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91 Cards in this Set
- Front
- Back
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What is a tort?
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A tort is generally defined as a wrongful act committed against a person or his or her property independent of a contract. A person who commits a tort is called the tort-feasor and is liable for damages to those who are affected by the person's actions. The word tort is French for injury or wrong. Torts can involv several different types of actions including a direct violation of a person's legal rights or a violation of a standard of care that causes injury to a person. Torts are classified as unintentional, intentional, or quasi-intentional.
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What is nonfeasence?
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Unintentional Torts: You choose or forget to perform a legally required duty. Example> Charting or performing CPR when you're supposed to.
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Ommission Negligence:
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Not doing what a prudent nurse would have done
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Malpractice
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A professional that can be sued for nonintentional wrong doing.
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4 things needed to claim negligence:
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a service was not completed, breach of duty, causality, damages:
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What are common causes for malpractice suits?
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Burns: from hot water, heating pads, lights, malfunctioning equipment, baths, showers
Falls: out of bed, due to wet floors, oversedation Failure to observe and take appropriate action: refusing to answer call lights, orthopedic injuries, not taking VS, leaving patients alone Mistaken identity Wrong surgical site Failure to communicate Lack of informed consent |
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What is informed consent?
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Informed consent is both a legal and an ethical issue. It is the voluntary permission by a client or by the client's designated proxy to carry out a procedure on the client. The are the basis of a small percentage lawsuits.
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What are the indications of a true emergency?
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True Emergency: exists when a person will either die or have permanent injury if treatment is not started
Consent considered implied; if awake, the person would want care Can be used with children younger than age 18 |
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What is the statute of limitations on filing a malpractice suit against a healthcare provider?
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A period after which a malpractice suit cannot be filed is Generally 2 years after the discovery of injury and
In children up to age 21 years |
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What would make me a suit prone nurse?
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Insensitive to patient needs
Undereducated Overconfident Authoritarian Inflexible Preoccupied with personal issues |
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What are ways I can protect myself from a lawsuit?
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Maintain good medical records (document, document, document!)
Establish good relationships with patients/clients. Keep nursing skills current Assess the client frequently for changes from baseline. Maintain professional manner in all situations with all patients, peers, members of other professions. Avoid making statements that may admit fault. What does this mean? |
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What are Advance Directives?
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They are the expressed desires about future medical care. They are meant to encourage people to discuss and document their wishes concerning the type of treatment and care that they want in advance so that it will ease the burden on their families and providers when it comes time to make such a decision.
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How is a malpractice proven?
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A wrong occurred because of a professionals failure to act as a reasonable and prudent professional would have acted.
3 essential characteristics Working in a professional capacity Wrong must be demonstrated Wrong must be shown to have been caused by the failure of the professional to act as a reasonable and prudent member of that profession. |
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What are unintentional torts?
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Unintentional torts- a wrong occurring to another person leading to injury, even though it was not intended
Same as negligence – failure to act as a reasonable and prudent person Malpractice- professional negligence; failure to act as a competent and caring nurse. |
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Why ethics?
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Guiding principles that all members of a discipline accept.
Helps professional groups settle questions about practice or behavior: if there is confusion we look to our principals. Includes responsibility, accountability, and confidentiality like Hippa Guides conduct of the professional. List of professional values. ANA code revised in 2001. when it was last updated |
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What are our guiding principals as nurses?
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Professional Nursing Code of Ethics: our guiding principals that we need to accept and follow
Helps professional groups settle questions about practice or behavior: if there is confusion we look to our principals. Includes responsibility, accountability, and confidentiality like Hippa Guides conduct of the professional. |
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The unbiased ethic....
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The nurse in all professional relationships, practices with compassion and respect for the inherent dignity, worth, and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems.
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The commitment and intervention ethic...
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The nurses’ primary commitment is to the patient, whether an individual, family, group or community.: old days we were committed to physician that is changes to advocate for the patient. So we need to intervene in a certain way: chain of command only. We would have to go to our instructor, director, in hospital it would be charge nurse.
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We advocate and watch out for...
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The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient.
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The accountability and delegation ethic...
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The nurse is responsible and accountable for individual nursing practice and determines the appropriate delegation of tasks consistent with the nurses’ obligation to provide optimum patient care.
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I owe something to myself ethic...
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The nurse owes the same duties to self as to others, including the responsibility to preserve integrity and safety, to maintain competence, and to continue personal and professional growth.
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Improve the environment and workplace....evidence based practice....
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The nurse participates in establishing, maintaining, and improving health-care environments and conditions of employment conducive to the provisions of quality health care and consistent with the values of the profession through individual and collective action.: to be a change agent: be proactive, research, communicate, need evidence or research based practice, our whole premise for how we do something
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Advance the profession....
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The nurse participates in the advancement of the profession through contributions to practice, education, administration, and knowledge development.
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I'm a collaborator....
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The nurse collaborates with other health professionals and the public in promoting community, national, and international efforts to meet health needs: community health fair,
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I stand a united front....
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The profession of nursing, as represented by associations and their members, is responsible for articulating nursing values, for maintaining the integrity of the profession and its practice, and for shaping social policy: join an organization, important to network with others that are doing the same thing bringing people together as a united front.
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what are Ethics?
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A system of valued behaviors/beliefs that declare what is right or wrong and what ought to be.
Can be for individuals, groups, or society Generally followed voluntarily due to lack of means of enforcement: what do I think is ethical. Can’t be enforced legally. May be different internally: They declare how you make decisions. |
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What is ethical accountability?
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Each person is responsible for his/her own actions
Key element to being a professional: Must be willing to accept the consequences of one’s own decisions. The buck stops with you don’t give the wrong drug. |
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Who am I accountable to?
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Accountability is answerability: all of the people below.
Nurses are accountable to? Clients Public Profession of nursing Physicians Administration Other nurses (peer review) |
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What are values?
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A personal belief about the worth of a given idea, attitude, custom, or object that sets standards that influence behavior
Value formation Value clarification |
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What are the definitions of these basic terms that are used in ethics? Autonomy, Beneficence, Nonmaleficence, Justice, Fidelity?
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Autonomous: keep education and join organizations. Educate client on the right to refuse. Right to refuse the physician and ask for education on why we are doing what we are doing. Commitment to include clients in decisions
Beneficence: Taking positive actions to help others Nonmaleficence: Do no harm: Avoidance of harm or hurt Justice: Being fair Fidelity: Commitment to do what’s right. |
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What are the steps in processing an ethical dilemma?
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Step 1: Collect, analyze, interpret the data.
Step 2: State the dilemma.: Abuse Step 3: Consider choices of action. Step 4: Analyze the advantages and disadvantages of each course of action. Step 5: Make the decision, act on it. |
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In the issues of bioethics what isssue is central to discussions about futile care, cancer therapy, physician-assisted suicide, and DNR
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Quality of Life
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What is it called when everything we do will not improve outcome and
interventions unlikely to produce benefit for the client. |
Futile Care
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Patient allocation should be based on ________________, instead of patient ratio.
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patient acuity
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What is paternalism?
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Telling them what to do like a parent, acting like we know everything.
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Which is the most common criminal law nurses break?
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Failure to renew their nursing license.
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Are nurses more apt to be involved in criminal or civil lawsuits?
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Civil lawsuits which are a violations of one individual's rights by another individual.
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The one who brings a complaint to court is called______________, and the individual that the complaint is filed against is called__________________.
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the plaintiff, and the defendant.
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________________of proof rests with the ________________
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burden, plaintiff.
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How is common law different than statutory law, and which type does nursing usually fall under and at which level?
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We fall under statutory laws at the state level because this is where licensing occurs-at the state level. Common laws are those that have been precedented by previous decisions in court, which requires judges to make decisions based on these precedential cases or stare decisis.
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What is a living will?
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Living will: a legal document with a notary. Similar to advance directive, but legal
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What is a durable power of attorney for health care?
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A designated person who will follow the wishes of the client, when they are incompetent.
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What do malpractice and negligence have in common?
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they are both unintentional torts. Negligence is the primary form of unintentional tort, and malpractice is a type of negligence in which professionals can be sued.
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What is utilitarianism?
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Utilitarianism (situational ethics): everybody is diffeernt: also called teliology, whatever is okay for the whole; like it is okay to lie to keep people from being sad. Ethical system of utility
GOOD: happiness, pleasure or lack of discomfort and pain Greatest good for the greatest number of people |
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What is deontology?
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Deontology (formalistic, principle, duty-based system)believe that standards don’t change for anyone: Treated like black and white situations. A+B=C
Based on discovery and confirmation of a set of morals or rules that govern the ethical dilemma to be resolved Absolute and unchanging “Survival of the species” |
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What are laws?
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Laws: Man-made rules that regulate human social conduct in a formally prescribed and legally binding manner. Laws are rules that protect the social fabric.
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What is natural law?
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Natural Law- the inherent tendency that humans have to take actions that follow their nature and purpose as human beings
Based on the idea to promote good and avoid evil Aimed at the preservation of society Like don’t kill: |
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What is criminal law?
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Law that regulates conduct considered offensive against the general public because it harms the welfare of society as a whole
Murder, robbery, rape, etc. Prosecuted by the state, not by individuals State vs. John Doe Violations are called crimes |
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What are statutory laws?
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Statutory law: STATE BILL law that arises from formal legislative enactments; whether federal (enacted by U.S. congress called statutes), state (called state statutes), or city level (they would be called ordinances, codes, or regulations), or from other legal entities with legislative power:
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These 4 laws:
Contract law Treaty law Marriage law Tort law: A tort is generally defined as a wrongful act committed against a person or his or her property independent of a contract. A person who commits a tort is called the tort-feasor and is liable for damages to those who are affected by the person's actions. The word tort is French for injury or wrong. Torts can involve several different types of actions including a direct violation of a person's legal rights or a violation of a standard of care that causes injury to a person. Torts are classified as unintentional, intentional, or quasi-intentional. fall under what type of umbrella named law? |
These are all considered civil Laws.
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Who falls prey under Statutory>>.Civil>>>Tort Lawsuits?
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Nurses.
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Which laws can fall under both criminal and civil designations?
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Statutory and Common laws.
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What are the 3 types of torts and give examples of each.
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Intentional: willful acts that violate another persons’ rights or property – usually physical acts (not always) like: Assault& Battery False Impris-onment, Intentional infliction of emotional distress, Conversion of property, Patient’s right to be cared for in a hospital. Unintentional Defamation of character- sharing information that unintentionally harms a person’s reputation:Slander – oral or spoken, Libel- written,
Sharing info verbally in the locker room or around the nursing unit. Quasi-intentional torts or those that involve situations of communication and often violate a person’s reputation, personal privacy or civil rights. Invasion of privacy – violation of a person’s right to keep information about self, family, and property from public scrutiny Not an absolute right – can and may be required by law to be breached Underage pregnancy: shared with health care team. Breach of confidentiality- revealing information obtained from privileged communication Privileged communication – special type of privacy that exists in certain professional relationships where its violation would destroy trust and confidence in the professional Physician-patient,Lawyer-client Priest-parishioner You have autonomy: but tell the doctors, Unintentional torts- a wrong occurring to another person leading to injury, even though it was not intended:negligence or malpractice |
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What role do nurses have in promoting client satisfaction?
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• Provide high-quality client care
• Maintain a safe work environment • Develop and follow policies and procedures • Educate clients • Organize other resources to continue/foster care outside of acute care setting • Communicate effectively with client and family • Understand and appreciate diversity/ethnicity of client |
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Name the different theories of leadership.
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Trait theory, Leadership Style:(Laiss e Faire, Democratic (also called supportive or participative), and Authoritarian; Relationship Task Orientation: High Relat./low task, or High task/low relat. Ultimately High task/high relate; Recent Theories: Situational & Transformational
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What is the trait leadership theory and what are its limitations?
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The trait theory focuses only the traits of an effective leader, without considering the leader's effectiveness in interactions with others. The following leadership traits are: high level of intelligence and skill, self-motivation & initiative, ability to communicate well, self-confidence & assertiveness, creativity, persistence, stress tolerance, willingness to take risks, and ability to accept criticism.
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What is the leadership style theory?
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This theory is based on 3 different styles of leadership: Laise a fair, Democratic, and Authoritarian.
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Describe the Laisse a fair style of leadership
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o Laissez-faire Style – described as permissive, nondirective or passive. Leader allows the group to determine their own goals and the methods to achieve them. Works best when the members of the group have the same level of education as the leader and the leader performs the same tasks as the group members.
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Describe the Democratic Leadership and the elements that make it effective.
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o Democratic Style – also called supportive or participative. All aspects of the process of achieving a goal, from planning and goal setting to implementing and taking credit for the success of the project, are shared by the group. Leaders using this style provide guidance to the group, and all members share control. This style works best with groups whose members have a relatively equal status and who know each other well because they have worked together for an extended period. Based on four beliefs:
• Every member of the group needs to participate in all decision making. • Within the limits established by the group, freedom of expression is allowed to maximize creativity. • Individuals in the group accept responsibility for themselves and for the welfare of the whole group. • Each member must respect all the other members of the group as unique and valuable contributors. |
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Describe the authoritarian style of leadership
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The Authoritarian Style – also called controlling, directive, or autocratic. Maintains strong control over all aspect of the group and its activities. The dictator – a leader using authoritarian style has no regard for the feelings and needs of the group. Achieving the goal is the only thing that matters. The Benevolent leader – uses a more paternalistic approach to achieving the goal. Attempts to include the group’s feelings and concerns in the final decision, but ultimately the leader makes the decision.
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What is the relationship -task orientation theory of leadership?
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High relationship-Low task: Rates leaders on whether they are oriented toward establishing relationships or achieving assigned tasks and resolving problems. Usually well- liked by members because the leaders accept members as individuals, are considerate of feelings, offer encouragement, and promote good feelings among members. Leader often sacrifices achievement of task when it conflicts w/feelings of group; often allows group to make own decisions w/out regard for task.
o High task-low relationship: leader similar to authoritarian style – leader does all planning with little regard to the input or feelings of the group, gives orders and expects them to be carried out without question; punishment includes verbal put downs and poor performance evals to keep from raising pay. o Both Extremes – the worst leader is the person with low relationship and low task orientation (like laissez-faire). Best leader is the one with high relationship and high task orientation; open to input, actively communicates w/group, gives constructive direction, quickly resolves conflict, achieves creative & effective solutions to problems. |
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What are 2 of the most recent theories of leadership?
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o Situational theory – recognizes that no one approach works in all situations. Leader needs to adjust leadership style & behavior to the situation; good leaders do this instinctively ; environment is important in exercising leadership.
o Transformational Theory – takes situational theory a step further ..this theory recognizes that multiple intangibles exist whenever people interact. Factors such as a sense of meaning, creativity, inspiration, and vision all are involved in creating a sense of mission that exceeds good interpersonal relationships and rewards. |
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What are some leadership behaviors? AACCEPS
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A-Acknowledges people are individual and different, A-Active listening, C-Continues life-long learning, C-Critical thinking, E-Establishes goals and outcomes, P-Problem solver, S-Skilled communicator.
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What are some leadership qualities? CCEIIOPSW
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Coping, Courage, Energy,Integrity, Initiative, Optimism, Perseverence, Self-Knowledge, and well-Rounded.
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Describe Delegation in nursing
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• Delegation is recognized as assigning or designating a competent individual the responsibility of carrying out a specific group of nursing tasks in the provision of care for certain clients. Delegation includes the understanding that the authorized person is acting in the place of the RN and may be carrying out tasks that generally fall under the RN’s scope of practice. The RN’s are always legally responsible for supervising non-nurses to ensure that the care given meets the standards of care. However if the facility or the state board of nursing has a pre-designated list of tasks, that non-nursing personnel may undertake in the care of clients, then the RN is responsible only for supervising them to make sure the tasks are carried out safely. The nurse should use the 5 rights of delegation to make sure that the task is proper for delegation
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What are the 5 rights of delegation?
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1. Right Task-Do the tasks delegated follow written policy guidelines?
2. Right Person- Does the person have the proper qualifications for the tasks? 3. Right direction or communication- Are the instructions and outcomes clearly stated? When should the person report changes? 4. Right supervision or feedback- How can the delegation process be improved? Are the client goals for care being achieved? 5. Right Circumstances- Are the tasks that are being delegated free from requiring independent nursing judgments? |
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What are my 4 responsibilities as a nurse if I am going to delegate?
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o Assess the client first! Assessment is a designated responsibility of RNs. Clients who are stable & unlikely to have drastic changes in health status are most suitable for delegation; delegated tasks must be uncomplicated, routine, performed w/out variation from policy/procedure & shouldn’t require nursing judgment while being performed.
o Know staff availability: availability, skill & competence level and education of the personnel to be assigned; must be matched w/level of care required by the client. o Know the job description: RNs usually delegate to unlicensed assistive personnel (ie, CNA, nurse’s aide, etc.); nurses must know the institution’s job description and scope of the UAP’s abilities. o Educate the staff member: delegation also requires educating the UAP about the task to be done; RN may demonstrate task, teach, and document teaching; be available to answer questions and check in throughout shift to ensure competent and safe care. |
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What 4 things should I avoid when delegating?
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• Assigning tasks that are highly invasive or have the potential to cause significant harm to clients.
• Assigning tasks that are designated under the scope of practice or standards of care as belonging exclusively to the RN • Assigning tasks that the person is not trained for or lacks the knowledge to safely complete • Assigning tasks when there is inadequate time to safely monitor or evaluate the practice of the person performing the tasks. |
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What are the 4 advantages of delegation?
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• Allows more time to be given to more clients than could be given by one RN.
• Frees the RN from lower-level time consuming tasks to they can spend more time planning/performing skills that less prepared ppl would be unable to do. • Maintains accountability & decision making with the RN. • Gives delegatees incentive to further their formal education, increase knowledge, and initiative. |
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Distinguish between delegation and supervision
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DELEGATION ALWAYS REQUIRES SUPERVISION, But POSSIBLE TO HAVE SUPERVISION WITHOUT DELEGATION
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What are the LEGAL implications regarding delegation
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•Delegation of tasks & supervision of less-qualified health care providers is one of the primary functions of today’s RNs due to restructuring of health care and the increased use of UAPs w/minimal education & experience.
• Dependent practitioners (licensed practical nurses/LPN or LVN) CANNOT delegate. • When an RN delegates a task, she is accountable for the safe/proper completion of the tasks & is responsible for determining whether the delegatee is competent to carry out those tasks. o Exception: if task is delegated to another licensed person (ie LPN/LVN) whose scope of practice covers the task delegated, the RN is responsible ONLY for supervision of the licensed person. • RN has an ethical obligation to refuse assignments that they are not competent to carry out & to refuse to delegate nursing tasks to ppl they believe are unable to perform them. • Indirect delegation puts RNs in a precarious legal position; indirect delegation is a list (made by institutions) of tasks that certain health-care personnel can perform; experts feel is covert licensure; basically giving permission to those not educated like a nurse to perform nursing tasks, but nurses are STILL accountable for the safe completion of the tasks; indirect also takes away much of the authority of nurses to delegate as they see fit. |
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What is the difference between a leader and a manager?
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A leader can express themselves either formally or informally. They may not be designated as leaders, but may have the qualities of good leaders. Managers are given such a title by a higher authority, and have been designated authority to supervise a group of employees in certain tasks. Managers are also held formally responsible for their actions: quality, quantity, and cost of the work.
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Name the 2 major theories of management.
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Time-Motion Theory, and Human Interaction Theory.
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What is the Time Motion Theory?
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TIME-MOTION THEORY: developed from the early industrial age in which theorists concentrated on ways to complete a task most easily and efficiently. Their efforts resulted in high productivity with decreased employee satisfaction. The incentive was money only. It is less desirable in today’s society and especially inappropriate and ineffective for managing RNs.
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What is the Human Interaction Theory?
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The other Major school of thought is the HUMAN INTERACTION THEORY. This theory came from recognizing the limits of the Time-motion theory. The hole in the theory is that they were actually seeing more productivity from lower-paid employees, than in higher-paid. This revelational difference was because of the employee’s attitudes fears and hopes and personal problems of the lower paid group were met my the manager who was able to elicit their commitment, loyalty, creativity, productivity, and continuous improvement.
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What the 2 major forces that bring about change and examples for each?
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external-forces outside the person or organization;
internal forces that start within the person or organization Example of external: when govern. Agencies pass down new rules and regs. Like Hippa that affect the organization. Example of internal: Hospital increases salaries or eliminates mandatory overtime from the work action of a group of nurses. |
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How does one bring about change?
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Change can occur only when the driving force is greater than the restraining force. Those who want change push, and the ones being pushed, push back. If you want change you have to identify the restraining forces and ways to overcome them.
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What are the characteristics of an effective change agent?
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An optimistic, committed, trustworthy goal-oriented person who can be a motivator, communicator, orgnanizer and negotiator.
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What is a nurse manager?
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Person is between employees and upper-level management on the totem pole.
Functions depend on how institution defines the nurse manager’s role in the facility. NM has to understand job description, responsibilities and level of authority at the institution of employment. |
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What are some tasks involved in the job description of a nurse manager?
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Staff management and evaluation of job performance, meetings with all personnel, terminations, quality assurance, budgets and staff justification and a reward system.
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How has the definition of nursing informatics evolved? What is the ANA definition of nursing informatics?
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The definition has evolved from “any type of information technology used in delivering nursing care or in the process of educating nursing students”, to combining the nursing theory with informatics. ANA definition of nursing informatics: “A specialty that integrates nursing science, computer science, and information science in identifying, collecting, processing, and managing data and information to support nursing practice, administration, education and research; and to expand nursing knowledge”.
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What is the function of nursing informatics?
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Function of nursing informatics: to manage and process data to help nurses enter, organize, and retrieve needed info; although technology forms the foundation of informatics, the nurse’s ability to use the technology and make it function to meet client’s needs is the real test of the system’s effectiveness.
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What is the function of nursing informatics?
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Function of nursing informatics: to manage and process data to help nurses enter, organize, and retrieve needed info; although technology forms the foundation of informatics, the nurse’s ability to use the technology and make it function to meet client’s needs is the real test of the system’s effectiveness.
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What is the ANA's defined purpose of nursing informatics?
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ANA’ defined purpose of nursing informatics is to analyze information requirements; design, implement and evaluate information systems and data structures that support nursing; and identify and apply computer technologies for nursing.
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T/F Nursing informatic supports all areas of nursing.
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True. Nursing informatics supports all areas of nursing, including practice, education, administration, and research; it facilitates and guides management.
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List 3 examples of when nursing informatics is used.
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1) Electronic health records (may be accessed @ bedside or @ other station in lab or hospital), 2) Internet access to research journals (for on the job research), 3) Telehealth (use of electronic health info to provide support and health care when distance separates physician from client; also telehealth/telephone).
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Why is nursing informatics so important to the practice of nursing?
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Makes documentation of health records more consistent, can be used in all areas of nursing practice, a standardized way of documentation makes records more uniform, evidence based practice will documented proving the profession's stability, and allows nurses to contribute more to a multidisciplinary system.
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What are the advantages of the EHR?
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Improved communication, complete- ness of documentation, and reduction in error are most important advantages of the EHR. Other advantages include:Document client care and provides communication among health-care team members.
Acts as a financial and legal record; also used for research and continuous quality improvement (CQI). Multiple care providers can access them at the same time @ different locations.EHR provides reminders about completing information or carrying out protocol; also provides warnings about incompatibilities ofmedications or variances from normal standards. Redundant info is reduced with use of EHR; reduces clients being asked same questions over and over. They require less storage space, are more difficult to lose, and easier to research. |
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What are the disadvantages of EHR?
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Electronic Health Record Disadvantages: High front-end cost to buy equipment and convert from paper system; training and problems adjusting to new system for employees.
Subject to glitches of any other electronic system HIPAA regulations can be very strict; regulates access to such private information; decisions must be made about who can enter data into the system and when entries should be made, along w/protecting access to personal health information. |
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What are the advantages of the Paper Record?
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Advantages of paper record:People know how to use it; it is fast for current practice. Portable and non- breakable. It accepts multiple data (charts, drawings, photos, etc).Legal issues and costs are understood.
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What are the disadvantages of the Paper Record?
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Disadvantages of paper record:
Can be lost.Often illegible and incomplete. Has not remote access; and can only be accessed by one person @ a time Often disorganized & has duplicate info.Hard to store difficult to research. Same client has separate records @ each facility (hospital, dr office, home care). Records are shared only through hard copy. |
