Legal Issues

Impaired RN

- More than half of all impaired nurses began abusing during their nursing education days. - detect problems early and get nurses into treatment. The ANA strongly supports "alternative to discipline" or "peer assistance" programs.

Do Not Resuscitate

-A written physician's order instructing health care providers not to attempt CPR. -Allows the person to die with comfort measures only and without the interference of technology. -Often requested by family. -Must be signed my a physician to be valid.

The Nurse's Responsibilities

-Be aware of legal issues and the wishes of the patient. -Nursing care of dying patients is holistic and encompasses all aspects of psychosocial (grieving process) and physical needs (physical changes that are associated with dying). -Focus on patient and family: respect, dignity, and comfort. -Recognize own needs when dealing with grief and dying.

Nurse Practice Acts

-Establish education requirements -Distinguish between nursing and medical practice -Define nurses scope of practice -Define nursing practice more specifically

General Breaches of the Standard of Care

-Failure to clarify health care provider orders -Failure to provide a safe environment for the patient -Medication errors (wrong med to the wrong patient, wrong dose, wrong amount) -Failure to follow standards of care or facility policy and procedure -Failure to recognize or notify the HCP of significant changes in the patient's condition -Failure to document in a timely and proper manner -Failure to monitor properly -Failure to protect patient against harm

HIPPA objectives

-How to release info to health care workers that "need to know" -Impermissible uses & disclosures result in lawsuits -Protect privacy of individually identifiable health info -Arrange for sharing info with families in a discreet manner -Access by patients to medical records including the right to see & copy -The responsibility of the RN as a patient advocate is to reinforce the rule & protect our patients. -Social Media

Role of the Nurse

-To promote health -To prevent illness -To restore health To facilitate coping with disability or death

HIPAA-Ensured Patient Rights

-To see and copy their health record -To update their health record -To request correction of any mistakes -To get a list of the disclosures a health care institution has made independent of disclosures made for the purposes of treatment, payment, and health care operations -To request a restriction on certain uses or disclosures -To choose how to receive health information

common categories of malpractice claims

1. Failure to follow standards of care 2. Failure to use equipment in a responsible manner 3. Failure to assess & monitor 4. Failure to communicate 5. Failure to document 6. Failure to act as an client advocate or to follow the chain of command

."You have the right to say who can access your health records and who cannot."

A client tells the nurse that she is getting divorced and wants to be sure that her soon-to-be ex-husband cannot have access to her medical information. Which response would be the most accurate for the nurse to give the client?

Make no attempt to resuscitate the client.

A dying client and family have requested that no attempts be made to resuscitate the client in the event of death. A doctor has written a DNR order. What is the nurse's responsibility if the client dies?

Advance Directives

A general term used to describe the documents that give instructions about future medical care and treatments

Negligence

A nurse does not assist with ambulation a postoperative client on the first day after surgery. The client falls and fractures a hip. What charge might be brought against the nurse?

Confidentiality

A nurse is caring for a client who is a celebrity in the area. A person claiming he is a family member inquires about the medical details of the client. The nurse reveals the information but later comes to find out that the person was not a family member. The nurse has violated which of the following?

Protect the patient's right to self determination

A patient is admitted to a home health-care program for palliative care. When completing the admission interview and nursing assessment the patient empathetically states, "I want no intervention to extend my life other than keeping me comfortable." When talking with family members, they want to continue with chemotherapy. What is the nurse's responsibility?

Assault

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

ABDOMINAL WOUND 5 cm IN LENGTH WITHOUT REDNESS, DRAINAGE OR EDEMA

ABDOMINAL WOUND 5 cm IN LENGTH WITHOUT REDNESS, DRAINAGE OR EDEMA VS LARGE ABDOMINAL WOUND HEALING

Defamation of character

An intentional tort in which one party makes derogatory remarks about another that diminish the other party's reputation.

When unit is understaffed

If the RN feels unsafe, she should not take the assignment. She could notify the supervisor and ask for additional staff. If the RN accepts responsibility for work the RN is held to a professional standard of judgement. The RN can't accept the responsibility and when something happens, claim we were understaffed. No legal grounds for this accusation after the fact.

False imprisonment

Confined or held against a person's will

Advance directives include

Living Will Durable Power of Attorney Do Not Resuscitate order

HIPAA

Federal law that protects patient's rights and their records, from anyone else without the patient's consent or knowledge.

Good Samaritan Laws example

For example, a nurse at the scene of an automobile accident may give emergency care without fear of a legal suit if such care appears necessary, unless care is given in a grossly negligent manner.

Malpractice

For which tort can the nurse be legally charged when the nurse accidentally administers a medication to the wrong patient and the patient experiences a serious reaction? A. Malpractice B. Assault C. Battery D. Fraud

True

Good Samaritan Laws are designed to protect health care providers when they give aid to people in emergency situations. True or False

it wasn't done

If you didnt document it,

Patient Self-Determination Act (PSDA)

In 1990, encourages everyone to decide now about the types and extent of medical care they want to accept or refuse if they become unable to make those decisions due to illness.

Good Samaritan Laws

Liability of physician, dentist, nurse, or emergency medical technician, etc., for rendering emergency care.

tort

May be intentional or unintentional: is subject to action in a civil court with damages usually being settled with money.

RN do if he/ she determines that the client is unsure or does not completely understand the situation

Nurse is responsible for notifying the person who had obtained the consent about the situation so that that person can clarify or reexplain the information.

Abuse

Nurses are frequently the first members of the public to detect this. Includes physical, verbal, sexual, or emotional attack; neglect; and abandonment. Targets include infants, children, and adult men and women of all ages. Abusers are men and women of all ages, races, socioeconomic groups, and religious backgrounds.

erroneous

Nurses are protected by law against suits from alleged abusers if they file a report of suspected abuse in good faith that turns out to be

Taking a picture of a client with the nurse's cell phone

Nurses must maintain the privacy of clients. Which example is a breach in privacy and would pose an ethical problem?

Nurse's role in informed consent

Obtaining informed consent is the responsibility of the person who will perform the diagnostic or treatment procedure or the research study. The role of the RN is to confirm that a signed consent form is present in the chart and to answer any questions about the consent. As an RN, you sign the consent form as a witness to having seen the client sign the form, not as having obtained the consent yourself.

Negligence

Performing an act that a reasonably prudent person under similar circumstances would not do or, failing to perform an act that reasonably prudent person under similar circumstances would do.

Malpractice

Professional negligence

role of the Mississippi Board of Nursing

Regulates the practice of nursing with licensure.

Invasion of privacy

Right to confidentiality

is unacceptable and breaches the client's confidentiality rights.

Several nurses on the same hospital unit communicate on the same social networking site. A nurse posts the following statement to the social networking page, "The lady in room 34 with heart failure was a train wreck!" This statement:

crime

The failure to report actual or suspected abuse is a

Living Will

The lay term used frequently to describe any number of documents that give instructions about future medical care and treatments or the wish to be allowed to die without heroic or extraordinary measures should the patient be unable to communicate for self

True

True or False: Nurses are obligated both ethically and legally to report abuse.

True

True or False: Nurses are protected by law against suits from alleged abusers if they file a report of suspected abuse in good faith that turns out to be erroneous.

HIPAA violation

The nurse is assigned to a group of clients on the medical floor. A visitor tells the nurse that their neighbor is a client at the hospital and doesn't know what is wrong. The nurse checks the client's EMR (electronic medical record) and proceeds to inform the visitor about the client's diagnosis. What type of violation has the nurse committed?

Obligation to report communicable diseases

To prevent a larger spread of the disease throughout the hospital/community. It allows public health officials to investigate the cause and start of the disease to get control of it.

Questions to ask when you suspect abuse

What do I observe? How does this affect patient care or teamwork? What should I do when I have a concern? Would my colleague benefit from assistance?

_____ Talking about a patient to another health professional in an elevator _____ Telling a neighbor about a famous person who is currently your patient ___ Leaving patient data on a computer screen in a hallway while administering medication

Which actions are violations of HIPAA? (Select all that apply.) _____ Talking about a patient to another health professional in an elevator _____ Telling a neighbor about a famous person who is currently your patient _____ Documenting untrue information on purpose in a patient's clinical record _____ Leaving patient data on a computer screen in a hallway while administering medication _____ Completing an incident report about a patient situation and asking the nurse manager to review it.

_____ Allowing patients the right to review and copy their clinical record _____ Explaining to a person inquiring about the condition of a patient that information about the patient is confidential _____ Giving medical information about an unconscious patient to a person's daughter who is the person indicated in the patient's proxy directive

Which actions meet obligations regarding the Health Insurance Portability and Accountability Act (HIPAA) of 1996? (Select all that apply.) _____ Allowing patients the right to review and copy their clinical record _____ Providing access to a patient's clinical record to all members of the nursing team _____ Holding patient rounds in a hallway out of the hearing range of the patient being discussed _____ Explaining to a person inquiring about the condition of a patient that information about the patient is confidential _____ Giving medical information about an unconscious patient to a person's daughter who is the person indicated in the patient's proxy directive

Intake 360 mL of water

Which one paints the best picture? -Intake 360 mL of Water -Patient Drink An Adequate Amount of Fluid

_____ A nursing license can be refused as a result of unlawful actions. _____ A nursing license allows a nurse to practice in the state in which the license was issued. _____ A state board of nursing is responsible for ensuring that graduates of accredited schools of nursing take the NCLEX licensure examination.

Which statements accurately pertain to nursing licensure? (Select all that apply.) _____ A state board of nursing can never revoke a nursing license. _____ A nursing license can be refused as a result of unlawful actions. _____ A nursing license is not necessary when practicing nursing in the home setting. _____ A nursing license allows a nurse to practice in the state in which the license was issued. _____ A state board of nursing is responsible for ensuring that graduates of accredited schools of nursing take the NCLEX licensure examination.

____Nurse practice acts identify what a nurse can and cannot do. _____ A purpose of a nurse practice act is to regulate the practice of nursing. _____ If a student nurse is involved in a disciplinary action by the state board of nursing, the student may be prohibited from taking the National Council Licensure Examination.

Which statements are associated with state nurse practice acts? (Select all that apply.) _____ Nurse practice acts identify what a nurse can and cannot do. _____ A purpose of a nurse practice act is to regulate the practice of nursing. _____ The federal government is the regulating agency responsible for state nurse practice acts. _____ Student nurses are not obligated to meet the same standards of care as are licensed nurses. _____ If a student nurse is involved in a disciplinary action by the state board of nursing, the student may be prohibited from taking the National Council Licensure Examination.

_____ The Joint Commission examines patients' clinical records to substantiate compliance with standards of care. _____ Clinical records are used by a quality management committee to monitor quality of care provided by the facility. _____ Clinical records serve as a legal document that can be used in a court of law to prove that a standard of care was met or not met.

Which statements associated with a patient's clinical record are considered accurate? (Select all that apply.) _____ The clinical record belongs to the patient. _____ The Joint Commission examines patients' clinical records to substantiate compliance with standards of care. _____ Clinical records are used by a quality management committee to monitor quality of care provided by the facility. _____ Clinical records serve as a legal document that can be used in a court of law to prove that a standard of care was met or not met. _____ Parts of a clinical record can be copied and used only by student nurses if the patient's name and medical record number is removed.

Assault

Which term best describes the situation when a nurse says to a pediatric patient, "If you don't be quiet, I will not let your parents visit you today?" A. Battery B. Assault C. Negligence D. Abandonment

Another individual has been identified to make decisions on behalf of the client.

While receiving report on a group of clients, the nurse learns that a client with terminal cancer has granted power of attorney for health care to her brother. How does this affect the course of the client's care?

Nursing Practice Standards

allow nurses to carry out professional roles, serving as protection for the nurse, patient, and the institution where the care is being provided.

PSDA

applies to hospitals, long-term care facilities, and home health agencies that get Medicare and Medicaid reimbursement.

Legal Issues sources

constitutions, statutes, administrative agencies, and court decisions

RN Accountability

for his or her own quality of practice & is responsible for the use of these standards to ensure knowledgeable, safe, & comprehensive nursing care.

ANA's 2015 Nursing: Scope & Standards of Practice

defines activities that are specific & unique to nursing.

Vulnerable populations

disadvantaged subsegment of a community requiring utmost care, specific ancillary considerations, and augmented protection in research; includes those living in poverty, women, children, older adults, rural and inner-city residents, new immigrants, the homeless, mentally ill patients, and people with disabilities and special health care needs

PSDA rules

health care agencies must ask you whether you have an advance directive. They also must give you information about your rights under state law

Battery

intentional physical contact with a person without consent

Legal issues concept

involve legislation and laws that are in place to protect the client and the nurse

Nurse Practice Act

list the violations that can result in disciplinary actions against a nurse and also intend to prevent untrained or unlicensed people from practicing nursing.

Abuse/Neglect

nurses must know what needs to be reported in their local area and to what authority. Nurses are frequently the first members of the public to detect

durable power of attorney

person a patient designates to make decisions based on care

Nurse role in Legal Issues

practice within these prescribed boundaries, as well as be aware of what constitutes malpractice or professional negligence

Other legal issues

related to informed consent, documentation, incident reporting, the Patient Self-Determination Act, and licensure

Nurse Practice Act

where nursing boundaries for nursing practice are defined in each state