Heath Care Law

Joint Commission requires policies and procedures. describe policy vs. procedure

-Policy: what you are supposed to do -Procedure: how you are supposed to do it

What is it and what how did it effect healthcare? Controlled Substance Act

-Put substances(medications) into 5 schedules according to medical use and dependence risk -Crisis - quantify

what are examples of unintentional torts?

-Negligence -Malpractice (professional negligence)

what is defamation of character?

-false statements that result in damage to the reputation -Slander: speaks -Libel: written

four elements must be satisfied to be considered malpractice:

1. Duty: 2. breach of duty: give substandard care 3. Causation: link between breach and harm 4. harm

can you delegate an initial assessment?

NO, the RN must do the initial assessment. you cannot delegate an assessment!

Which act protects a person who is HIV positive? The National Organ Transplant Act The Americans with Disabilities Act (ADA) The Patient Self-Determination Act (PSDA) The Health Insurance Portability and Accountability Act of 1996 (HIPAA)

The Americans with Disabilities Act (ADA)

A nurse is teaching staff members about the legal terminology used in child abuse. What definition of battery should the nurse include in the teaching? Maligning a person's character while threatening to do bodily harm A legal wrong committed by one person against property of another The application of force to another person without lawful justification Behaving in a way that a reasonable person with the same education would not

The application of force to another person without lawful justification

which traditional legal disciplines affect health care the most?

tort law and constitutional law

What is false imprisonment?

unjustified restraints

what is a felony?

serious offense with significant harm (ex: misuse of controlled substances, practicing without a license)

the process of introducing, adopting, changing, or repealing law

legislation

the process of seeking help through the courts to address a perceived wrong.

litigation

What are advanced directives?

living wills: when a patient is incapacitated - if they cant make decisions for themselves

civil law is derived from?

negligence and malpractice

the process of putting laws into action through the establishment of rules.

regulation

what is the difference between employer/employee liability and criminal liability?

1. Employer/employee liability -If you don't follow the rules and something happens then you are liable. If the employer fails to do something then they are liable. 2. Criminal liability -When harm has come to a patient and you have broken a law and a jury decides that whoever had harm done to them deserves compensation -Intentional most of the time

What does the nurse understand by the word felony? A felony is a less serious crime that has a penalty of a fine or imprisonment for less than one year. A felony is the publication of false statements that occurs when one speaks falsely about another. A felony is the publication of false statements that occurs when false entries are made in a medical record. A felony is a crime of a serious nature that has a penalty of imprisonment for longer than one year or even death.

A felony is a crime of a serious nature that has a penalty of imprisonment for longer than one year or even death.

Which color tag is used for a client who is expected to die after a disaster with mass casualties? Red tag Black tag Green tag Yellow tag

Black tag

What is the priority nursing intervention before a client undergoes amniocentesis? Starting an intravenous infusion of normal saline Performing a vaginal and rectal examination Ensuring that informed consent has been obtained from the client Informing the client that the procedure may precipitate an infection

Ensuring that informed consent has been obtained from the client

What is it and what how did it effect healthcare? Health Insurance Portability and Accountability Act of 1996

Protects patient personal health information that we cannot disclose

A woman arrives at the prenatal clinic stating that her pregnancy test is positive. She asks the nurse for information regarding an abortion. After verifying that the woman is at 8 weeks' gestation, the nurse counsels her that having an abortion is controversial and that many women have long-lasting feelings of guilt after an abortion. What is the nurse's legal responsibility? To share her own thoughts on abortion with the client To provide the client with correct, unbiased information To ask why the client wants information about abortion To notify the primary healthcare provider because this is beyond the scope of nursing practice

To provide the client with correct, unbiased information

why do we have health care law?

We have health care law to protect the public and you

regulatory law is derived from?

administrative law

what is a misdemeanor?

although injurious, but does not inflict serious harm (ex: parking ticket)

willful; you did it on purpose

intentional

what does scope of practice mean?

what you can and can't do as a nurse

professional nursing practice is regulated by ..?

-the states; nurses must hold a state-issued license to practice nursing -Practice can vary from state to state; for this reason, nurses should be familiar with the nursing practice act and scope of practice in the state in which they work.

A 13-year-old girl tells the nurse at the pediatric clinic that she took a pregnancy test and got a positive result. She confides that her grandfather, with whom she, her younger sisters, and her mother live, has repeatedly molested her for the past 3 years. When the nurse asks the girl whether she has told anyone else, she replies, "Yes, but my mother doesn't believe me." Legally, who should the nurse notify? Police concerning a possible sex crime Primary healthcare provider to confirm the pregnancy Child protective services for immediate intervention Girl's mother about the pregnancy test's positive result

Child protective services for immediate intervention

what is assault?

intentional threat

what is battery?

intentional touching without consent or reason to (elder abuse)

common law is derived from?

judicial decisions

A ______ holds the legal authority for nursing practice and regulates nursing practice

state board of nursing

when must a consent form be signed?

surgery, anesthesia, taking blood, etc.

A family member brings a relative to the local community hospital because the relative "has been acting strange." Which statements meet involuntary hospitalization criteria? Select all that apply. "I cry all the time; I'm just so sad." "Since I retired I've been so depressed." "I'd like to end it all with sleeping pills." "The voices say I should kill all prostitutes." "My boss makes me so angry—he's always picking on me."

"I'd like to end it all with sleeping pills." "The voices say I should kill all prostitutes."

A client has been diagnosed with type 1 diabetes mellitus. When providing instructions on sharps disposal, the nurse should instruct the client to place the syringes in what? Bubble wrap/packaging wrap A garbage bag in the trash can A cardboard box with a firmly secured lid A plastic liquid detergent bottle with a screw-top lid

A plastic liquid detergent bottle with a screw-top lid

What is the school nurse's most important action when monitoring an adolescent who has just returned to high school after a suicide attempt? Observing the adolescent with frequent summonses to the health office Requesting that teachers and friends report any changes in the client's behavior Speaking with the adolescent regarding feelings about returning to school Telling the teachers what happened and having them ask whether there are any problems

Speaking with the adolescent regarding feelings about returning to school

Which is an appropriate action for the registered nurse regarding assisted suicide? Nurses may have an open attitude toward the client's end of life. Nurses' participation in assisted suicide violates the code of ethics. Nurses may listen to the client's expressions of fear and to attempt to control the client's pain. Nurses can participate in assisted suicide only if the individual could make an oral and written request.

Nurses' participation in assisted suicide violates the code of ethics.

Which situation does not cover nurses who respond to a mass casualty incident (MCI) for malpractice or negligent lawsuits under the Good Samaritan Act? Terrorist act Neighborhood fire Roadside car accident High school sporting event

Terrorist act When terrorist acts occur, nurses are often required to go to an assigned site to offer aid. When this occurs, the nurse is not covered from malpractice or negligent lawsuits. Nurses who respond to injuries that occur in a neighborhood fire, roadside car accident, or a high school sporting event are covered under the Good Samaritan Act.

A nursing student is recalling the order of priority for giving consent to perform an autopsy in cases where a medical examiner review is not needed. Which person receives the highest priority for giving consent? Surviving child Surviving parent Surviving spouse The client in writing before death

The client in writing before death

What is it and what how did it effect healthcare? Patient Self-Determination Act of 1991

-Inform patient regarding rights for medical care -Patients are more involved/informed in their care

what are quasi-intentional torts?

-Invasion of privacy •Ex: looking through patient's belongings without a reason, asking irrelevant questions, looking up a fellow employees health record, share information

What is it and what how did it effect healthcare? Social Security Act of 1965

-Established Medicare and Medicaid -It insured old people

A client who had previously signed a consent form for a liver biopsy reconsiders and decides not to have the procedure. What is the nurse's best initial response? "Why did you sign the consent form originally?" "I can understand why you changed your mind." "Can you tell me your reasons for refusing the procedure?" "You must be afraid about something concerning the procedure."

"Can you tell me your reasons for refusing the procedure?" The response "Can you tell me your reasons for refusing the procedure?" attempts to explore why the client is refusing the procedure; the question promotes communication. The response "Why did you sign the consent form originally?" is accusatory; the client has the right to withdraw consent at any time. The response "I can understand why you changed your mind" is a conclusion without appropriate data; it may also increase the client's anxiety level. "You must be afraid about something concerning the procedure" is a conclusion without appropriate data; it also puts the client on the defensive.

A 17-year-old mother is to sign the consent for her son's myringotomy. What should the nurse say to the mother about this procedure? "This procedure may not help." "Tell me what you know about this procedure." "Your son will need to have this done again when he's older." "One of your parents must also sign this because you're too young."

"Tell me what you know about this procedure." Informed consent requires that the responsible person understand the procedure. Predicting therapeutic outcomes is not within the role of the nurse. Predicting future surgical interventions is not within the role of the nurse. A 17-year-old mother is an emancipated minor who has the legal authority to sign her child's consent form.

A nursing student is listing the points that need to be remembered about the loss of a client's medical records. Which point listed by the nursing student is accurate? "Loss of medical records may lead to libel charges." "The registered nurse should maintain accurate nursing records." "There is an assumption that the care provided to the client was negligent." "The healthcare facility needs to demonstrate why the medical records were lost."

"There is an assumption that the care provided to the client was negligent." In case a client's medical record is lost, there is an assumption that the care provided to the client was negligent. Loss of medical records may lead to a malpractice claim. The entire institution is responsible for maintaining medical records. Primary healthcare providers need to demonstrate why the medical records were lost.

what is malpractice insurance?

-A contract between the nurse and the insurance company -Provides a defense when a nurse is in a lawsuit involving negligence or malpractice -Nurses covered by institution's insurance while working

What is it and what how did it effect healthcare? Patient Protection and Affordable Care Act of 2010

-AKA Obama Care -Lower the cost of healthcare by insuring that everyone has health insurance (lower cost/universal coverage) = preventative care -If you didn't have health insurance you would have to pay tax for not having it

what is an informed consent?

-Agreement to allow care based on full disclosure of risks, benefits, alternatives, and consequences of refusal -The nurse's signature as a witness to the consent means that the patient voluntarily gave consent, the patient's signature is authentic, and the patient appears to be competent to give consent

A 13-month-old child is admitted with a tentative diagnosis of bacterial meningitis, and the practitioner schedules a lumbar puncture. What is the most important action the nurse should take in preparation for the lumbar puncture? Asking the parents what they were told about the test Using a doll to demonstrate the procedure to the child Obtaining a pacifier for the child to suck on during the procedure Telling the parents that they may stay with their child during the test

Asking the parents what they were told about the test

A nurse is recalling common terms that are used in health ethics. What does beneficence in health ethics refer to? Beneficence refers to the agreement to keep promises. Beneficence refers to taking positive actions to help others. Beneficence refers to the ability to answer for one's actions. Beneficence refers to avoiding harming or hurting an individual.

Beneficence refers to taking positive actions to help others.

what are tort laws?

Civil wrong against a person or property (ex: give the wrong medicine, sent the wrong patient for the wrong procedure, did the wrong procedure on a person)

A nursing student is recalling the definition of Nurse Practice Acts. What do the Nurse Practice Acts do? Nurse Practice Acts describe and define the legal boundaries of nursing practice within each state. Nurse Practice Acts reflect the knowledge and skills possessed by nurses practicing in their profession. Nurse Practice Acts are legal requirements that describe the minimum acceptable nursing care. Nurse Practice Acts protect individuals from losing their health insurance when changing jobs by providing portability.

Nurse Practice Acts describe and define the legal boundaries of nursing practice within each state.

A psychiatric nurse is hired to work in the psychiatric emergency department of a large teaching hospital. While reviewing the manuals, the nurse reads, "People with mental health emergencies shall be triaged within 5 minutes of entering the emergency department." What does the nurse consider this statement to represent? Hospital policy Standard of care Hospital procedure Mental Health Bill of Rights

Hospital policy Policies are statements that help define a course of action; what is to be done is stated in policies, and how a task or skill is to be performed is defined in a procedure manual. Standards of care are published by the American Nurses Association; they reflect current knowledge and represent levels of practice agreed on by experts within the specialty; in legal terms, the standard of care is that level of practice that a reasonably prudent nurse would provide. A hospital procedure defines how a task or skill is to be performed. The Mental Health Bill of Rights states that all clients have the right to respectful care, confidentiality, continuity of care, relevant information, and refusal of treatment, except in an emergency or by law.

A student nurse employed as a nursing assistant may perform care:

Identified in the hospital's job description

While visiting the hospital, the spouse of a client slips and falls on a recently washed floor in the hallway leading to the client's room. To meet the criteria of ethical practice, what action should the nurse who witnessed the occurrence take? Initiate an agency incident report. Report the fall to the state (provincial) health department. Write a brief description of the incident to be kept by the nurse manager. Determine that no documentation is needed because the visitor is not a client in the hospital.

Initiate an agency incident report. Health care agencies document the occurrence of any event out of the ordinary that results in or has the potential to harm a client, employee, or visitor. Falls by visitors are not required to be reported to state (provincial) health departments. However, incident reports are required to be presented to accrediting agencies for review when an agency is in the process of being accredited. Writing a brief description of the incident to be kept by the nurse manager is not a requirement of ethical practice. However, a nurse who is involved in an incident or is a witness to an incident should write an accurate description of the event, along with the names of individuals involved. This documentation should be kept by the nurse at home. Lawsuits may take several years before they come to trial, and personal notes may help the nurse recall the event. The documentation must accurately contain the same elements included in the formal incident report. Taking no action is irresponsible. All events out of the ordinary that result in or have the potential to harm a visitor should be documented in an agency incident report.

A client is placed on a stretcher and restrained with straps while being transported to the x-ray department. A strap breaks, and the client falls to the floor, sustaining a fractured arm. Later the client shows the strap to the nurse manager, stating, "See, the strap is worn just at the spot where it snapped." What is the nurse's accountability regarding this incident? Exempt from any lawsuit because of the doctrine of respondeat superior Totally responsible for the obvious negligence because of failure to report defective equipment Liable, along with the employer, for misapplication of equipment or use of defective equipment that harms the client Exonerated, because only the hospital, as principal employer, is responsible for the quality and maintenance of equipment

Liable, along with the employer, for misapplication of equipment or use of defective equipment that harms the client

A nurse fails to act in a reasonable, prudent manner. Which legal principle is most likely to be applied? Malice Tort law Malpractice Case law

Malpractice Malpractice is the unskilled or faulty treatment by a professional that causes injury or harm to a client. It can result from a lack of professional knowledge or skill that can be expected in others in the profession, or from a failure to exercise reasonable care or judgment in the application of professional knowledge, experience, or skill. Malice is the desire or intent to inflict injury, harm, or suffering. Tort law is a wrongful act, not including a breach of contract of trust, that results in injury to another person and for which the injured person is entitled to compensation. Case law is law established by judicial decisions in particular cases instead of by legislative action.

A client dies in the hospital 2 hours after being admitted. Who has the authority to decide if a post-mortem should be conducted? Surviving spouse Nursing manager Medical examiner Primary healthcare provider

Medical examiner If a client dies within 24 hours of being admitted to the hospital, the medical examiner has the right to decide whether a post-mortem should be conducted. If the client's death does not need to be reviewed by the medical examiner and the client has not requested an autopsy in writing, the surviving spouse may request a post-mortem. The nursing manager and the primary healthcare provider are not authorized to make decisions regarding a post-mortem.

What does a nurse understand by the term regulatory law as applied to nursing practice? Regulatory law provides fair and equitable treatment when civil wrongs or violations occur. Regulatory law describes and defines the legal boundaries of the nursing practice within each state. Regulatory law reflects the decisions made by administrative bodies such as the State Boards of Nursing. Regulatory law results from judicial decisions made in courts based on the judgments of individual legal cases.

Regulatory law reflects the decisions made by administrative bodies such as the State Boards of Nursing.

A 16-year-old single mother of a 1-year-old infant and the infant's grandmother bring the baby to the emergency department and report that the infant accidentally fell down the stairs. The nurse knows that a consent form for treatment should be signed. Who has the responsibility for signing the consent? The mother, despite her age No one, because this is an emergency The grandmother, because she is a relative Family court, because the mother is a minor

The mother, despite her age

A 3-year-old child with eczema of the face and arms has disregarded the nurse's warnings to "stop scratching, or else!" The nurse finds the toddler scratching so intensely that the arms are bleeding. The nurse then ties the toddler's arms to the crib sides, saying, "I'm going to teach you one way or another." How should the nurse's behavior be interpreted? These actions can be construed as assault and battery. The problem was resolved with forethought and accountability. Skin must be protected, and the actions taken were by a reasonably prudent nurse. The nurse had tried to reason with the toddler and expected understanding and cooperation.

These actions can be construed as assault and battery. Assault is a threat or an attempt to do violence to another, and battery means touching an individual in an offensive manner or actually injuring another person. The nurse's behavior demonstrates anger and does not take into account the growth and developmental needs of children in this age group. Although the behavior (scratching) needs to be decreased, this can be done with mittens, not immobilization. A 3-year-old child does not have the capacity to understand cause (scratching) and effect (bleeding).

When should a medical examiner decide whether a postmortem examination should be conducted? When a client dies under normal circumstances When a client dies after 48 hours of admission to the hospital When a client dies within 24 hours of admission to the hospital When the client gives a written consent to perform autopsy before death

When a client dies within 24 hours of admission to the hospital

A nurse is caring for a patient who states "I just want to die" for the nurse to comply with this request the nurse should discuss:

advance directive

What is statutory law?

do's and don't of nursing (Nurse Practice Act)

what is malpractice?

failing to do something that harms the patient

what is negligence?

failing to do something you are responsible for (ex: not giving medicines at the right time)

criminal law is derived from?

felony and misdemeanor

the collection of laws that have a direct impact on the delivery of health care or on the relationships among those in the business of health care or between the providers and the recipients of health care

health care law

Tort law or law of medical liability is the legal discipline for ____

malpractice

Legal guidelines for defining nursing practice and identifying the minimum acceptable nursing care- when you get your license you are MINIMALLY safe

standards of care