Fundamentals of Nursing Exam #1 - Legal Aspects in Nursing Flashcards

Terms Definitions
Describe what is meant by "Standards of Care."
Legal guidelines used to:

1) measure nursing conduct

2) determine whether or not the nurse acted as any reasonable prudent nurse would act under the same or similar situation.
What are the legal guidelines used to measure nursing conduct and determine whether or not the nurse acted as any reasonable prudent nurse would act under the same or similar situation called?
Standards of Care
Differentiate the sources from which the standards of care derive.
1) Nurse practice act of each state

2) Professional nursing organizations

3) Healthcare facility/agency policies and procedures
The following identifies with which Standard of Care:

Statutes created and enacted by the legislature of each state; Rules and regulations created by state boards of nursing impose regulatory law on nursing practice
Nurse practice act of each state
The following identifies with which Standard of Care:

JCAHO (Joint Commission on Accreditation of Healthcare Organizations), ANA, Individual institutions
Professional nursing organizations
This federal statute (law):

- Protects patients and workers
- Must provide reasonable accommodations
- Nondiscrimination based on disease/disability
Americans With Disabilities Act
This federal statute (law):

- Must provide stabilizing treatment
Emergency Medical Treatment and Active Labor Act
This federal statute (law):

- Is state specific
- Requires that the patient be given written information explaining his right to refuse treatment
- Includes documentation as in a living will or power of attorney (asked in admitting or ER)
Advance Directives
This federal statute (law):

- Allows a competent client to make an informed decision to donate all or part of his body for organ donation or medical research after death.
Uniform Anatomical Gift Act
This federal statute (law):

- Prohibits health insurance companies from discriminating based on health status
- Sets standards regarding the exchange of private and sensitive health information
HIPAA (Health Insurance Portability and Accountability Act)
What is the purpose of a living will?
A living will is a written declaration of a patient's wishes for health care in the event the patient is not able to communicate.
What is the purpose of a durable power of attorney?
A durable power of attorney is a written declaration stating that another person may act on behalf of the patient in the event the patient is unable to do so.
Identify the student nurse’s responsibility in the clinical setting for applying HIPAA guidelines.
1) Confidentiality of records
2) Use only initials on documents
3) Avoid conversations in public areas, with family
4) No Duplication of hospital records (Medication sheets, lab results)
Explain licensure as a legal requirement.
Per Nurse Practice Act, Licensure permits a nurse to provide special skilled services to the public while providing the public with certain assurances concerning the quality of those services in their state

- Must pass NCLEX

- Licensure may be suspended or revoked for improper conduct
Explain the Florida Nurse Practice Act including the role of the State Board of Nursing
The Board:

- adopts rules
- develops standards for nursing programs
- disciplines nurses who violate regulations
A willful act that violates another's rights.
Intentional Tort
The following are examples of what:

- Assault (threaten)
- Battery (physical contact)
- False Imprisonment
- Fraud
- Invasion of privacy
Intentional Tort
Identify the following tort:

- A threat to cause harm
Assault
Identify the following tort:

- Offensive physical contact
- Performing without consent
Battery
Identify the following tort:

- Restraining or detaining a competent patient against his will
False-Imprisonment
Identify the following tort:

- Misleading another person
- Ex. Nurse telling a lie; failing to disclose information; making a statement in reckless disregard of whether it is truthful or accurate
Fraud
Identify the following tort:

- Violates a person's right to be free from unwanted interference in his private affairs
- Patient privacy per HIPAA
Invasion of Privacy
Identify the following tort:

- Client's and family members believe that care was unprofessional and did not measure up to standard practice
Negligence and Malpractice
Name the most common causes of patient injury due to negligence.
- Failure to recognize changes in patient condition
- Failure to communicate
- Medication errors, IV therapy errors, infiltrations/phlebitis
- Burns, Falls
- Errors in sponge, instrument, or needle counts (surgery)
- Failure to follow orders/protocols
- Failure to document
- Failure to report an impaired co-worker
How can patient injury due to negligence be prevented?
Nurses can follow their state's nurse practice act.

(Which will include: Assess thoroughly, often, and communicate changes in condition; follow up on labs/reports done on your patients, communicate abnormals; Know hospital policy and procedures; Medications, know what you are giving, follow protocol, check ID every time; LISTEN to your patients and develop rapport with clients and families; Document in a timely and thorough manner; Know current best practices and keep up with new developments; Attend to patient safety; provide confidentiality and privacy)
List the criteria used for establishing malpractice.
1) Duty to the patient
2) Breach of the duty
3) Causation
4) Damages
The following is an example of which criteria for malpractice:

The nurse fails to meet standard of care (job description, work policies, nurse practice act...)
Breach of the duty
The following is an example of which criteria for malpractice:

The act or failure to act caused foreseeable injury
Causation
The following is an example of which criteria for malpractice:

The plaintiff proves that there has been actual injury or damage.
Damages
Explain the nurse’s role in obtaining consents.
- Witnessing client’s signature on a consent form
- You are NOT responsible to explain the procedure, treatments or options
- Must notify physician or supervisor if concerned
List factors required for informed consent.
1) Completeness (Disclosure) - tell patient everything regarding a treatment decision

2) Comprehension - The patient must understand the explanation.

3) Voluntariness - The patient must be free to accept or reject the treatment; no pressure or coercion to give consent.

4) Competence - The patient (or guardian) must have the capacity to understand the information and make a choice about THIS situation.
Identify the legal liability of students.
1) Prepare carefully for clinical
2) Never attempt a procedure or make judgement about which you feel unsure
3) Notify your instructor or staff nurse regarding significant changes in your patient
What does liability insurance provide?
Liability insurance provides some legal protection from nursing malpractice; the insurance company pays for the attorney's fees and for any judgement or settlement.
Identify liability insurance issues.
Most policies have exclusions (items not covered).

Common exclusions are: AIDS transmission, sexual abuse, injury under the influence, criminal activity and punitive damages.
The following is an example of which factor regarding informed consent:

Informing patient everything regarding a treatment decision
Completeness (Disclosure)
The following is an example of which factor regarding informed consent:

The patient must understand the explanation.
Comprehension
The following is an example of which factor regarding informed consent:

The patient must be free to accept or reject the treatment; no pressure or coercion to give consent.
Voluntariness
The following is an example of which factor regarding informed consent:

The patient (or guardian) must have the capacity to understand the information and make a choice about THIS situation.
Competence
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