Ethics Flashcards
Bill of Rights for Psychiatric Clients
- tx must be least restrictive
- client must be told their dx and participate in tx plan
- discussion on how to prepare for discharge
- right to consent to tx, refuse tx, and to be discharged
- right to make own life decisions
- confidentiality
Legal Commitment
Involuntary hospitalization: committed to a healthcare facility until no longer DTS/DTO
- when person is acute danger to themselves/others
- no insight, don’t want to be in hospital
- doc signs involuntary legal paperwork stating clinical opinion is that they need to be hospitalized
Voluntary: most clients have the right to leave voluntarily as long as no DTS/DTO
-doc and client sign paperwork for hospitalization
Medication over objection
process in which a judge requires a client to undergo tx
Mandated Outpatient
Kendra’s Law - court ordered assisted outpatient treatment (AOT) for individuals w/ history of mental illness and hx of violence or hospitalizations
Confidentiality
HIPAA
civil and criminal penalties for violation of client privacy
Duty to Warn
when client says they want to harm someone else
homicidal ideation/plan
states have differing variations on this
nurse’s duty to report this immediately to supervisor, docs, and other team members
psychiatrist usually determines if police/third party needs to be called and calls them
needs to be evaluated further to determine course of action
priority nursing intervention would be to implement safety actions (constant supervision)
Seclusion
- placement of person in a room that isolates them after becoming agitated and/or DTS or DTO
- typically has a bed and nothing in the room that could be used to cause harm
- may include placing pt in a room w/ locked door
- decreased stimulation
goal = to give client opportunity to regain self control
Restraint
physically preventing pt freedom of movement when DTS or DTO through the use of force or straps (mechanical or human)
follow hospital policy
Seclusion and Restraints: Procedure
per hospital policy
- placed under constant observation
- asked about need for bathroom/water/food
- vital signs
- circulation check
- provider order (time period for when order is placed and when provider needs to get there to assess)
- procedure for reassessmnet
- have the practitioner release from restraints when no longer DTS/DTO
Professional Guideline
ANA - code of ethics/scope and standards of practice, standards of care (care must be provided to what a nurse in a similar situation would do)
Tort
wrongful act that results in injury, loss, or damage
- intentional
- unintentional
Unintentional Tort
negligence: causing harm by failing to do what a reasonably prudent person would do in similar situation
malpractice: need to prove four elements
1. duty: contract w/ the pt
2. breach of duty: deviation from the standard of care
3. injury or damage: physical, financial, emotional
4. causation: injury resulted directly from breach of duty
Assault
threat
no actual physical touch is required
ex) threat to patient of an injection
Battery
harmful or unwarranted contact
ex) forcing walking against the will of the client
False Imprisonment
not allowing a pt to leave AMA
inappropriate use of restraints
