1119 Leadership and Professional Development, Unit 1
What agency protects the public from unsafe nursing practices, provides approval for nursing education, issues licenses and provides nursing practice and education guidance for currently licensed nurses?
BON
What Board Position Statement number on the Board rules associated with Alleged Patient Abandonment explains that typically leaving employment after a shift is over, with or without notice, is not abandonment?
Board Position Statement 15.6
What is a legal immunity for rescuers who provide first aid in an emergency to accident victims - an emergency outside of the hospital or ER?
Good Samaritan Laws - you are still held accountable for outcome because you have more knowledge than lay persons and still have to stay within your scope of practice
What type of action means that any administrative, civil, equitable, or criminal action permitted by the home state's laws that are imposed on a nurse by the home state's licensing board or other authority including actions against an individual's license such as revocation, suspension, probation or any other action that affects a nurse's authorization to practice?
Home State Action
When does your license expire?
If you take boards in January 2016 and your birthday is July 6; your license may expire for the first time on July 6, 2017, then every two years afterward
According to the BON, what type of assessments can the LVN and the RN perform?
LVN - focused, RN - comprehensive
What entity dictates how to perform duties the correct way?
NPA
What.... 1. defines the scope of practice 2. establishes requirements for licensure and entry into practice 3. creates a BON to oversee nursing practice 4. identifies legal titles for nurses, such as RN and LVN 5. determines what constitutes grounds for disciplinary action
NPA (Nurse Practice Act)
At what time are you allowed to hold your self out as an LVN?
Once you have passed the NCLEX-PN licensure exam
What three distinctive areas of nursing does the NPA represent?
RN, LVN, APRN (advanced Practice RN)
What Standard (number) holds that the nurse is accountable to accept only those assignments that are within the nurse's education/training/experience, as well as his/her physical and emotional ability? If you accept an assignment, you are responsible.
Standard (1)(T)
What is the six step decision making model? (cont. - steps three and four) Step three: Is the act supported by either research reported in nurse and health related literature or in scope of practice statements by national nursing organizations? If the answer is YES - continue; if the answer is NO - STOP!
Step four: Do you possess the required knowledge and have you demonstrated the competency required to carry out this activity safely? If the answer is YES - continue; if the answer is NO - STOP!
What is the six step decision making model? (cont.- steps five and six) Step five: Would a reasonable and prudent nurse perform this activity in this setting? If the answer is YES - continue; if the answer is NO - STOP!
Step six: Are you prepared to assume accountability for the provision of safe care and the outcome of the care rendered? If the answer is YES - continue; if the answer is NO - STOP
What is the six step decision making model? (steps one and two) Step one: Is the act consistent with the NPA, Board Rules, and Board positions statements and guidelines? If the answer is YES - continue; if the answer is NO - STOP!
Step two: Is the activity appropriately authorized by valid/order protocol and in accordance with established policies and procedures? If the answer is YES - continue; if the answer is NO - STOP!
What agency offers nurses life renewing opportunities for recovery from chemical dependency and mental illness and integrates nurses back into the profession thus protecting them and promoting professional accountability?
TPAPN - Texas Peer Assistance Program for Nurses
What agency has the mission to protect and promote the welfare of the people of Texas by ensuring that each person holding a license as a nurse is competent to practice safely
Texas BON
What does compact state mean?
That state will acknowledge and accept your license from the state of Texas
What review board protects patients from inappropriate research, has a committee which scrutinizes every research proposal and ensures safety to all patients?
The IRB - Institutional Review Board (advocacy)
Is an LVN allowed to modify a plan of care?
Yes, but cannot start the care plan
What designates an individual legally responsible for making medical decisions when a person is unable?
a proxy directive
If you have a patient that is going for surgery and you smell alcohol on their breath, what should you do?
advise the physician because the patient is not NPO
Age - eliminate prejudice. This is patient ________.
advocacy
Ethnicity - represent cultural experiences, prepare to learn and grow with the knowledge that a patient shares with you, apply knowledge gained to care given. This is patient _____________.
advocacy
Patients have the right to refuse treatment or medication, i.e. cancer patients - chemo; homeless patients; CHF patient diet. You are responsible to the patient to inform fully of consequences of treatment choices, always keeping the patient's rights in mind, informed consent. This is all patient __________.
advocacy
Sexuality - try to assess each person's sexual health and support the individual's right to express their own sexuality. This is patient ______.
advocacy
Understanding your feelings and the patient's feelings about components of their identity including spirituality, sexuality, ethnicity and age. This is patient _______________.
advocacy
What is protecting the rights of patients such as HIPPA?
advocacy
What is the act of informing and supporting a person so that the person can make the best decisions for personal health? (may involve referring patient problems to ethics committee; use of holistic approach, following a chain of command for problem solving)
advocacy
What is the fundamental principle of patient advocacy that protects people from infringements on their rights as patients and human beings?
advocacy
Upon issuance of license to a new nurse, when must a nurse renew their license?
after one year, there are no CEs or CUs for the new nurse to fulfill during the first year. After the first year, the license is renewed every two years
What is failure to obtain an informed consent be?
assault and battery
How many times can you take the NJE and what score must you make to pass?
can take multiple times, 50 questions - must pass with a 75%
What is abandonment:
cessation of the nurse-patient relationship without notice or patient's permission
What is terrorism?
deliberate creation and exploitation of fear for bringing about political change
What does a living will do?
directs another person or a physician as to the patient's wishes if the patient is incapable of making a decision
What is a situation in which a decision must be made between two opposing alternatives when there is not an exact right or wrong answer?
ethical dilemma
What are the six patient rights?
ethical rights, advocacy, respect, dignity, honesty, compassion
How often does your license need to be renewed?
every two years
What is negligence?
failure to provide same care that another person would provide under same circumstances
If a patient is not allowed to leave their room, what is this considered if it is against their will?
false imprisonment
What agency does the LVN receive authority to delegate an unlicensed person (such as a CNA)?
from the NPA of that individual's state
What setting does the BON strongly discourage the newly licensed nurses from accepting employment at? (they recommend achieving 12 to 18 months of experience in an acute heath care setting first)
home health environment - although they cannot stop this
What specifies aspects of care the person does or does not desire and the circumstances in which to apply these wishes?
instructional directive
What is the functional principle of patient advocacy?
it protects people from infringements on their rights
What are the major areas of liability?
lack of safety, knowledge, skill, observation and reporting, documentation and acceptability of responsibility for nursing action.
What is a legal obligation a person has to make for compensation of an action?
liability
What individuals might be deemed incompetent?
mentally retarded, minors
What type of Tort Law is broken when a nurse does not give discharge instructions before the patient leaves the hospital?
negligence
An incident report is primary tool of risk management. This is made when an error is discovered or when one occurs and results in harm. The incident report becomes part of the chart. Is the incident report noted in the nurse's notes?
no
Can BON members and BON staff lobby the legislature regarding any bill that may go before the Texas Legislature and amend the Nursing Practice Act (NPA) or other statutes, in or outside the authority of the BON, that otherwise impact nurses?
no
Can a facility policy or an MD order discharge the nurse's responsibility for assuring patient safety, or for complying with all of the other rules and requirements in the NPA?
no
Can the BON draft legislation, support or oppose proposed bills during a legislative session?
no
Does the BON have any jurisdiction over facility policies?
no
Does the BON have any jurisdiction over workplace/employment issues, such as floating or staffing ratios?
no
Is a living will valid during pregnancy or during surgery?
no
Is an LVN allowed to take care of 10 patients in an acute care setting?
no
If the nurse notifies his/her employer that he/she is quitting the job at the end of the assigned shift, is this abandonment?
no, because the nurse finished the shift - cannot be reported for patient abandonment
As a nurse, you are the patient advocate. What are you in charge of?
patient care and safety
What can an LVN do according to the care plan?
perform it, plan it with the RN, evaluate, collect data and assess
Who can be sued for malpractice?
physicians, lawyers, nurses and dentists
Are ethical decisions based on principles and logical reasoning or emotions?
principles and logical reasoning
What is assault?
purposely threatening physical harm
When you have been assigned too many patients to care for or too many patients that need extra care, you can ask for ____________ ______________ which notifies your superiors of the situation.
safe harbor - you may still need to take care of the patients but it has been acknowledged that it is an unsafe environment for you and the patients.
What is it called when you publicly talk badly about someone else?
slander
What is a right?
something that you are entitled to
Whose mission is to protect and promote the welfare of the people of Texas?
the BON
In 2008, what exam was created in order to insure the safe practice of nurses and their knowledge of the Texas State BON?
the Jurisprudence Exam (NJE)
What is the privilege called that means current, official authority from a remote state permitting the practice of nursing as a RN, LPN or LVN in the party state?
the Multi-State Licensing Privilege
What compact exchanges info from one state to another, holding a nurse accountable for meeting all state practice laws in the state in which the patient is located at the time care was provided through the mutual recognition of the party state licenses?
the Nurse Licensure Compact
Within the facility, who evaluates nursing services, the qualifications of a nurse, the quality of patient care rendered by nurses, the merits of a complaint concerning a nurse or nursing care, and a determination or recommendation regarding a complaint?
the Peer review committee of the facility
What was created in 1909 by the State of Texas that is a state agency to serve the PUBLIC and regulate safe nursing practices
the Texas BON
Who is responsible when the client is forewarned of a potential hazard to his/her safety and chooses to ignore the warning?
the client is found responsible - i.e. a client ambulates without assistance (has been warned, and call system is within reach) and falls by themselves, they are responsible.
What is required for an informed consent?
the patient must have knowledge and understanding of the procedure or process performed, knows the risks and outcomes as advised by the physician.
Who does the BON represent through assuring licensed nurses meet minimum standards of safe practice?
the people of Texas
Who's responsibility is it to get the consent signed for surgery?
the physician
What are the steps called that a nurse must use for critical thinking?
the six steps
What are some things that the patient can refuse regarding their care?
their care, meds, treatment, procedures, can refuse to eat but cannot refuse to be put on a specific diet (i.e. low sodium)
Who does the nursing association represent?
their members
Research related rights - it is your responsibility to ensure that the patient's rights are not infringed upon when participating in research.
this falls under advocacy
What is the purpose of interpretive quidelines for the LVN scope of practice?
to promote understanding by all of the accurate application of the standards of nursing
What is one of the primary functions of a nursing association?
to represent its members in legislative, political and practice matters
What is battery?
touching an individual without consent
The Texas Peer Assistance Program for Nurses (TPAPN) offers nurses with a chemical dependency or mental illness opportunities for recovery and protects them in the profession. true or false
true
What is the designated time in which a person can file a lawsuit for a child?
until age 21 plus one day
Does the BON and nursing associations have separate but equally important roles?
yes
In the home setting, is it the nurse's responsibility to report unsafe conditions?
yes
Is it necessary to have a DNR written in the chart, even with out-of-hospital DNRs?
yes
Is threatening to touch a patient assault?
yes
Can a nurse serve as a witness to an informed consent?
yes, and the nurse can write "witness to signature only"
Does a nurse have the right to refuse to engage in any activity that the nurse, in good faith, believes may cause him/her to violate one or more provisions of the NPA and board rules?
yes, based on NPA, Section 301.352
What can you do to express your concerns about staffing/floating that may cause potential harm for patients and jeopardizes your license?
you may wish to consider speaking with your nurse manager before disaster strikes
What is the number of the main rule which is applicable to the nursing practice?
15.27
How many CUs or CEs do you have to have to renew your license every two years?
20 hours
How long will the graduate vocational nurse (GVN) certificate be valid?
75 days
What issues are mandatory to report? select all that apply 1. communicable diseases 2. immunizations 3. child abuse 4. abuse of a disabled or elderly individual 5. gunshot or stab wounds 6. rapes and sexual assaults
ALL apply
What is it called when the patient leaves against medical advice? What should you do if a patient does this?
AMA. Try to get them to sign that they are leaving AMA. Document regardless
Spirituality - try to understand the beliefs and customs related to the religion of the patient you are caring for. This is patient ____________.
Advocacy
What does ANA stand for?
American Nursing Assoc.
The NPA (Nurse Practice Act) defines what?
Defines the scope of the nursing practice
