Taylor - Fundamentals Of Nursing - Adn 1 Exam #1 Chapter 6 & 7 Legal, Values, Ethics, Advocacy

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JCAHO

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Joint Commission on Accreditation of Healthcare Organizations
Have their own standards of care.
Audit acute care hospitals and accredit them.Insurance companies will not fund your institution if you fail.

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Good Samaritan Law

Back 2

a law that holds certain health practitioners blameless when undertaking to aid a person in an emergency.

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Four sources of law exist at the federal and state level

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constitutional
statutory
administrative
common

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litigation

Back 4

the process of bringing and trying a lawsuit

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plaintiff

Back 5

the person or government bringing suit against another

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defendant

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the person being accused of a crime or a tort; presumed innocent until proven guilty

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Public law

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law in which the government is involved directly

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Private law

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aka: Civil law
regulates relationships between people
relating to contracts, ownership of property, and the practice of nursing, medicine, pharmacy and dentistry.

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Criminal law

Back 9

concerns state and federal criminal statutes such as murder, criminal negligence, theft and possession of drugs.

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Nurse Practice acts

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particular to each state,lists violations that can result in disciplinary actions
and serves to exclude untrained or unlicensed people from practicing nursing.

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Standards of care

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put forth by the ANA and JCAHO

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credentialing

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refers to ways that professional competence is ensured and maintained.
3 Processes are used in nursing:
accreditation
licensure
certification

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accreditation

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the process by which an educational program is evaluated and recognized as having met certain standards.

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licensure

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process by which the state determines that a candidate meets certain minimum requirements to practice and grants a license to do so.

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certification

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process by which a person who has met certain criteria established by a non-governmental association is granted recognition in a specific practice area.

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crime

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a violation punishable by the state

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tort

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subject to action a civil court with damages usually being settled with money.
can be intentional or unintentional in nature.

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Intentional tort
Assault

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a threat or an attempt to make bodily contact with another person without that person's consent.

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Intentional tort
Battery

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an assault that is carried out and includes willful, angry and violent or negligent touching of another person's body or clothes or
administering an injection against the patient's will is an example

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Intentional tort
Defamation of character

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when one party makes derogatory statements about another that diminishes that other party's reputation.

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Intentional tort,
Invasion of property,,

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all information of a client is considered
confidential.
Congress passed HIPAA to address the patients right to privacy.

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Intentional tort
Faqlse imprisonment

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unjustified retention or prevention of movement without proprt concent.

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Intentional tort
Fraud

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willful or purposeful misrepresentation that could or has caused harm.

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unintentional tort
negligence

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performing an act that a reasonably prudent person would not do, or failing to perform an act that a reasonably person would do - an act of omission or commission.

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unintentional tort
Malpractice

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negligence by a professional person.

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unintentional tort
liability

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involves four elements that must be proven to show malpractice or negligence has occurred:
duty - an obligation to use due care, defined by the standard of care.
breach of duty - failure to meet the standard of care.
causation - shows that the failure to meet the standard of care actually caused the injury
damages - the actual harm or injury resulting to the patient.

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Standards of Care

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rules set forth by the state's Nurse Practice Act.

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Nurse as defendant

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do not discuss case with anyone
do not alter patient's records
cooperate with attorney
be courteous, do not volunteer information.

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Nurse as Fact Witness

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a nurse who has knowledge of the actual incident must base their testimony only on firsthand knowledge and not on assumptions.

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Nurse as Expert witness

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explains to the judge and jury what happened based on the patient's record and to offer an opinion about whether the nursing care met acceptable standards.

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Informed and Voluntary consent

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every person is granted freedom from bodily contact by another person unless consent is granted.

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Obtaining Informed Consent

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the responsibility of the person who will perform the diagnostic or treatment procedure or research study.

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To ensure Informed Consent you must have:

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disclosure
comprehension
competence
voluntariness
witness

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Informed Consent:
disclosure

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patient/surrogate has been informed of:
nature of the procedure
risks and benefits
alternatives
fact that no outcomes are guaranteed.

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Informed Consent:
comprehension

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patient/surrogate can correctly repeat in his own words that for which they are giving consent

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Informed Consent:
competence

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patient/surrogate understands the information needed to make this decision

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Informed Consent:
voluntariness & witness

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the patient/surrogate is voluntarily consenting or refusing without any coercive or manipulative influences.
A witness to signature only- not that the patient knows what they are signing or competence. RN must be advocate if the patient later shows that they are not fully informed.

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Contract

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an exchange of promises between two parties.

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Collective Bargaining

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a legal process in which representatives of organized employees negotiate with employers about such matters as wages, hours and working conditions.

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Competence Practice

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each nurse is responsible for making sure that his educational and clinical backgrounds are adequate to fulfill the nursing responsibilities described in the job description.

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Executing Physician Orders

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nurses are legally responsible for carrying out orders unless an order would lead a reasonable person to anticipate injury if it were carried out.
it is good to double-check an order that a patient questions.

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documentation

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documentation should show that you are carefully assessing the patient, recognizing significant cues and reporting them and all actions taken, appropriately.

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Whistle-blowing

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an effort by a member or past member of an organization to deliver a warning to the public concerning a serious wrongdoing or danger created or masked by the organization.
some laws are designed to protect the nurse for advocating for patients, without fear or reprisal.

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Risk Management Programs

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programs designed to identify, analyze and treat risks in order to reduce malpractice claims.

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Incident, Variance or Occurrence
reports

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used by healthcare agencies to document the occurrence of anything that results in harm to the patient, employee or visitor.
Used for quality improvement &
identifying risks
this is filled out by the person involved
not used for disciplinary action.

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Sentinel Events

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the Joint Commission defines this as an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof.
Opportunities for error are opportunities for improvement.

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Never Events

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extremely rare medical errors that should never happen to a patient.

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Patient's Bill of Rights

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the expectations, rights and responsibilities of the patient while receiving care in a hospital.

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Restraints

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The Nursing Home Reform Act of 1987 states that the nursing home resident has the right to be free from physical or chemical restraints imposed for the purposes of discipline or convenience and not required to treat a medical condition.

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Advance Directives

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allow individuals to state in advance what their choices for healthcare are should certain circumstances develop.

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Living Wills

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provide specific instructions about the kinds of healthcare that should be provided or forgone in particular situations.

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Power of Attorney

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appoints an agent the person trusts to make decisions in the event of a subsequent incapacity.

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DNR

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do -not -resuscitate
no attempts should be made to resuscitate a patient who stops breathing or whose heart stops beating.

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Felony

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crime punishable in state or federal jail for more than 1 year.

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misdemeanor

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crime punishable by fines and jail time of less than 1 year.

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False imprisonment

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using an illegal restraint.

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slander

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verbal defamation of character

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libel

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written defamation of character.

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abandonment

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an unintentional tort involving the leaving of a patient without providing coverage.

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PHI

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protected health information.

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HIPAA Privacy rule

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federal law enacted to ensure that health information is protected while allowing the flow of health information needed to provide and promote high quality healthcare and protect the public's health and well-being.

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Proper Documentation

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if it is not written it has not been done!

must be done immediately, promptly.

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Reportable Conditions

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diseases such as tuberculosis must be reported to the health department to safeguard patients, staff and the public.

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AMA

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Leaving Against Medical Advice
patient refuses treatment and wants to leave.
patient must be informed of the risks.
consequences of leaving must be explained and documented.
patient must sign himself out.
patient will not receive follow-up services

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Patient has a right to see his records, but...

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it must be a written request.
patient must be accompanied by a doctor or nurse in case questions arise since it is possible that the patient is not knowledgeable enough to understand the contents of the records.

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Nurses' Bill of Rights

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practice in a manner to fulfill obligations e.g. proper staffing.
Environment needs to meet standards of JCAHO and Dept. of Health.
Environment allows you to practice in accordance with the Code of Ethics.
Allowed to openly advocate for client and self.
Must be fairly compensated.
Must have a safe working environment.
The right to negotiate a contract.

Front 67

which organization is responsible for ensuring that RN's are minimally qualified to practice nursing?

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State Boards of Nursing.