Exam 2 legal Flashcards by Yuko Porter

leagl issu
What is the most important legislation for nursing?

Texas NPA (Nursing Practice Act)
Practice boundries are defeined

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leagl issue/Nursys?

Mnitors nurses’ licensure status in all states

✓ the only national database for verification of nurse licensure for RNs, LPN/VNs and APRNs licensed

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a) What is public law?
b )Constitutional law?

a) defines citizen’s relationship with government
b) highest lwa, the rights of the people.
Freedom of religion, right to die, right to abortion

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Legislative law?

enact/make laws that govern us (codes, statues)
NPA

The nurse can violate sections of the NPA but the BON will CHOOSE (has the power) to decide what sanctions to assign the nurse!

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Administrative law?

Protect citizen’s rights at federal & state
Authority to act by the legislative laws

how to enforce(apply) legislative laws

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Criminal law

intentionally harm others
Relationship with goverment

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Administrative law
FEDERAL (national) EX

Civil Rights Act 1964 (federal)
No discrimination in the workplace
HIPAA
Protect medical information
(we don’t get sued or go jail to vaiolated HIPPA)
OSHA
Establish safe workplace
protect employees from infection(PPE) & workplace violence, immunization, “sharps” container,
Social Security, Medicare

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Administrative law
state level

BON enforces NPA

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Texas Nurse Practice Act
a) §217.11
b) §217.12

a) The standard practice establish a minimum acceptable level of nursing practice
Failure to meet theses standards may result in action against the nurse’s licence even if no actual pt injury result
b) Listed unprofessional conduct

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a) Civil law, what is it?
b) Tort law

a) how individuals relate to each other in everyday matters(between people)

A wrongful act committed against another person, organization, or their property, that causes harm
You have a personal, direct liability

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Joint liability

liability=responsibility

Institute responsible/accountable for maintaining safe, quality environment
Hiring the “best” is essential

Pt will sue not just you, but hospital too

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What are are intentional torts?

Assault, battery, false imprisonment, invasion of privacy, defamation, and slander

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Intentional tort
a) assault
b) battery

1: jsut threat to touch another
threaten to give a treatment against patient’s will
Ex: threaten to give medication if they don’t calm down
b) actual touching another person without their consent
Force a treatment against patient’s will
Ex: restraining them without an order

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Intentional tort
False imprisonment

Person incorrectly led to believe they can’t leave a place
Restrain a patient who is of sound mind and not in danger of hurting self or others

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a) Quasi intentional tort?
b) Defamation?

a) Mix of unintentional and intentional
b) false communication or publication
* libel (L= letter, written word)
✓ documenting something in the EMR that is not true/social media
* slander (S= speech)
✓ stating something during handoff report that is not true

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Invasion of right of privacy
What are expectation?

HIPPA

Exceptions! pt abuse, specific infectious diseases, blood alcohol level

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Negligence?

Failure to provide the care
Didn’t do something what someone should do
(but not intentional)
General term for carelessness

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Malpractice?

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Professional negligence
wrongful conduct (misbehavior)

Standard of practice

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basis of quality, competent healthcare
protect the public

➢ It helps determine what a reasonable, prudent nurse should do

Things that impact our standards of practice:
a) Internal Standards set by
b) external Standards set by

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a)Institutional policy & procedure (will be different between hospitals)
b) SBO
Professional organizations
Federal Organizations/Guidelines

Violating standards of care
Example 5

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NOT DOCUMENTING CARE
Charting an action was done but it was not done
Crushing medications that cannot be crushed
Giving IVP, IVPB medications too rapidly
Not setting alarm limits appropriately

STEP 1 BROKEN DOWN
a)Duty of care
b) Breach of duty

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a) Standard care must be established
b) Fell below standard care

a) Omission?
b) Commission?

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a) nothing was done when something should have been done (negligence)
b) Acting in a way that causes injury to the patient (always nonintentional) (malpractice)

STEP 3 BROKEN DOWN
Foreseeability

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➢ Nurse must had knowledge or availability of information
Certain events may be resonably expected to cause specific results

STEP 4 BROKEN DOWN Causation

breach of duty caused injury (I did not do the duty of care I should have so it caused injury to my patient)

How to avoid malpractice claims?

Always put patient rights and welfare first ✓ Be kind, caring Practice within scope of Nurse Practice Act Use EBP Be aware of relevant law Practice in areas of individual competence Upgrade skills

Good Samartian Law

A person who in **good faith** administers emergency care at the scene of an emergency or in a hospital is not liable in civil damages for an act performed during the emergency unless the act is willfully or wantonly negligent. **DON’T EXCEED YOUR SCOPE OF PRACTICE** Law vary with states so stay informed

Informed consent Consent is giving who has **legal capacity** who can get it and who not?

Competent adult Legal guardian or person with durable power of attorney Emancipated or married minor Parent/state/legal guardian of a **child less than 18 years old, court order**

Informed consent a) Voluntary action b) If pa refuses care?

a) It has to be voluntary consent not forced consent b) We must understand the pt will (Dr. needs to explain this as well)

Informed consent Person giving consent must be given sufficient information means?

**FULL DISCLOSURE** Risks involved+ side effect Expected or desired outcomes, benefits Options Alternative therapies, including no therapy at all Name of person performing treatment/procedure (so you don’t explain this!) Patient can withdraw consent

Informed concent Nurses role a) Ensure provider gave necessary information means? b) Ensure client understood information means? c) if pt has more queststion, what to do?

a) we are Not responsible for explaining the procedure b) **patient advocate** reinforcing information originally given by provider **do not give new information** c) Notifying provider

Implied concent

Treatment is immediately needed & in patient’s best interest. Pt unable to sign the consent Validated by 2 provider

Patient Self Determination Act Advance Directive a) Includes? b) If pt has an AD? c) If pt revokes AD?

a) living will, durable power of attorney, DNR b) ask for a copy of the document. Post to pt records c) document pt decision and notify MD Nurse should not be a witness to signing AD

Living Will

Legal document pt's wishes if pt becomes unable to express desires when facing end of life issues ✓ 2 witnesses required

Medical Power of Attorney

a) Durable Power of Attorney Proxy(agent) makes health care decisions for client unable to make decisions Proxy knows client and their wishes

Advance directive Nursing role

Provide written information Document client’s AD status Ensure AD current, reflect client’s current decision Recognize client’s choice takes priority Inform health care team of client’s AD

Incident report a) unexpected and unusual happen to who? b) this can not be subpoenaed as evidence, why? c) example?

a) client, employee, volunteer, visitor b) Confidential information c) ✓Med errors ✓ Procedure/treatment errors ✓ Equipment related injuries ✓ Needle stick injuries ✓ Client falls/injuries ✓ **Loss of property**

Nurse role in reporting incidets

1. 1st Assess for injuries 2. Institute immediate care to decrease further injury 3. Notify provider 4. Carry out provider orders 5. Complete incident repor

incident report a) Complete within? b) Can share with pt? c) Document in EMR? d) What this use for?

a) 24 hours of event b) NO! Confidential c) NO! d) data useful to performance improvement

Incident report What include?

Pt's name, date/time/location of event Factual description of event & injuries incurred Name of witnesses & client comments regarding incident Corrective action taken, provider notified Name, dose of medication or equipment involved in event

Patient Bill of Rights

High quality hospital care Clean, safe environment Professional involvement, advocacy in care Protection of privacy Help when leaving hospital Help with billing claims

Exam 2 legal Flashcards

(43 cards)