Nursing 100 Quiz #2 : Ch. 8, 9, 15, 23 + Collaboration

What is true of claims of negligence and student nurses?

Because the student is not yet a licensed professional, faculty member or licensed nurse is meant to supervise.

What does learning right and wrong look like for infants?

Begin with no concept of right or wrong. If the need for basic trust is met, infants will develop the foundation for secure moral thought.

What bioethical dilemma does life bring up?

Bioethical abortion issues: When does life begin? Nurses serving in women's and children's health settings must be prepared to face this morally laden issue. Reproduction issue: Influence by genetic screening, genetic engineering, and cloning.

What is storage?

The physical location of data in the EHR system

What do HIPAA regulations focus on?

The privacy and security of patient data.

Reporting Statutes-Child Abuse Prevention and Treatment Act:

There are laws mandating the reporting of specific health problems and suspected or confirmed abuse. Health professionals must report the following under penalty of fine or imprisonment for failing to do so (infant and child abuse, dependent elder abuse, or specified communicable diseases). Most laws grant immunity from suit within the context of the mandatory reporting statute.

What is true about Federal States related to Nursing/Healthcare?

They have a major effect on nursing care by mandating standard of care in all settings that receive federal funds (Medicare, Medicaid)

How can electronic health records (EHR) systems have the greatest impact on cost and quality?

They must be interoperable with the ability to exchange information across systems and settings in a standardized manner.

What was the goal of both the Bush and Obama administrations, but has not been reached?

To have universal EHR adoption in the United States by 2014.

What do risk management systems do?

Track incidents and accidents in the facility. Assist in the development of policies and procedures to improve practice. Provide knowledge about federal and state laws, licensing laws, and health care case law.

What is delegation?

Transferring responsibility while remaining accountable for outcomes Requires knowing which skills are transferable Results in improved quality of patient care, improved efficacy, increased productivity, and an empowered staff

What is false imprisonment?

Unlawful restraint or detention of another person against his or her wishes. Nurses have no authority to detain a patient even if there is likelihood of harm or injury.

What difficult questions need to be answered when making ethical decisions?

What is safe care?, When staffing is inadequate, what care should be accepted or refused?, What does it mean to be ill or well?, What is the proper balance between science/technology and the good of humans?, Where do we find balance when science will allow us to experiment with the basic origins of life?

What are "do not resuscitate" orders?

Written by physicians on the basis of directives by the patient. Nurses have absolute duty to respect patients DNR orders.

What are the 8 functionalities of EHR systems?

1. Health information and data 2. Results management 3. Computerized provider order entry (CPOE) with or without decision support 4. Clinical decision support 5. Electronic communication and connectivity 6. Patient support for patient education and home monitoring, when applicable 7. Administrative processes 8. Reporting and population health management

Who is part of the nursing team?

1. Nurse Executive (CNO=Chief nursing officer; DON) 2. Nurse Manager (Supervisor) 3. Charge Nurse/Team Leader: can vary from day to day; some nurses are just assigned to have this duty 4. Nurse (RN) 5. Nursing Assistnat (CNA) 6. HUC (Health Unit Coordinator/Secretary): discharges patients; answers the phone

What is durable power of attorney for health care?

A document that authorizes patient to name the person who will make the day-to-day and end-of-life decisions when he or she becomes decisionally incompetent.

What are some defenses against claims of negligence?

A nurse may never say they were "following physician's orders". Emergency situations, government immunity, Good Samaritan immunity, ANA Code of Ethics and American Medical Association Code of Medical Ethics.

What is value clarification?

A process by which people attempt to examine the values they hold and how those values function as a part of the whole.

What is gross negligence?

A reckless act that reflects a conscious disregard for the patient's welfare.

What is an ethical theory?

A system of principles by which a person can determine what ought and ought not to be done.

What is an EHR?

A system that captures, processes, communicates, secures, and presents data about a patient. Integration of information from multiple sources. Serves as a primary source of information for patient care and quality. Connects the different settings (hospitals, home health, primary care physician)

What could leaving the hospital against medical advice result in?

Aggravated current condition and complicated future care. Permanent physical or mental impairment or disability. Complications leading to death.

Institutional Licensing Laws:

All facilities that provide health care services must comply with licensing laws. The laws generally contain minimum standards for maintenance of the physical plant, basic operational aspects for major departments like nursing, dietary, clinical labs, and pharmacy, essential aspects of patient rights and informed consent process, and copies of licensing laws from state health departments.

What are some reasons for malpractice insurance?

All nurses purchase malpractice insurance More states recognize nurse malpractice as a legitimate claim in a civil suit Functions for RNs and advanced practice nurses are expanding Increasing floating and cross-training mandates Some employers may fail to initiate an adequate defense for nurses and insurance coverage limits are lower than the actual judgment made against the nurse in a lawsuit

The Patient Safety and Quality Improvement Act:

Allows certain disclosure of patient safety data.

What is true about a patient's right to refuse treatment?

An adult of sound mind has a right to refuse any treatment that has previously been agreed to. The nurse must notify the provider if the patient refuses treatment and the provider should give patient information about the consequences, risks, and benefits of refusing treatment and explore available alternatives.

HIPAA and clinical information systems

Any institution that collects/stores protected health information (PHI) is required to name a privacy officer, provide employee training, and implement HIPAA policies and procedures. Only employees can have access to know specific information. Individuals who violate HIPAA may be subject to criminal penalties and civil monetary penalties

The use of physical restrains:

Any restrain-chemical or physical-is imprisonment. The nurse must use the least restrictive restraint and only when all other strategies have been exhausted. Physical and chemical restraint use and seclusion are governed by federal and state statures and accrediting bodies. Charges of assault and battery, and false imprisonment can be leveled against a nurse who uses restraints improperly.

When does the negligence and the doctrine of res ipsa loquitur apply?

Applies when the negligent act clearly lies within the range of a jury's common knowledge and experience to determine the standard care-"the thing that speaks for itself".

What is assault and battery?

Assault is causing a person to fear that he or she will be touched without consent. Battery is the unauthorized touching or the actual harmful or offensive touching of a person and may rise to the level of a crime. To avoid these, a nurse should ask patient's permission before initiating any procedure and document permission granted.

What is liability?

Asserts that every person is responsible for the wrong or injury done to another as the result of carelessness.

What do nursing care delivery models do?

Assist nurses in achieving desirable outcomes for their patients (faster diagnosis and intervention=safer patient environment) Results in success based on decision-making authority for nurses and effective methods of communicating with colleagues.

Nurse Case Law:

Body of written opinions about nursing practice. One important case established "affirmative duty". Case law and common law provide courts with guidelines for deciding future cases.

Priority setting:

By using proper sequence, does not jeopardize patient care Determine which patient's needs should be addressed first High priority: immediate threat to patient survival or safety (blood pressures has dropped to 60/40 and patient is dizzy) Intermediate priority: Non-life threatening (Patient complains of pain 4 out of 10) Low priority: potential problem may not be directly related to patient's illness or disease (patient request stool softener)

Nurse/patient ratio and Mandatory overtime statutes:

California was the first to enact a law in January 2004 that mandates the establishment of minimum nurse/patient ratios in acute care facilities (critical care units, step-down and medical-surgical units, and maternity departments). Research indicates that better nurse/patient ratios can result in lower "failure-to-rescue" rates and lower inpatient mortality rates.

What is true about ethical issues?

Certain ethical issues will be resolved within the context of the patient-provider relationship. Other ethical issues that may be more encompassing are addressed in group settings. (Institutional ethics committees are common)

What is one of the specific functionality recommendations essential for improving the quality and safety of health care?

Clinical decision support: Automatic reminders about preventative practices (vaccines), drug alerts for dosing and interactions (helps prevent medication errors), and electronic resources for data interpretation and clinical decision making.

What is clinical care coordination?

Clinical decisions are based on complete patient assessment Priority setting Organizational skills are crucial to implementation Use of resources Time management Evaluation: compared actual patient outcomes with expected outcomes

What is characteristic of Magnet hospitals?

Clinical promotion systems and research and evidence-based practice. Nurses have professional autonomy over their practice and control over the practice environment. Empower the nursing team to make changes and be innovative. This results in a strong collaborative relationship among team members and improved patient quality of care outcomes.

What are CPOE (Computerized Provider Order Entry)?

Clinician with order writing authority sits at a computer to directly enter patient care orders. It eliminates lost orders and illegible handwriting and prevents medical errors. Improved communication and readily accessible knowledge, requires key information, calculation assistance, checks performed in real time, assistance with medication monitoring, decision support, and rapid response and tracking of adverse events.

What is team nursing?

Collaborative care style that encourages each member of the team to work with and help other members. Hierarchical communication from charge nurse to charge nurse, charge nurse to team leader, and team leader to team members. Decision making occurs at clinical level. High level of autonomy for team leader/charge nurse.

What is moral development?

Forming a worldview and value system through an evolving, continuous, dynamic process that moves along a continuum of development.

What is case management?

Collaborative process of assessing, planning, facilitating, and advocating for options and services to meet an individual's health needs. Coordinate and links health care services to patients and their families while streamlining costs and maintaining quality. Communication and use of available resources promote quality cost-efective outcomes in this model. RN are usually case managers. Case managers focus on discharges (what they will need after dischargee, equipment to go home, services when they go home) Follow patients to make sure hospital is abiding by insurance policies.

What is data capture?

Collection and entry of date of dat into an EHR system

What is criminal negligence?

Constitutes a crime that is deemed so reckless that it results in serious injury or death to the patient.

What can the court do regarding gross negligence?

Court may award special damages meant to punish the nurse for the outrageous conduct; these are referred to as punitive damages.

Common Law:

Created through cases heard and decided in federal and state appellate courts (also known as decisional or judge-made laws).

The Nurse and Criminal Law:

Crime is an offense against society that is defined through written criminal statutes or codes. They are punishable by fines, imprisonment, or the death penalty in some states. An increasing number of nurses are being charge with criminal acts.

What is decision making?

Decentralized management means that decision making occurs at the level of the staff. Encompasses: Responsibility-duties and activities an individuals is employed to perform. Autonomy-independent decisions about patient care. Authority-legitimate power to give commands and make final decisions specific to a given position. Accountability-answerable for the actions

How are health care decisions made ethically?

Decisions are made with the patient, family, other nurses, and other health care providers. Nurses must develop a reasoned thought process and sound judgment in all situations that take place within the nurse-patient relationship.

What are some leadership qualities?

Dependable, problem solver, communicator, competent, accountable, evaluator, coordinator, delegator, educator

What are bioethical dilemmas?

Dilemmas that pose a choice between perplexing alternatives in the delivery of health care because of the lack of a clear sense of right or wrong. Nurses should consider the dilemmas that might arise in a given practice setting.

What are intentional torts in nursing practice?

Direct violations of a person's legal rights with consequences that include fines and punitive damages, but may rise to the level of criminal acts.

What are medical and physician directives?

Document that lists desire of patient in a particular scenario. If properly executed, provides physician with immunity from claims of negligence in the patient's death.

HIPAA: Health Insurance Portability and Accountability Act

Early 1990s: U.S. President and administration leaders sought out a way to decrease cost of health care. Decided on the use of an electronic data interchange within the health care industry. Recommended national standards for electronic interchange and information privacy and security--> HIPAA

Finding information on the internet:

Effective and efficient Internet searching is a must in today's information overloaded society: search engine, advance searching, etc Professional association and societies are good starting points for professional information. Scientific and research information usually require literature resources that can only be found in scholarly databases such as CINAHL.

Health Insurance Portability and Accountability Act of 1996 (Public Law No. 104-191) (HIPAA):

Ensures confidentiality of a patient's medical records and sets guidelines for maintaining the privacy of health data.

What is a value system?

Entire framework on which actions are based.

What is the purpose of ethical principles?

Establishes a common ground among nurses, patients, families, other health care professionals, and society for discussion of ethical questions and ethical decision making. Permit people to take a consistent position on specific or related issues. Provides an analytical framework by which moral problems can be evaluated.

What is the purpose of staff involvement?

Establishes nursing practice or problem-solving committees or professional shared governance councils. Discusses what is going right and what is going wrong in the hospital and comes up with interventions to make it better. Interdisciplinary collaborations-leaders from different backgrounds. Staff communication (group meetings, news letters to get information out, emails, bulletin board) Staff education (educational conferences; unit specific or hospital specific)

What is true of statues of limitation in malpractice cases?

Establishes time limits within which a person may initiate a lawsuit. Time limits vary depending on state laws and a variety of case circumstances.

Where did the first use of health information technology (HIT) occur?

European Countries: Germany initiated a universal HIT process in 1993. Norway in 1997 and United Kingdom in 2002.

What is total patient care?

Ex: Critical Care units Registered nurse works directly with patient, family, and health care team members RN is responsible for patient during shift of care, although care can be delegated. Approach may not be cost-effective owning to high number of registered nurses needed. Patient satisfaction is high.

What is primary nursing?

Ex: Nursing Home One primary registered nurse assumes responsibility for caseload. Communication is lateral from nurse to nurse and from caregiver to caregiver. Flexible model uses a variety of staffing levels and mixes. RN works with a limited number of patients. The RN is more like a charge nurse or a nurse manager; does not have a heavy patient load.

Negligence:

Failure to act in a reasonable and prudent manner

Most frequent allegations of nursing negligence:

Failure to make sure patient is safe Improper treatment or negligent performance of treatment Failure to monitor patient and report findings Medication errors Failure to follow policies and procedures

Web: Consumer Health Information Technology

Has made significant changes in the way people use the Web, most notable in helping patients be good consumers of health information.

What is corporate liability?

Health care corporations can be held to a specified standard of care. Health care facilities have been found corporately liable for failing to have adequate numbers of qualified nursing staff. The Joint Commission has developed standards related to orientation, training, and education of agency staff.

What is true of personal liability for team leaders and managers?

Held to the standard of care of a reasonably prudent supervisor. Team leaders and managers have been held negligent for issues like: Triage of staff and equipment, supervision of subordinates, delegation of patient care tasks, reporting of team member performance deficits, and supporting or invoking the chain or command process when indicated.

What dilemmas does technology create for bioethics?

Illness that once led to mortality are now manageable and are classified as chronic illnesses. Cost is a consequence of prolonging life with technology. Manipulation of DNA

What are code of ethics?

Implicit standards and values for the profession. American Nurses Association Code of Ethics (Box 9-1 in text pg. 169) International Council of Nurses Code fir Nurses (Box 9-2 in text pg. 169)

What is nonmaleficence?

Implied a duty not to inflict harm, to astain from injuring others, and to help others further their own well-being by removing harm.

What are nurse managers and administrators held liable for?

Inadequate training, failure to periodically reevaluate staff competencies, failure to discipline or terminate unsafe workers, negligence in developing appropriate policies and procedures, and failure to uphold institutional licensing laws and state and federal statures.

What are felony acts in nursing?

Major criminal offenses. Nurses are commonly charged with drug trafficking, fraud in billing services for Medicare patients, theft, rape, murder.

What are bioethics?

Interdisciplinary field within health care that has evolved with modern medicine to address questions that rise as science and technology produce new ways of knowing. Physicians, nurses, social workers, and psychiatrist, clergy, philosophers, and theologians are joining to address ethical questions in health care.

What is information communication?

Interoperability of systems and linkages for exchange of data across disparate systems.

What bioethical dilemmas stand in between right to health care?

Is each person entitled to the same health care package? Does ability to pay affect specific level of entitlement? Access to health care and respect for human dignity are at the core for nursing practice.

Statutory Law

Laws written and enacted by legislative bodies. Violations are criminal offenses and are punishable by fines or imprisonment.

What does learning right from wrong look like for school-age children?

Learn that good behavior is rewarded and bad behavior is punished. Begin to make choices that are based on an understanding of good and bad.

What is libel and slander, in terms of defamation of character?

Libel is defamation caused by written word; nurses subject to libel for subjective comments written in the medical record. Slander is defamation caused by spoken word; nurses subject to slander when they repeat subjective comments about patients in public places.

What happens if there is a violation of the nurse practice act or rules and regulations?

Licensing boards have the authority to hear and decide cases against nurses. Penalties could include issuing a formal reprimand, probation, levying fees, and limiting, suspending, or revoking the nurse's license.

What are some dilemmas that health professionals will face?

Life and death, quality or life vs. quantity, right to decide, informed consent, alternative treatment issues, stem cell research, therapeutic and reproductive cloning, in vitro fertilization and donor insemination, surrogate motherhood, and organ transplantation.

What are additional consequences to criminal charges?

Loss of job and livelihood Suspension or revocation of license Out-of-pocket fines levied by the nursing board Significant attorney's fees Malpractice insurance may not cover costs in all case

Magnet Recognition

Magnet hospital are recognized for quality patient care, nursing excellence and innovations in professional nursing practices. Consumers rely on them as the ultimate credential for high quality nursing. Achieving magnet status is the highest level of honor awarded by the ANCC and is recognized as the "gold standard" of nursing excellence.

What are the challenges of autonomy?

Makes way for the crucial legal step of informed consent. When are patients competent to make informed consent decisions? Can family members or surrogates make decisions? Questions about informed consent are raised for minors, confused or older adults, mentally compromised, imprisoned, inebriated, unconscious, and those in emergency situations. Nurses also must take responsibility for understanding and educating people about advance directives.

What is a misdemeanor offense in nursing?

Minor criminal offense. Nurses are commonly charged with illegal practice of medicine, failing to report child abuse, falsification of medical records, and assault and battery and physical abuse of patients.

What is Kohlberg's theory?

Most widely accepted; is it a cognitive development process that is sequential in nature. Rules are imposed by authority. Conformity to expected social and religious mores. Autonomous thinker who strives for a moral code beyond the issues of authority and reverence.

What information must be disclosed in an informed consent?

Nature of the therapy or procedure, expected benefits and outcomes, potential risks, alternative therapies, and risks of not having the procedure.

What must the nurse do when a patient leaves against medical indvice (AMA)?

Nurse must act promptly to notify the provider. Nurse must clearly articulate the danger inherent in leaving. Value of AMA document will depend a great deal on the nurse's charting, which should note that leaving the facility could result in the following.

What elements are essential to proven negligence or malpractice?

Nurse owed patient a special duty of care based on the establishment of a nurse-patient relationship Nurse breached duty to the patient Patient suffering actual harm or damage Cause or a causal connection established between the standard of care by the nurse and the patient's injury

What are State Statues?

Nurse practice act and board of nursing rules and regulations that defines the scope and limitations of nursing practice. Varies from state to state but common elements include the following: Definition of the term registered nurse, description of professional nursing functions, standards of competent performance, behaviors that represent misconduct or prohibited practices, grounds for disciplinary violations, and fines and penalties for violations.

What is intentional infliction of emotional distress?

Nurse's behavior is so outrageous that it leads to the patient's emotional shock.

Reporting incidents or unsusual occurences:

Nurses are legally bound to report every critical incidents to the manager that result in patient injury or death because they may lead to malpractice claims. Nurses have to know the appropriate procedures for completing and filing the incident report, in that they must describe the event OBJECTIVELY, avoiding subjective comments or personal opinions. Nurses should never note in the medical record that the incident report was completed or filed and should never photocopy the incident report. The report should not be written in the chart.

How does a hospital achieve Magnet Status?

Passing rigorous and lengthy processes that demand widespread participation from staff.

What are the challenges of accountability?

Nurses have an obligation to uphold the highest standards of practice, to assume full and professional responsibility for every action, and to commit to maintaining quality in the skills and knowledge base of the profession. Obligation to denounce a harmful action or potentially threatening situation may fall to a fellow member of the profession; to remain silent is to consent to the action of the threatening situation.

What is true of restrains?

Nurses may lawfully apply restraints in an emergency when, in their judgment, no other strategies are effective in protecting the patient from harm. Careful nursing documentation is essential when restraints are applied.

How must nurses balance science and morality?

Nurses must examine life and its origins, as well as its worth, usefulness, and importance. Nurses must determine their own values and seek to understand the values of others.

What is true about examining value systems?

Nurses must examine their own value systems; values clarification. Forming a "worldview": Provides a cohesive model for life, encourages personal responsibility for living life, and prepares one for making ethical choices.

What is the duty of nurses in terms of personal liability with floating and cross training?

Nurses should be cognizant of state statutes and case law services outside their usual practice area. In no case is a nurse permitted to render services if the requisite knowledge to act competently is lacking. Nurses have a legal duty to refuse specific tasks that they cannot perform safely and competently but should consider negotiation and compromise with the supervisor.

Evaluating information found on the Internet:

Objectivity: clear purpose, factual or opinion, primary or secondary in origin, sponsor of site Accuracy: documentation and referencing, compare to other websites Currency: dates, compare to current literature Usability: well designed, stable, easy to use, error-free, readable by intended audience

What are the opportunities and barriers to EHR systems?

Opportunities: Financial incentives, quality care, safety, efficiency, continuity of care (continuing care between the hospital and PCP so they known the patient's medical history and medical needs) Barriers: Meeting guidelines is strenuous and costly, lack of interoperability (corporate competition-don't all use the same system), and EHR implementation cost.

What is Point of Care Technologies?

Paramount to deliver safe, efficient, quality patient care Easy access to patient data (past and present), references, policies, procedures, evidence-based literature. Hand-held computers, laptops, tablets, smart phones, and PDAs. Moves from practice that relies on memory to continuous use of resources as they are needed.

What is true about balancing autonomy and beneficence?

Patient's autonomous decisions conflict with beneficent duty to look out for the patient's best interests.

What do organizational skills include?

Performing tasks correctly, performing the correct tasks, utilizing resources, managing time, evaluating outcomes, and progressing to an improved level of health

What is invasion of privacy?

Person's private affairs (including health history and status) are made public without consent. Nurse has a legal and ethical duty to maintain patient confidentiality.

What are values?

Personal beliefs about worth that act as a guide to behavior.

What is informed consent?

Physician or advanced practice nurse has the duty to disclose information so patient can make intelligent choices. Mandate by federal statue and state law. The provider cannot delegate the duty t the RN. If the nurse has reason to believe that the patient has not given informed consent, the provider should be immediately notified. In no case should the nurse attempt to convey information required for informed consent.

What is autonomy?

Principle of respect for the person: primary moral principle. Unconditional intrinsic value for all persons. People are free to form their own judgments and actions as long as they do not infringe on the autonomous actions of others. Concepts of freedom and informed consent are grounded in this principle. Ex: explaining risks in terms that a patient will understand

What is veracity?

Principle of truth-telling. Belief that truth could at times be harmful held for many years. Consumers expect accurate and precise information revealed in an honest and respectful manner. To develop trust between provides and patients, truthful interaction and meaningful communication must occur

What is philosophy of care?

Professional nursing staff's values and concerns for the way they view and care for patients. Focuses on nursing unit's purpose, patient, family, and staff involvement and work unit standards of care. Selection of nursing care delivery model that supports professional nursing practice. Selection of a management structure that supports professional nursing practice.

Americans with Disabilities Act of 1990 (ADA):

Prohibits discrimination against persons with disabilities by removing barriers that might prevent the same opportunities available to persons without disabilities.

Emergency Medical Treatment and Active Labor Law (EMTALA):

Prohibits refusal of care for indigent and uninsured patients seeking medical assistance in emergency departments. Prohibits transfer of unstable patients (women in active labor) from one facility to another. Applicable to nonemergency facilities (like urgent care clinics)

What is beneficence?

Promoting goodness, kindness and charity. Abstaining from injuring others and to help others further their own well-being by removing harm; risks of harm must be weighed against possible benefits. (ex: resuscitating a drowning victim)

What is the challenge of paternalism?

Provider tries to act on behalf of the patient and believes that his or her actions are justified because of a commitment to act in the best interest of the patient. Interferes with a patient's right to self-determination.

What is security?

Provides better protection of confidential health information because of incorporated controls.

What is information processing?

Provides effective retrieval and processing of data into useful information

What bioethical dilemma does death present?

Quality of life and definition of death issues: With advances in health care, what is usual and what is heroic care has become unclear. Euthanasia and assisted suicide present new ethical questions. Nurses in every setting must be prepared to consider end-of-life questions.

What does learning right from wrong look like for adolescents?

Questions exiting moral values and his or her relevance to society. Becomes more aware of contradictions in adults' value systems.

What is knowledge building?

Remaining competent, pursuing lifelong learning, sharing the knowledge. Actively pursuing learning opportunities, both formal and informal and learning to share knowledge with other professional colleagues.

What does time management include?

Remaining goal oriented, identifying priorities, and establishing personal goals

Patient Self-Determination Act of 1990:

Requires federally funded hospitals (Medicare, Medicaid) to inform adult patients in writing about their right to make treatment choices and to ask patients if they have a living will or durable power of attorney.

What does personal liability require?

Requires the nurse to assume responsibility for patient harm or injury that is a result of negligent acts. Nurse cannot be relieved of liability by another professional, much as a physician or nurse manager. Damage can be levied against current assents and future earnings.

What is utilitarianism?

Rooted in the assumption that an action or practice is right if it leads to the greatest possible balance of good consequences, or to the fewest possible bad consequences. Strongest approach for bioethical decision making-Which action will lead to the greatest ratio of benefit to harm for all persons involved?

What is deontology?

Rooted in the assumption that humans are rational and act out of principles that are consistent and objective, and compel them to do what is right. A decision is right only if it conforms to an overriding moral duty and wrong only if it violates that moral duty. All decisions are made in such a way that the decision could become universal law.

What bioethical dilemmas does allocation of scare resources present?

Should the recipient of scare resources be selected on the basis of quality of life? ability to pay? best prognosis? first-com, first-served? Nurses should be prepared to consider questions regarding allocation of scarce resources.

Malpractice:

Special type of negligence-failure of a professional, a person with specialized education and training, to act in a reasonable and prudent manner.

What are advance directives?

Statues that grant adults the right to refuse extraordinary medical treatment when there is no hope of recovery. Patient's wishes are made known through execution of a formal document known as the living will.

What does learning right from wrong look like for adults?

Strives to make sense of the contradictions and learns to develop own set of morals and values. Begins to make choices that are based on an internalized set of principles.

In terms of transparency and Disclosure of Error, what is true when errors occur in practice?

Studies confirm that telling the patient and family about the mistake results in less severe ramifications for the clinicians and facilities. In 2001 TJC established a safety standard requiring institutions to have a process in place to disclose unanticipated outcomes to patients.

What are nursing ethics?

System of principles that govern the actions of the nurse in relation to patients, families, other health care providers, policymakers, and society.

What is telehealth?

Telecommunications technology to assess, diagnose, and in some cases, treat persons who are located some distance from the health care provider. Home care area has seen significant changes as a result of telehealth. Telehome care devices: automated blood pressure monitors, glucometers, peak flowmeters, pulse oximeters, weight scales, and video monitors. Real time data capturing improves management of chronic diseases.

What is true about the negligence and the doctrine of res ipsa loquitur?

The Expert nurse witness is not required to help establish the standard of care.

What does the Federal Statues cover?

The Federal False Claims Act that makes it an offense to submit a false claim to the government for payment of healthcare services.

Affirmative Duty:

The duty that nurses exercise independent judgment to prevent harm to patients.