Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
63 Cards in this Set
- Front
- Back
|
Meaning of Law
|
those rules that prescribe and control social conduct in a formal and legally binding manner.
|
|
|
Statutory law
|
created by various legislative bodies, such as state legislatures or Congress.
|
|
|
Common law:
|
develops within the court system as judicial decisions are made in various cases and precedents for future cases are set. In this way, a decision made in one case can affect decisions made in later cases of a similar nature.
|
|
|
Administrative law:
|
established through the authority given to government agencies, such as state boards of nursing, by a legislative body. These governing boards have the duty to meet the intent of laws or statutes
|
|
|
Sources of Law:
|
a. Constitution: The Bill of Rights, comprising the first 10 amendments to the Constitution, is the basis for protection of individual rights.
b. Statutes: Localities, state legislatures, and the U.S. Congress create statutes. These can be found in multivolume sets of books and databases. Nurses have an opportunity to influence the development of statutory law both as citizens and as health-care providers. c. Administrative law: The Dept. of Health and Human Services, the Dept. of Labor, and the Dept. of Education are the federal agencies that administer health-care-related laws. At the state level are dept.’s of health and mental health and licensing boards. [specific statutory laws give state nursing boards the authority to issue and revoke licenses, which means that each board of nursing has the responsibility to oversee the professional nurse’s competence] |
|
|
Civil Law:
|
usually involves the violation of one person’s rights by another person. Areas that particularly affect nurses are tort law, contract law, antitrust law, employment discrimination, and labor laws.
|
|
|
Negligence:
|
the unintentional tort of acting or failing to act as an ordinary, reasonable, prudent person, resulting in harm to the person to whom the duty of care is owed. The legal elements of negligence consist of duty, breach of duty, causation, and harm or injury. All four elements must be present in the determination. For example, if a nurse administers the wrong medication to a client, but the client is not injured, then the element of harm has not been met. However, if a nurse administers appropriate pain medication but fails to put up the side rails, and the client falls and breaks a hip, all four elements have been satisfied. The duty of care is the standard of care. The law defines standard of care as that which a reasonable, prudent practitioner with similar education and experience would do or not do in similar circumstances.
|
|
|
Malpractice
|
(professional negligence). When fulfillment of duties requires specialized education, the term malpractice is used. In most suits, the facility employing the nurse who cared for the client is named the defendant.
|
|
|
Respondeat superior:
|
“let the master answer” holds employers liable for any negligence by their employees when the employees were acting within the realm of employment and when the alleged negligent acts happened during employment. [nursing instructors can also be sued under this]
|
|
|
Good Samaritan Laws:
|
protects nurses and physicians when administering emergency care, as long as they behave in the same manner as an ordinary, reasonable, and prudent professional in the same or similar circumstances. In other words, when assisting in emergency care, nurses must still observe professional standards of care. However, if payment is received, this law does not hold.
|
|
|
Confidentiality:
|
HIPPAA was passed as an effort to preserve this law and protect the privacy of health information and improve the portability and continuation of health-care coverage. This includes giving information by telephone to individuals claiming to be relatives, giving information without a client’s signed release, or removing documents from a health-care provider with a client’s name or other information.
|
|
|
Slander and Libel:
|
categorized as quasi-intentional torts. Nurses rarely think of themselves as being guilty of slander or libel.
|
|
|
Slander:
|
the spoken word; Making a false statement about a client’s condition that may result in an injury to that client.
|
|
|
Libel:
|
written word; Making a written false statement. Ex: stating that a client who had blood drawn for drug testing has a substance abuse problem, when the client does not carry that diagnosis, could be considered a slanderous statement.
|
|
|
False Imprisonment:
|
confining an individual against their will by either physical (restraining) or verbal (detaining) means. Examples:
o Using restraints on individuals without the appropriate written consent o Restraining mentally handicapped individuals who do not represent a threat to themselves or others o Detaining unwilling clients in an institution when they deserve to leave o Keeping persons who are medically cleared for discharge for an unreasonable amount of time o Removing the clothing of clients to prevent them from leaving the institution o Threatening clients with some form of physical, emotional, or legal action if they insist on leaving. |
|
|
Assault
|
threatening
|
|
|
Battery
|
touching: Holding a violent client down against their will and injecting a sedative IS battery. Most medical treatments, particularly surgery, would be battery if it weren’t for informed consent from the client.
|
|
|
Types of Standards
|
several types
|
|
|
Internal Standards:
|
usually explained in a specific institutional policy and included in policy and procedure manuals. It is the institution’s responsibility to notify health-care personnel about changes and usually accomplish this by written memos, meetings, and in-service education.
|
|
|
Organizational Standards
|
State and National Standards
|
|
|
Nurse Practice Acts:
|
define the boundaries within that state
|
|
|
Patient’s Bill of Rights:
|
was replaced by the Patient Care Partnership in 2003 and is derived from the ethical principle of autonomy.
|
|
|
Informed Consent:
|
gives health-care personnel the right to deliver care and perform specific treatments without fear of prosecution. It is the physician’s responsibility to give information to a client about a specific treatment or medical intervention.
|
|
|
Criteria for informed consent:
|
o A mentally competent adult has voluntarily given the consent
o The client understands exactly to what he or she is consenting o The consent includes the risks involved in the procedure, alternative treatments that may be available, and the possible result if the treatment is refused o The consent is written o A minor’s parent or guardian usually gives consent for treatment |
|
|
Implied consent
|
occurs when consent is assumed. This may be an issue in emergency when an individual is unable to give consent. (car wrecks).
|
|
|
Professional Protection against Law Suits
Preventive Strategies: |
demonstrating care and concern and making clients and families aware of choices and methods can help decrease liability.
|
|
|
Tips for avoiding legal problems
|
o Keep yourself informed regarding new research related to your area of practice
o Insist that the health-care institution keep personnel apprised of all changes in policies and procedures and in the management of new technological equipment o Always follow standards of care or practice for the institution o Delegate tasks and procedures only to appropriate personnel o Identify clients at risk for problems, such as falls or the development of decubiti o Establish and maintain a safe environment o Document precisely and carefully o Write detailed incident reports, and file them with the appropriate personnel/dept. o Recognize certain client behaviors that may indicate the possibility of a lawsuit |
|
|
Avoiding Medication Errors
|
follow the 7 rights [drug, dose, route, time, client, reason, documentation], monitor client responses, and check client medications for multiple drugs for the same actions.
|
|
|
Documenting Appropriately:
|
“not documented, not done”. According to the law, if something has not been documented, then the responsible party did not do whatever needed to be done. If a nurse did not “do” something, that leaves the nurse open to negligence or malpractice charges.
|
|
|
Legally credible
|
documentation is an accurate accounting of the care the client received, it also indicates the competence of the individual who delivered care
|
|
|
Charting by exception
|
creates defense difficulties. When this method is used, investigators need to review the entire patient record in an attempt to reconstruct the care given to the client. Clear, concise, and accurate documentation clears the individual of any negligence or malpractice.
|
|
|
Documentation is credible when it is:
|
o Contemporaneous: documenting at the time care was provided
o Accurate: documenting exactly what was done o Truthful: documenting only what was done o Appropriate: documenting only what could be discussed comfortably in a public setting |
|
|
Professional Liability Insurance:
|
developed to protect nurses against personal financial losses if they are involved in a medical malpractice suit. If a nurse is charged with malpractice and found guilty, the employing institution has the right to sue the nurse to reclaim damages.
|
|
|
Common Actions leading to Malpractice Lawsuits
The Six F’s |
1. Failure to assess a patient appropriately
2. Failure to report changes in a patient’s status 3. Failure to document in a patient’s record 4. Failure to obtain informed consent 5. Failure to report a coworker’s negligence 6. Failure to provide adequate education |
|
|
Two Additional causes of malpractice
|
1. Altering or falsifying a record
2. Violation of a standard of practice |
|
|
Do Not Resuscitate Orders:
|
only a physician can write this order. The ANA advocates that every facility have a written policy regarding the initiation of such orders. The client, or if the client is unable to speak for him/herself, a family member or guardian should make clear the client’s preference for either having as much possible done or withholding treatment
|
|
|
Advance Directives: Patient Self-Discrimination Act:.
|
addresses questions regarding life-sustaining treatment; allowing people the opportunity to make decisions about treatment in advance of a time when they might become unable to participate in the decision-making process. This spares the family the burden of having to decide what they would’ve wanted
|
|
|
living will
|
is a legally executed document that states an individual’s wishes regarding the use of life-prolonging medical treatment in the event that he/she is no longer competent to make informed treatment decisions on his/her behalf and is suffering from a terminal condition.
|
|
|
Historical Development of Bioethics:
|
the study of medical morality, which concerns the moral and social implications of health care and science in human life.
|
|
|
Values:.
|
“estimated or appraised worth of something, or that quality of a thing that makes it more or less desirable, useful.” They are judgments about the importance or unimportance of objects, ideas, attitudes, and attributes.
|
|
|
Value systems:
|
a set of related values.
|
|
|
Intrinsic values:
|
those related to sustaining life, such as food and water
|
|
|
Extrinsic values:
|
not essential to life; things, people, and ideas, such as kindness, understanding, and material items, are extrinsically valuable
|
|
|
Personal values:
|
qualities that people consider valuable in their private lives; concepts such as strong family ties and acceptance by others
|
|
|
Professional values:
|
qualities considered important by a professional group; autonomy, integrity, and commitment
|
|
|
Values clarification
|
is deciding what one believes is important; the process that helps people become aware of their values. Nurses need to be aware of what they do and do not value; this process helps them to behave in a manner that is consistent with their own values. This in turn simplifies solving problems, making decisions, and developing better relationships with others when one begins to realize how others develop their own values
|
|
|
Belief systems:
|
an organized way of thinking about why people exist in the universe. The purpose is to explain such issues as life and death, good and evil, and health and illness. People may have a personal belief system, may participate in a religion that provides such a system, or both.
|
|
|
Morality:
|
one’s own code for acceptable behavior; arising from an individual’s conscious. Morals act as a guide for individual behavior and are learned through instruction and socialization.
|
|
|
Autonomy:
|
the freedom to make decisions for oneself. This requires that nurses respect patients’ rights to make their own choices about treatment. Ex. Informed consent.
|
|
|
Nonmaleficence:
|
requires that no harm be done, either deliberately or unintentionally. This requires that nurses protect from danger individuals who are unable to protect themselves because of their physical or mental condition. .
|
|
|
Beneficence:
|
demands that good be done for the benefit of others. It requires helping patients meet all their needs, whether physical, social, or emotional. It is caring in the truest sense, and caring fuses thought, feeling, and action
|
|
|
Justice:
|
obliges nurses and other personnel to treat every person equally regardless of gender, sexual orientation, religion, ethnicity, disease, or social standing. This principle also applies to the work and educational setting
|
|
|
distributive justice
|
necessitates the fair allocation of responsibilities and advantages, especially in a society where resources may be limited
|
|
|
veil of ignorance
|
eliminates information about age, gender, socioeconomic status, and religious convictions from the issues.
|
|
|
Confidentiality:
|
states that anything said to nurses and other personnel by their patients must be held in the strictest confidence. Exceptions only exist when patients give permission for the release of information or when the law requires the release of specific information.
|
|
|
Veracity:.
|
requires nurses to be truthful. This is fundamental to building a trusting relationship. Deliberately omitting a part of the truth is deception and violates this principle
|
|
|
Accountability:
|
is linked to fidelity (loyalty) and means accepting responsibility for one’s actions. Nurses are accountable to their patients and to their colleagues; good or poor.
|
|
|
Ethical Codes:
|
one of the hallmarks of a profession; a formal statement of the rules of ethical behavior for a particular group of individuals; makes clear the behavior expected of its members. Ethical codes are subject to change, as society and technology evolve.
|
|
|
ANA Code of Ethics:
|
provides values, standards, and principles to help nursing function as a profession.
|
|
|
Ethical Dilemmas (analysis of case studies):
|
an ethical dilemma occurs when a problem exists that forces a choice between two or more ethical principles. Deciding in favor of one principle will violate another, bringing the added burden of emotions; feelings of anger, frustration, and fear often override rationality in the decision-making process.
|
|
|
Use of the Nursing Process in Resolving Ethical Dilemmas
|
1: Identify the problem and ask, “Am I directly involved in this dilemma?” An issue is not an ethical dilemma for nurses unless they are directly involved or have been asked for their opinion about a situation.
2: Determine the goals of treatment, identify the decision makers, and list and rank all the options. 3: the patient or surrogate decision maker(s) and members of the health-care team reach a mutually acceptable decision. The role of the nurse is to ensure that communication does not break down. 4: to determine whether the ethical dilemma has been resolved. |
|
|
Role of Ethics Committees (aka the death committee):
|
determining who shall live and who shall die.
|
|
|
Exploration of Current Ethical Issues:
|
assisted suicide, genetic screening, stem cell use and research.
|
