Chapter 5: anita finkelman Health Policy and Political Action

1. Which ethical principle underlies nursing actions respecting each patient's values and beliefs? 1) Autonomy 2) Beneficence 3) Justice 4) Responsibility

1) Autonomy

As an advocate for the client, the nurse must make sure that "safe, effective care" is given in conformity with the: 1) Nurse Practice Act (NPA) 2) American Nursing Association (ANA) 3) National Council for Licensure Examinations 4) State Board of Licensure

1) Nurse Practice Act (NPA)

What criteria should policy meet?

1. Achieve specific outcomes 2. Affect a large number of people 3. Address a specific need

What criteria should policy meet? Is policy always intended to reduce costs?

1. Achieve specific outcomes 2. Affect a large number of people 3. Address a specific need No.

A child's immunization may cause discomfort during administration, but the benefits of protection from disease, both for the individual and society, outweigh the temporary discomforts. Which principle is involved in this situation? 1. Fidelity 2. Beneficence 3. Nonmaleficence 4. Respect for autonomy

2. Beneficence

A nurse and teacher are discussing legal issues r/t the practice of their professions. The teacher asks what the functions are of the Nurse Practice Act (NPA) in that state. The nurse would include which thoughts in response? Select all that apply. 1. accredit schools of nursing 2. enforce ethical standards of behavior 3. protect the public 4. define the scope of nursing practice 5. determine liability insurance rates

3, 4 The state's NPA serves to protect the public by setting minimum qualifications for nursing in relation to skills and competencies. One way it fulfills responsibility to protect the public is by defining the scope of practice in that state. The state board of nursing approves schools to operate but does not accredit them. The state board of nursing does not enforce ethical standards. A state NPA has no role in in setting liability insurance.

What is policy analysis?

A process for understanding the nature, intent, and impact of a policy by assessing its strengths and weaknesses

Identify the concept demonstrated in clinical practice per the following definition: To be answerable for one's own actions

Accountability

Below is an example of which ethical term? Patient decides not to have open-heart despite blockages

Autonomy

Identify the ethical term for: Obligation to keep promises

Fidelity

The process of influencing the authoritative allocation of scarce resources refers to what?

Politics.

The nurse discusses the status of morning care completed by unlicensed assistive personnel​ (UAPs). Which behavior is the nurse​ demonstrating? 1) Accountability 2) Safety 3) Responsibility 4) Client-centered care

1) Accountability ​Rationale: Accountability is being responsible for the outcome of a completed task or assignment. Nurses are accountable for their own actions and behaviors but are also accountable for the actions of​ others, such as UAPs. Responsibility is the obligation to perform duties within the nursing role.​ Client-centered care and safety are competencies that support accountability in nursing practice.

The nurse delegates vital signs to an unlicensed assistive personnel​ (UAP). The UAP reports the vital signs to the​ nurse, which indicate hypotension and bradycardia. The nurse then assesses the client. Which moral principle is exhibited by the​ nurse? 1) Accountability 2) Fidelity 3) Nonmaleficence 4) Beneficence

1) Accountability ​Rationale: Under the principle of​ accountability, the nurse is responsible for the outcomes of care rendered and the care given by trainees and subordinates. Fidelity is faithfulness to an agreement. Beneficence is the act of doing well. Nonmaleficence is the avoidance of causing harm.

Which action by the nurse correctly exemplifies the seven rights of medication​ administration? (Select all that​ apply.) 1) Checking for the right dose by performing a dose calculation and checking the medication 2) Documenting administration of the prescribed order in the client record 3) Checking the prescribed order and looking at the time 4) Checking for the right frequency by looking at the​ client's chart 5) Verifying the right medication by asking the​ client, "Is this what you normally take at​ home?"

1) Checking for the right dose by performing a dose calculation and checking the medication 2) Documenting administration of the prescribed order in the client record 3) Checking the prescribed order and looking at the time ​Rationale: Verifying the right time and dose and documenting the administration of the medication are all included in the seven rights of medication administration. Frequency is not one of the seven rights of medication administration. Although checking for the right medication is one of the seven​ rights, asking the client if the pill is what the client takes at home does not constitute checking the right medication. The nurse would need to verify that the medication is correct by checking the medication against the​ client's medication administration record.

When the nurse described the client as "that nasty old man in 354," the nurse is exhibiting which ethical dilemma? 1) Gender bias and ageism 2) HIPPA violation 3) Beneficence 4) Code of ethics violation

1) Gender bias and ageism

Which statement should the nurse recognize as being correct regarding nursing​ negligence? (Select all that​ apply.) 1) It occurs without the deliberate intent to bring harm to another individual. 2) It is conduct that deviates from what a reasonable individual would do in a particular circumstance. 3) It is an unintentional tort. 4) It is a crime. 5) It is conduct deviating from the standard of practice dictated by the profession.

1) It occurs without the deliberate intent to bring harm to another individual. 2) It is conduct that deviates from what a reasonable individual would do in a particular circumstance. 3) It is an unintentional tort. ​Rationale: Negligence is defined as conduct that deviates from what a reasonable individual would do in a particular circumstance and is considered an unintentional tort. Negligence occurs without the deliberate intent to bring harm to another individual. Malpractice is defined as any conduct deviating from the standard of practice dictated by the profession. A crime is considered to be committed against the state rather than an individual. Next Question

The client asks the​ nurse, "Why am I receiving this​ medication?" Which action should the nurse take if not familiar with the​ medication? 1) Looking up information on the medication and telling the client the reason it is being given 2) Holding the medication and documenting that the client refused 3) Leaving the​ client's oral medication at the bedside and allowing the client to decide whether to take it 4) Instructing the client to tell the nurse the reason why the client thinks the medication is being given

1) Looking up information on the medication and telling the client the reason it is being given Rationale: The nurse should urge the client to question any medication administered about which the client is unsure. The nurse also should be familiar with medications before administering them to a client. With this​ action, the new nurse is acting as a client advocate in preventing medication errors. Asking the client to tell the nurse the reason why the client thinks the medication is being given is inappropriate—many clients will not be able to do​ this, and this is the responsibility of the nurse. Leaving a medication at the​ client's bedside is never appropriate. Holding the​ client's medication because the client is asking about it is also inappropriate and does not improve the safety of medication administration.

The nurse suspects that a client is a victim of an assault. Which should be the​ nurse's priority​ action? 1) Notifying the supervisor and contacting police to report the injuries as suspicious 2) Reporting the suspicion to risk management and asking them to investigate 3) Looking in the​ client's medical record to see if there is any history of assault or violence 4) Documenting the findings and saying nothing to the other team members

1) Notifying the supervisor and contacting police to report the injuries as suspicious ​Rationale: Any injury that is suspected as part of an assault or abuse should be reported to law enforcement. The findings should be documented but must also be reported. Risk management may be consulted for guidance and​ verification, but they do not provide the report to law enforcement. A history of assault or violence may not be relevant to the current findings. Next Question

All clients have the right to be cared for by a competent and safe nurse according to which guideline for nursing​ care? 1) Standards of practice 2) Code of ethics 3) Nurse practice acts 4) Licensing process

1) Standards of practice ​Rationale: Standards of practice describe the competency level of nursing care as described by the American Nurses Association​ (ANA), which outlines the rights of a client to have competent and safe nursing care. Nurse practice acts regulate the licensing and practice of nursing by describing the scope of practice but does not cover the​ client's rights to competent and safe nursing care. The licensing process establishes an assessment for a minimum knowledge base relevant to the client population that the nurse serves but does not cover the rights of clients. A code of ethics is a guide for carrying out nursing responsibilities while maintaining moral principles but is not associated with the right of clients to have competent and safe nursing care.

The nurse is teaching a class regarding standards of care in nursing. Which statement by a participant indicates an​ understanding? (Select all that​ apply.) 1) ​"Nurse practice acts and administrative rules form the basis of the standard of care for​ nurses." 2) ​"The American Nurses​ Association's standards of practice are the prevailing national nursing​ standard." 3) ​"The Joint Commission is the primary agency responsible for establishing nursing standards of​ care." 4) ​"Employers can​ limit, but not​ expand, the nursing scope of​ practice." 5) ​"The nurse's specific job description will aid in defining the standard of​ care."

1) ​"Nurse practice acts and administrative rules form the basis of the standard of care for​ nurses." 2) ​"The American Nurses​ Association's standards of practice are the prevailing national nursing​ standard." 4) ​"Employers can​ limit, but not​ expand, the nursing scope of​ practice." 5) ​"The nurse's specific job description will aid in defining the standard of​ care." ​Rationale: The American Nurses Association​ (ANA), not The Joint​ Commission, is primarily responsible for establishing nursing standards of care. All other choices are correct. Next Question

The nurse has just completed hospital orientation. Which statement by the nurse reflects correct understanding of the role of the Occupational Safety and Health Administration​ (OSHA)? (Select all that​ apply.) 1) ​"OSHA provides employer and employee with training materials that address workplace safety and health​ hazards." 2) ​"OSHA requires my employer to provide me with personal protective equipment​ (PPE) when it is needed to protect my health and​ safety." 3) ​"According to OSHA​ regulations, employers must reduce or eliminate workplace​ hazards." 4) ​"According to OSHA​ regulations, employers must maintain conditions or adopt practices that are needed to protect workers on the​ job." 5) ​"According to OSHA​ regulations, all employers must have an emergency​ eye-wash station."

1) ​"OSHA provides employer and employee with training materials that address workplace safety and health​ hazards." 2) ​"OSHA requires my employer to provide me with personal protective equipment​ (PPE) when it is needed to protect my health and​ safety." 3) ​"According to OSHA​ regulations, employers must reduce or eliminate workplace​ hazards." 4) ​"According to OSHA​ regulations, employers must maintain conditions or adopt practices that are needed to protect workers on the​ job."

When designing a plan for pain management for a postoperative patient, the nurse assesses that the patient's priority is to be as free of pain as possible. The nurse and patient work together to identify a plan to manage the pain. The nurse continually reviews the plan with the patient to ensure that the patient's priority is met. Which principle is used to encourage the nurse to monitor the patient's response to the pain? 1. Fidelity 2. Beneficence 3. Nonmaleficence 4. Respect for autonomy

1. Fidelity

Describe the policy-making process.

1. define the problem 2. specify criteria 3. identify solution options and select the best 4. implement the policy 5. monitor and evaluate the policy

Describe the policy-making process. The process of influencing the authoritative allocation of scarce resources refers to what?

1. define the problem 2. specify criteria 3. identify solution options and select the best 4. implement the policy 5. monitor and evaluate the policy Politics.

A member of the American Nurses Association​ (ANA) is giving a presentation about the​ ANA's primary methods of advancing the nursing profession. Which activity should be​ included? (Select all that​ apply.) 1) Assisting deans with implementing quality nursing education standards 2) Cultivating high standards of nursing practice 3) Fostering a positive and realistic view of nursing 4) Implementing nurse educator faculty development programs 5) Advocating for​ nurses' rights in and away from the workplace

2) Cultivating high standards of nursing practice 3) Fostering a positive and realistic view of nursing

The nurse suspects that a child is a victim of abuse. The department of​ children's services investigates and finds no evidence of abuse. Which describes the consequences to the reporting​ nurse? 1) The documentation will need to be changed by the nurse. 2) Good faith immunity will protect the​ nurse, and there will be no negative consequences. 3) The rest of the healthcare team will be questioned and possibly face legal action by the parents. 4) The nurse will be fired and possibly sued.

2) Good faith immunity will protect the​ nurse, and there will be no negative consequences. ​Rationale: Good faith immunity protects healthcare providers from any negative consequences if a report of suspected abuse or neglect turns out to be unfounded. This protects against the possibility of a lawsuit or having the rest of the healthcare team questioned. Documentation must not be changed or altered in any way based on the outcome of an investigation. OK

The nurse is reviewing actions that reflect accountability. Which action should the nurse​ question? 1) Performing the procedure under the policies and protocols of the organization 2) Performing all procedures and tasks delegated even when unsure of how to perform them 3) Accepting responsibility for doing the procedure 4) Having the ability to perform the procedure or intervention

2) Performing all procedures and tasks delegated even when unsure of how to perform them ​Rationale: All practitioners must ensure that they perform competently and that they​ don't work beyond their level of competence. They must inform a senior member of staff when they are unable to perform competently. To be​ accountable, practitioners/nurses must​ (1) have the ability to perform the procedure or​ intervention, (2) perform the procedure under the policies and protocols of the​ organization, and​ (3) accept responsibility for doing the procedure. Next Question

Which action by the nurse ensures that an order written by a healthcare provider is within the​ nurse's scope of practice in that particular​ state? 1) Asking the healthcare provider if the order is permitted 2) Referring to the state nurse practice act 3) Referring to the hospital policy 4) Asking the designated supervisor

2) Referring to the state nurse practice act ​Rationale: A state nurse practice act defines the scope of practice for a professional nurse in that state. Hospital policy must support the scope of practice as defined by the nurse practice act. A nurse manager may be a good resource for verifying whether an action is​ permitted, but the nurse must be personally responsible for understanding the scope of practice. The healthcare provider is not responsible for understanding what is in the scope of practice of nursing in a particular state.

Under the Health Insurance Portability and Accountability​ Act, which is an acceptable reason to disclose protected health​ information? (Select all that​ apply.) 1) Press release 2) payment 3) Nurse knowing the client personally 4) Treatment 5) Operations

2) payment 4) Treatment 5) Operations ​Rationale: The privacy rule of the Health Insurance Portability and Accountability Act specifies that protected health information may be disclosed to other covered entities for the purposes of​ treatment, payment, or operations. Protected health information cannot be shared as part of a press release or if the client is known by the nurse. It must meet one of the three allowed purposes. Next Question

The nurse planning to administer a blood pressure medication finds that the client is​ pale, diaphoretic, and tachycardic and has a blood pressure of​ 60/44 mmHg. Which action should the nurse​ take? 1) Repeating vital signs in 30 minutes 2) Giving the medication as ordered 3) Holding the medication and notifying the provider 4) Giving the medication but continuing to monitor the client

3) Holding the medication and notifying the provider ​Rationale: The nurse is obligated to​ validate, verify, and practice with a questioning attitude and act as a client advocate. The nurse should not follow an order that is not appropriate or that could lead to a worsening of the​ client's condition. If the medication is​ given, the blood pressure could drop further. A decision to withhold the medication cannot be made without notifying the provider. Next Question

The distribution of nurses to areas of "most need" in the time of a nursing shortage is an example of: 1) Utilitarianism theory 2) Deontological theory 3) Justice 4) Beneficence

3) Justice

A client is referred to a surgeon by the general practitioner. After meeting the surgeon, the client decides to find a different surgeon to continue treatment. The nurse supports the client's action, utilizing which ethical principle? 1. beneficence 2. veracity 3. autonomy 4. privacy

3. Autonomy is the right of individuals to take action for themselves. Beneficence is an ethical principle to do good and applies when the nurse has a duty to help others by doing what is best for them. Veracityrefers to truthfullness. Privacy is the nondisclosure of information by the health care team.

A client with cancer has decided to discontinue further treatment. Although the nurse would like the client to continue treatment, the nurse recognizes the client is competent and supports the client's decision using which ethical principle? 1. Justice 2. Fidelity 3. Autonomy 4. Confidentiality

3.Autonomy refers to the right to make one's own decisions, which is the principle supported in this situation. Justice refers to fairness. Fidelity refers to trust and loyalty. Confidentiality refers to privacy of personal health information

Eligibility to receive low-income loans or reimbursement for expenses is provided to hospitals that follow safety provisions of service established by: 1) Board of Nursing Examiner (BNE) 2) Nurse Practice Act (NPA) 3) American Nurses Association (ANA) 4) Americans with Disabilities Act (ADA)

4) Americans with Disabilities Act (ADA)

The nurse administers an incorrect medication to a client and realizes the error a few minutes later. Which action should the nurse​ perform? 1) Do not complete an incident report because the client did not experience any adverse effect. 2) Document the error but do not complete an incident report unless the client has an adverse reaction. 3) Complete an incident report and document the report in the medical record. 4) Complete an incident report but do not document the report in the medical record.

4) Complete an incident report but do not document the report in the medical record. ​Rationale: An incident report should be completed for every event that occurs that is outside of the normal operations of the hospital. The completion of an incident report should never be mentioned in a medical record. An incident report should be completed whether or not the client experiences any harm. The facts surrounding the event should be documented in the medical record but not the incident report. Next Question

The nurse documents that a client who has an infected leg developed a rapid heart​ rate, decreased blood​ pressure, and a fever of 101.8degrees°F but does not report them to the provider. Two days​ later, the​ client's leg must be amputated due to severe infection and gangrene. Which legal concept​ applies? 1) Failure to document 2) Failure to act as a client advocate 3) Failure to follow standards of care 4) Failure to communicate

4) Failure to communicate ​Rationale: A failure to communicate has occurred because the nurse did not communicate the change in client condition to the provider. The specific change in condition was very suspicious for infection and deterioration of condition. The nurse did fail to act as an​ advocate, but this is mostly applicable to situations in which an order or plan of care is contrary to the​ client's best interest. The standard of care was not necessarily breached because the nurse technically followed orders.

Which requires the nurse to protect the privacy and confidentiality of a​ client's protected health​ information? 1) Code of ethics 2) Nurse practice act 3) Standard of practice 4) Health insurance and portability and accountability act

4) Health insurance and portability and accountability act ​Rationale: The Health Insurance Portability and Accountability Act​ (HIPAA) contains the privacy​ rule, which prevents the disclosure of protected health information unless it is for the purposes of​ treatment, payment, or operations. Nurse practice acts regulate the practice of nursing by outlining licensure requirements and defining the scope of practice. A code of ethics describes the practice of nursing while maintaining a moral code. Standards of practice identify the​ client's right to competent and safe nursing care but are not associated with the requirement to maintain confidentiality.

A client asks why a dx test has been ordered and the nurse replies, "I'm unsure but I will find out for you." When the nurse later returns and provides an explanation, the nurse is acting under which principle? 1. Nonmaleficence 2. Veracity 3. Beneficence 4. Fidelity

4. Fidelity means being faithful to agreements and promises. This nurse is acting on the client's behalf to obtain needed information and report it back to the client. Nonmaleficence is the duty to do no harm. Veracity refers to telling the truth for example, not lying to a client about a serious prognosis. Beneficence means doing good, such as by implementing actions (e.g., keeping a salt shaker out of sight) that benefit a client (heart condition requiring sodium-restricted diet)

What is problem identification? What do nurses do at this stage?

A health-related issue is identified as a problem, frame the issue

The Canada Health Act embraces which of the following five principles? A: Public administration, comprehensiveness, universality, portability, accessibility B: Social justice, equity, acceptability, efficiency, effectiveness C: Accountability, equality, economy, collaboration, coordination D: Insured health services, provider compensation, hospital services, community care, pharmaceuticals

A: Public administration, comprehensiveness, universality, portability, accessibility

What is advocacy?

Acting on behalf of our patients.

What is advocacy? How do nurses act as advocates in regards to policy In what ways do nurses bring unique skills to health policy making?

Acting on behalf of our patients. Participation in the policy process.

How do politically active nurses act? (5)

Articulate what nurses do and why, have clear political strategy before taking political action, aware of the position of other involved groups, listen to other policy perspectives, lobby at individual and federal levels

Identify the ethical term for: Patients right to choose; consent

Autonomy

A nurse manager appropriately behaves as an autocrat in which situation? A: Planning vacation time for staff. B: Directing staff activities if a client has a cardiac arrest. C: Evaluation a new medication administration process. D: Identifying the strengths and weaknesses of a client education video.

B: Directing staff activities if a client has a cardiac arrest.

Which of the following best defines leadership? A: being in a leadership position with authority to exert control and power over subordinates B: a process of interaction in which the leader influences others toward goal achievement C: managing complexity D: being self- confident and democratic

B: a process of interaction in which the leader influences others toward goal

What is reflected by health policy? Is it formulated, enacted, and enforced through political processes at local, regional, provincial, territorial, and federal levels?

Beliefs, attitudes, values of those designing the policy, yes

Below is an example of which ethical term? A nurse offers pain meds to a post-op patient

Beneficence

Identify the ethical term for: Duty to "do"; promote good; care given is in the patient's best interest

Beneficence

An operating budget accounts for which of the following? A: The purchase of major and minor equipment B: Construction and renovation C: Income and expenses associated with daily activities within an organization D: Applications for new technology

C: Income and expenses associated with daily activities within an organization

Why does politics exist? A: It is required by law B: Resources cannot be limited by political process C: Some people control more resources than others D: Resources must be equally distributed amongst stakeholders

C: Some people control more resources than others

What is politics?

Conflicting interests struggle for advantage or dominance in the making and execution of public policies

Economics is the study of which of the following? A: The cost, quality interface B: Cost accounting C: The cost of doing business D: How to manage scarce resources

D: How to manage scarce resources

A process used today by nurses or nurse managers in health care organizations, which of the following best describes management? A: scientific management B: decision making C: commanding and controlling others, using hierarchical authority D: planning, organizing, coordinating, and controlling

D: planning, organizing, coordinating, and controlling

What is health policy? What is allocated by health policy?

Decisions, plans, and actions that are undertaken to achieve specific health care goals within a society, resources

What are health inequalities?

Differences in health status among population groups defined by specific characteristics, can be due to biological factors and individual choices

What are health inequities? What are these differences considered to be? What are these differences attributed to?

Differences in health that could be avoided if reasonable action were taken, unfair and socially unjust, unequal distribution of social and economic factors that influence health

What is advocacy as defined by the CNA?

Engaging others, exercising your voice, mobilizing evidence to influence policy and practice, speaking out against inequity and inequality, participating in political processes and acknowledging the importance of evidence, power, and politics in advancing policy options

What are the defining attributes of social justice according to the CNA? (10)

Equity, human rights, right to health democracy and civil rights, capacity building, just institutions, enabling environments, poverty reduction, ethical practice, advocacy, partnerships

What do stakeholders do? What do stake holders control?

Exert political pressure on health policy makers in an effort to make the health care system work to their economic advantage, health care resources

What is social justice?

Fair distribution of society benefits and responsibilities, and their consequences

What are the priorities of the office of nursing policy? (3)

Healthcare access through workforce stability, healthcare quality through workforce development, healthcare sustainability through system transformation

How does policy impact nursing?

How care is delivered, who receives care, types of services received, reimbursement, types of providers.

How does policy impact nursing? Does the US have a universal healthcare system?

How care is delivered, who receives care, types of services received, reimbursement, types of providers. No.

What does the office of nursing policy do? (4)

Issue identification and synthesis, enhancing evidence-base for policy development, brokering knowledge, creating opportunities

What are some examples of ways nurses can influence public policy? (10)

Join a professional organization, write letters to print media, become informed on public issues and share political recommendations, work on political campaigns, testify to state legislature committee on health legislation, donate money, conduct research with policy implications and publish, become an environmental luminary, express through art, become active in International Council of Nurses

Identify the ethical term for: Obligation to be fair; equal treatment to all patients

Justice

How can nurses be involved in the political process?

Lobbying, being involved with professional organizations such as ANA, KNA; belonging to a political action committee (PAC), grassroots advocacy, and participating in government.

What is the Canadian Nurses Association (CNA)? Along with provincial professional associations, what does it encourage? (2)

National professional voice of registered nurses in Canada, political awareness, activisim

What is involved in agenda setting? (2)

Negotiation and debate, mobilization of support from interested politicians and interest groups

Does the US have a universal healthcare system?

No.

Is policy always intended to reduce costs?

No.

Below is an example of which ethical term? A nurse questions the meds being too extreme for patient

Nonmaleficence

Identify the ethical term for: Duty to do no harm; prevent harm

Nonmaleficence

How do nurses act as advocates in regards to policy In what ways do nurses bring unique skills to health policy making?

Participation in the policy process. Expertise, experience, understanding consumer needs, link to healthcare professionals and organizations; understanding the healthcare system, understanding inter professional care (to decrease fragmentation of care to improve quality outcomes).

What are the steps in the development of health policies? (6)

Problem identification, agenda-setting, policy formulation, policy adoption, policy implementation, policy evaluation

What responsible actions can nurses and the nursing profession take toward eliminating avoidable disparities? (3)

Pursue roles in advocacy, partnering, policy change

What do nurses need to know about health policy and politics? (5)

Relevance of health policy and politics, impact of control and distribution issues on incomes/workloads/work environments/clients, play a role in policy because of knowledge and experience with determinants of health, ethical and moral obligation, need to develop strong political and advocacy skills

Why do politics exist?

Resources can be limited and some people control more resources than others

Identify the concept demonstrated in clinical practice per the following definition: To be trustworthy and dependable

Responsibility

Who funds Medicaid?

State and federal government.

Who is health care defined and controlled by?

Those with political influence and power

Why was Health Canada's Office of Nursing Policy (ONP) created?

To help Canadians maintain and improve their health through development of policy which integrates the views of nurses and the nursing profession

How can nurses demonstrate effective advocacy skills? (10)

Understand the environment, know the desired outcome, have a strategy, be regular and consistent, know your audience, make it personal, focus on solutions not problems, be certain of the facts, use many approaches, be persistent

A nurse makes a significant medication error. Which information should the nurse expect the risk manager to ask​ about? 1) Any process that was in place that allowed the error to occur 2) If the nurse will agree to have the error reported 3) The hours the nurse worked the previous day 4) Whether the nurse intended to commit the error

​1) Any process that was in place that allowed the error to occur Rationale: When an error​ occurs, it should always be​ reported, whether or not the nurse involved agrees. Reporting of errors should be nonpunitive and should not be considered a negative. Fatigue levels may be​ considered, but a nurse who is experiencing fatigue should not be allowed to work. It should be assumed that the nurse did not intend to commit the error because this could become a human resources or criminal issue. Reporting of errors is mostly beneficial when safety gaps in processes are identified. Then work can be done to improve processes and prevent future errors. Next Question

The nurse does not turn a client as​ ordered, and the client develops a pressure injury. Which legal concept​ applies? 1) Breach of duty 2) Scope of practice 3 )Foreseeability 4) False imprisonment

​1) breach of duty ​Rationale: A duty is a legally enforceable compulsion to act based on competency and experience. Not doing what should be done in this situation represents a breach of​ duty, which is defined as a deviation from the standard of care owed to the client. Foreseeability is another aspect of​ negligence, in that the nurse should have known the consequences of not performing the duty. Scope of practice and false imprisonment do not apply to this situation. Next Question

A client requires a longer length of stay because a nurse does not administer an ordered medication or document why the medication was not given. Which legal concept applies in this​ case? 1) Breach of duty 2) Failure to follow standards of care 3) Failure to act as a client advocate 4) Scope of practice

​2) Failure to follow standards of care Rationale: A nurse has a legal obligation to follow a healthcare​ provider's order. It is always appropriate to question an unclear or questionable​ order, but​ follow-up must​ occur, and documentation must support the decision not to follow the order. This was a specific failure rather than a general breach of duty. Scope of practice is not applicable to this scenario. Failure to act as a client advocate is applicable when an order or plan of care is not advisable and the nurse intervenes. Next Question

Which scenario should the nurse recognize as an example of failing to assess and monitor a​ client? 1) The nurse fails to notify the healthcare provider in a timely manner when conditions warrant it. 2) The nurse fails to act on prescribed​ orders, and the client suffers an adverse event. 3) The nurse fails to document a​ client's allergy, and the client has an allergic reaction to a medication. 4) The nurse fails to treat the client who reports a​ headache, and the client subsequently has a stroke.

​4) The nurse fails to treat the client who reports a​ headache, and the client subsequently has a stroke. Rationale: The nurse who fails to treat a client who complains of a headache and then subsequently suffers a stroke is failing to assess and monitor. The other clinical scenarios are negligent acts that lead to malpractice.​ However, they do not fit the scenario of failing to assess and monitor. Next Question

Which statement by the nurse promotes personal and professional​ accountability? 1) ​"I do what I think is​ right." 2) ​"I took the bar​ exam." 3) ​"I'm not a member of any professional​ organization." 4) ​"I passed the NCLEX after graduating from an accredited​ school."

​4) ​"I passed the NCLEX after graduating from an accredited​ school." Rationale: Nursing as a profession embraces and promotes personal and professional accountability. Aspects of the profession that promote accountability include the​ following: (1) the requirement to successfully complete​ exhaustive, specialized training to acquire the body of knowledge necessary for performance of the role—passing the NCLEX after graduating from an accredited school is an example for​ this; (2) the direction of the professional individual toward​ service, whether in a community or an organizational​ capacity; (3) allegiance to a code of​ ethics; (4) the autonomy of the​ role; and​ (5) membership in a professional organization.