NURSING JURISPRUDENCE N4
A nurse can hold a home state license in ______ state. If a nurse moves from one party state, to another, Rule 220.2 permits nurse to practice on former home state license for _____ days while waiting for a new license. If they nurse moves to a non-party state the license converts to a ______ state license.
1, 90, single
Criteria for Continuing Education: - Must complete _____hours in ___ years. - First time renewal is _______. - CE hours must be in your _____ ____ _______. - Keep records for ___ years.
20, 2 Exempt Area of practice 4
A _________ State License would allow a nurse to practice in a state that borders their home state, in which they have their license.
Party
Duty to the Patient: Position Statement 15.14 states: Neither the __________ __________ or ___________ ____________ can override the NPA, rules and regulations. ** the nurse has a duty to intervene**
Physician's order, facility's policy
A nurse must p________, a_________ for, and strive to protect the h______, s______ and r_________ of the patient.
Protect, advocate, health, safety, rights
The mission of the Texas BON is ___________/____________ of the welfare of ____________ of Texas by ensuring that each person holding a license as a nurse in the state is competent to practice safely.
Protection/promotion, the people
The BON fulfills its mission through the _____________ of the _________ of nursing and the approval of __________ __________ __________.
Regulation, practice, nursing educational programs
If the safety of an assignment is in question, CONSIDER WHAT ABOUT THE ASSIGNMENT SHOULD BE CHANGED TO MO MAKE YOU FEEL COMFORTABLE ACCEPTING IT! - Is a __________ person/remedial training available for questions or assistance? - Will several of your patients be _________ during the shift? - Can an additional ______ be assigned to work with you?
Resource, discharged, CNA
What are the 5 rights of Delegation?
Right Task (low of high risk) Right Circumstance ( stable or unstable) (workload) Right Person (experience/competency) Right Direction (communicate outcome expected) Right Supervision
The BON Rule 217.11 states that nurses must make and accept, " only assignments that take into consideration clients _______ and that are commensurate with the nurse's __________ preparation, e_________, k_________, and physical and emotional ability". **TEXAS COURTS HAVE UPHELD THAT THE NURSE'S OBLIGATION TO THE PATIENT SUPERSEDES FACILITY POLICIES**
Safety, educational, experience, knowledge
Nursing Peer reviews are _____________ from board reviews and as well as con_______. What are the 2 types of Nursing Peer Reviews?
Separate, confidential, Incident-based, Safe Harbor
RN Delegation to UAP Rule 225 is delegation for _________ clients in independent living environments.
Stable
Answer True or False to the following statements about the BON: The BON represents the people of Texas. The BON lobbies the legislature. The BON doesn't regulate practice settings.
True False- The BON can't lobby the legislature. True
NPA 301.352 gives the nurse the right to refuse to engage in conduct related to patient care if they believe the conduct would _________ the NPA or BON rules.
Violate
Key factors when filing a complaint against another nurse: - Any ____________ of the BON rules MUST be reported. - Report through the facility's ___________ ____ __________. - Must be ________/_________ by person making the report. - Include the _______ of the nurse being reported.
Violation Chain of Command Written/signed Identity
A _______ State License must be obtained in the state the the nurse permanently resides in.
Home
A nurse must comply with laws of the state in which they are currently practicing in. Any violation that occurs in a remote state, will be reported to their _______ state's nursing board. That state will then investigate and take disciplinary actions.
Home
The BON's mission which is derived from the Nursing Practice Act, supersedes the interest of " any _______, the ________ ________, or any _________ ________ _________"
Individual, nursing profession, special interest group
Under Safe Harbor, the nurse's ______ is protect but is DOESN'T protect the nurse from ______ _______. The nurse also recognizes that a request for Safe Harbor must be submitted ________ refusing an assignment as well as recognize that the ________ comes FIRST!
License, civil action, before, patient
Rule 217.16 covers m_______ i__________ which is defined as conduct that doesn't indicate the nurse's continuing to practice professional nursing poses a risk of harm to the client or other person.
Minor Incident
Answer True of False to the following statements about Professional Associations: Professional Associations don't represent their members. Professional Associations lobby the legislature. Professional Associations make efforts to improve work conditions and benefits for the nurses. .
False- Professional Associations do represent their members. True True
RN Delegation to UAP Rule 224 is the delegation for _________ care clients.
Acute
Prohibited Tasks under Rule 224.8 and 225.12 include: Nursing _______________ ______ of Care Professional Judgement and ______________ Responsibility for initial ________________ _______________ administration, including IV fluids (May be delegated in an INDEPENDENT LIVING SITUATION not an ACUTE CARE SETTING)
Assessments Plan Intervention Teaching Medication
_____________ is defined as the routine care, activities, and procedures that are within the authorized scope of practice of the RN or LVN or part of the routine functions of the UAP.
Assignment
Decision Making Model Step 2 focuses on if the activity/intervention is ____________ by a _______ _________. Questions to ask yourself: Is there a valid order? Is one necessary? Does a current policy exist regarding the procedure? Clarify any questionable order(s)- Rule 217.11 ** IF THE ANSWER TO ANY OF THESE QUESTIONS IS NO, THEN THE ACT ISN'T WITHIN YOU SCOPE OF PRACTICE*
Authorized, valid order
The Nurse Practice Act (NPA) - Defines the authority of the _____, it's _____________, and powers. - Defines _______ and the __________ of the scope of nursing practice. - _________ types of licenses and titles - ________ titles - States the ____________ for licensure - Identifies the grounds for __________ ____________.
BON, composition Nursing, boundaries Identifies Protects Requirements Disciplinary action
Refusal of Assignment under Safe Harbor: A nurse may refuse an assignment if he/she lacks _______ ________ and ability that would be necessary to render care of the patient OR if the assignment would constitute unprofessional behavior such as, t______, f________, patient a______, or f______________.
Basic knowledge, theft, fraud, abuse, falsification
Criteria that must be met for Safe Harbor to apply: - Assignment must be invoked in GOOD FAITH, _______ engaging in the activity or anytime an assignment has __________ that the nurse believes may result in _________ _______. - The nurse must notify their supervisor in _________ or _________. - The supervisor may NOT refuse to accept the form. - May use a _______ ________ form to make an initial written request. - A Comprehensive Written Request must be completed ____________ leaving the work setting! ** Safe Harbor is rendered INVALID if invoked AFTER an error has occurred**
Before, changed, patient harm Writing, verbally Quick Request Before
SB 476 permits nurses to refuse to work overtime. Overtime is defined as a requirement to work shifts to hours that are in addition to the hours or days scheduled regardless of the length of a scheduled shift or the number of scheduled shifts each week. *NOTE* Time immediately _________/_________ a shift is NOT included. This includes time to get report or document! Prescheduled and compensated ____-______ time is NOT included!
Before/after On-call
Decision Making Model Step 5 focuses on if there is documented evidence of your current ___________ (education, knowledge, skills, abilities, experience and judgements) to __________ the activity/intervention safely & effectively, in accordance with the accepted nursing "s_________ of c_______" ** IF NO, THEN THE ACT ISN'T WITHIN YOUR SCOPE OF PRACTICE**
Competence, perform, standard of care
A Minor Incident NEVER: - Contributes to a patient's ___________ or causes serious ________. - Is classified as __________ conduct - Involves a serious violation of Unprofessional Conduct Rule 217.12 (fraud, theft, patient abuse, exploitation) - A practice-related violation involving impairment or suspected impairment by reason of che________ dep___________
Death, harm Criminal Chemical Dependency
_________ is defined as authorizing an UAP to provide nursing services while retaining accountability for how the UAP performs the task. It doesn't include situations in which an UAP is directly assisting a RN by carrying out nursing tasks in the presence of a RN.
Delegation
Standards that apply to the RN: - Make nursing ____________. - Develop nursing ______ _______. - Evaluate patient ______ to nursing care. - Perform _____________ assessment. - ___________ tasks to UAP - Practice independently within the ____/_____ rules. - __________ to care for all patients.
Diagnosis Care plan Response Comprehensive Delegate NPA/BON Education
The 8 step Decision Making Model for Determining Nursing Scope of Practice provides _________ for nurses regarding safe scope of practice.
Direction
The Incident Based Peer review Committee is: - A ______ finding mission - Evaluates the practice in an atmosphere of collegiality - Determines if the incident has ______ and should be reported to the _____.
Fact Merit, BON
