results from judicial decisions made in courts when ind. legal cases are decided. Ex. -informed consent and the client's right to refuse treatment. Most common- negligence and malpractice
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Statutory Law is either ___ or ___
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criminal Law, or civil law. Criminal Law - prevents harm to society and provides punishment for crimes. 2 Crimes - felony - serious nature. Misdemeanor - less serious crime. Penalty of a fine or imprisonment for less than a year. Misuse of a controlled substance
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Civil Laws
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protects rights of individual persons w/in our society and encourage fair and equitable treatment among people. Usually involves payment of monye.
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Standards of Care
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legal guidelines for nursing practice and provide the minimum acceptable nursing care. Standards reflect values and priorities of the profession (made by ANA) - outline scope, fx, and role of the nurse in practice. Set out in every state by NPA, by federal and state laws, by professional and specialty nursing org., and by policies and procedures established by health care facility wh. nurses work.
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The Joint Commission
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p326 requires that accredited hospitals have written nursing policies and procedures. These are internal standards of care available on all nursing units.
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Darling Vs. Charleston Community Memorial Hospital
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One of the 1st and most important cases discussing nurse's liability. (doctor poorly casted a leg, foot turned gangrene and had to be cut off, nurses tried to contact dr, but did not go over their head to do what was right)
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Americans with Disabilities Act
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(Statutory law) - federal statute enacted by US Congress in 1990. Very broad civil rights statute, protecting the right of the disabled. How employers should treat HIV infected health care workers and clients. Several cases have held that the health care provider has to disclose the fact that he or she has HIV
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Emergency Medical Treatment and Active Labor Act
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-Came as a result of "patient dumping" - transferring fr. private to public w/out appropriate screening - Must have it now! Must stabilize client if it is emergency, unless client says otherwise. Other emergency room does not have to accept them.
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Mental Health Parity
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-Regulation on mental health benefits -forbids restrictions from placing lifetime or annual limits on coverage that are less generous than those placed on medical or surgical benefits. Involuntary - 96 hours detention and judge must act to keep them there.
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Advance Directives
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Living Wills -written, wh/ procedures he/she wants when terminally ill or in a persistent vegetative state. Difficult to interpret and not clinically sp. in unforeseen circumstances
Durable Power of Attorney for Health Care - legal document that allows designated agent to make decisions when he/she is no longer able to. |
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Patient Self Determination Act
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Right to refuse treatment and formulate advance directives
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National Organ Transplant Act of 1984
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Prohibits purchase or sale of organs. Clients in end-stage renal disease are eligible for Medicare coverage for a kidney transplant, but private insurance pays for other transplants. United Network for Organ Sharing - contract w/ govt and sets policies and guidelines for procurement of organs. Clients moved up for GREATEST NEED.
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Health Insurance Portability and Accountability Act (1996)
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Rights to clients -1. protects ind. fr. losing their health ins. when changing jobs by providing portability - no loss of coverage due to pre-existing coverage exclusion as long as they have had 12 mos. of continuous group health ins. coverage. 2. Privacy Section -a. rights to consent to use and disclose protected health info, b. inspect & copy one's medical record c. to amend mistaken or incomplete info.
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Privacy and Confidentiality
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-right of clients to keep info about themselves fr. being disclosed. -how health care providers treat client information once it has been disclosed to others.
HIPAA and protects employees. |
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Licensure
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Sate Board of Nursing licenses all registered nurses in the state in wh/ they practice.
-hearings of suspension or revocation of a license do not occur in court, but rather a panel of professionals conducts the hearing. Nurses can appeal to admin. and judicial review after all other options. |
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Good Samaritan Laws
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Still must practice w/in scope in emergencies
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Public Health Laws
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Important esp. in community health settings. Reporting of communicable diseases, school immun., and laws intended to promote health and reduce risks in communities. CDC & Occupational Health and Safety Act - guidelines on a national level for safe and healthy communities and work environments. Protection of public health, advocating for rights of people, regulating health care and H.C. financing, and ensuring prof. accountability for care provided. Reporting child abuse, domestic violence
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The Uniform Determination of Death
requires two standards for determination of death: |
1. Cardiopulmonary standard -irreversible cessation of circulatory and respiratory fxs 2. whole-brain standard - irreversible cessation of all fxs of the entire brain, incl. brain stem. Done to facilitate legal recovery of organs for transplantation. Most states adopt this. Use EITHER.
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Oregon Death With Dignity Act (1994)
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1st statute that permitted Dr or health care provider-assisted suicide. Competent person w/ terminal illness w/in 6 mos to die. Supreme Court said some court cases unconstitutional to assist in suicide. Some states DO legislate this though. ANA against it.
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Tort
Intentional Tort |
-civil wrong made against a person or property. -WILLFUL acts that violate another's rights, such as assault, battery, and false imprisonment. Quasi - ____acts where intent is lacking but volitional action and direct causation occur - invasion of privacy. Unintentional ___ -negligence or malpractice
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Intentional Torts - Assault, Battery and False Imprisonment
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any intentional threat to bring about harmful or offensive contact - no contact actually necessary. Threaten. Client must give consent.
-Any intentional touching w/out consent (either harm or just offensive tough). Battery always includes assault. |
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Quasi-Intentional Torts - Invasion of Privacy, Defamation of character
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Types of invasion - intrusion on seclusion, appropriation of name or likeness, publication of private or embarrassing facts, and publicity placing one in a false light in the public's eyes. -Publication of false statements that result in damage to a person's reputation.
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Malice, Slander, Libel
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-published w/ malice in the case of a public official or public figure - means that the person publishing the info knows it is false and publishes it anyway or publishes it w/ reckless disregard as to the truth. - VERBAL false statement. -WRITTEN defamation of character
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Unintentional Torts -Negligence
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-(annonym for nursing) - conduct that falls below a standard of care. EX. Driver acts unreasonably in failing to stop at a stop sign. -professional negligence - nursing care fallow below a standard of care - nursing malpractice occurs. not checking armband and then admin. medication to a wrong client.
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Informed Consent
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Full disclosure of risks, benefits, alternatives, and consequences of refusal. Explains alternative treatments and risks. Exception is emergencies. Does not fall w/in nursing duty because they don't perform surgery or direct medical procedures. Nurse may sign as witness.
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Malpractice Insurance
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Or profess. liability insur is a contract btwn the nurse and the ins. company. Provides for a defense when a nurse is in a lawsuit involving profess. negligence or medical malpractice. Nurses employed by health care instit. are generally covered by that instit.'s ins. and do not need to purchase suppl. ins. unless nurse practices outside of employ. inst. Only covers while working w/in scope of their employment. BUT - friends/family ask - may want ind. ins
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Short Staffing
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Legal problems occur if there are not enough nurses to provide competent care or nurses work excessive overtime. CA - fixed nurse-to-client ratio for all areas of acute care nurs. Need to make written protests to nursing admin before taking assignment where there is too many clients.
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Floating
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sometimes required to "float" fr. area in wh. they normally practice to other nursing units based on census load and client acuities. "Floaters" need to inform supervisor of any lack of exp. in caring for the type of clients on the nursing unit. Request and receive an orientation to unit.
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Physicians' Orders
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Nurses follow physicians' orders unless they believe the orders are in error or harm clients.
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Risk Management
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a system of ensuring appropriate nursing care that attempts to identify potential hazards and eliminate them before harm occurs. Steps involved include 1. identifying possible risks 2. analyzing them 3.Acting to reduce risks 4. evaluating steps taken. Requires GOOD DOCUMENTATION
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Incident report or occurrence report
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Provides a database for further investigation in an attempt to determine deviations fr. standards of care and corrective measures needed to prevent recurrence and to alert risk management to a potential claim situation. Visitor fall, failure to follow physician orders. NEVER document in the client's medical record that an occurrence report was completed.
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Some insurance companies, medical and nursing orgs. and TJC require use of . . .
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quality improvement (QI) and risk management procedures.
Note: Nurse charts sponges and instrument counts for surgery, even though physician performs procedure! |
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Professional Involvement
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Nurses need to be involved in proff. organizations and on committees that define standards of care for nurs. practice.
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