exam i: ch6 - legal and ethical basis for practice

Question 1

what is the fundamental goal of psychiatric care

Answer 1

strike BALANCE between rights of patient and rights of society

Question 2

branch of knowledge and philosophical beliefs about what is right or wrong in a society.

Answer 2

ethics

Question 3

the study of specific ethical questions that arise in healthcare

Answer 3

bioethics

Question 4

results when there is a conflict between two or more courses of action, each carrying favorable and unfavorable consequences.

Answer 4

ethical dilemma

Question 5

what are the 5 basic principles of ethics

Answer 5

• beneficence
• autonomy
• justice
• fidelity
• veracity

Question 6

the duty to promote good

Answer 6

beneficence

Question 7

respecting the rights of others to make their own decisions

Answer 7

autonomy

Question 8

distribute resources or care equally

Answer 8

justice

Question 9

maintaining loyalty and commitment; doing no wrong to pt

Answer 9

fidelity

Question 10

one’s duty to always communicate truthfully

Answer 10

veracity

Question 11

law that de-institutionalized the mentally ill

Answer 11

Community Mental Health Act of 1963

Question 12

law that improved access to tx and equality in terms of payment

Answer 12

Mental Health Parity Act of 2010

Question 13

law that provided funding for the mentally ill

Answer 13

Affordable Care Act of 2010:

Question 14

list some criteria that is considered nursing malpractice

Answer 14

• The RN fails to completely perform their duties and that failure harms the patient
• Practicing outside their scope of practice
• Abandoning the patient under the nurses care
• Medication and /or treatment errors
• Falsifying documents; pre-charting on pts
• Adding information after the fact without specifying it is a late entry

Question 15

why is releasing information to a pt’s employer bad? (3 reasons)

Answer 15

breach of confidentiality
invasion of privacy
violation of HIPAA

Question 16

t/f: discussing pt hx with other nursing staff to determine tx is a breach of privacy

Answer 16

false

Question 17

occurrence that causes death or serious injury to a patient who is under the care of professionals

Answer 17

sentinel events

Question 18

examples of sentinel events

Answer 18

• Suicide in a hospital
• Surgery on wrong site or instrument left in a surgical patient
• Overdosing with medication
• A rape or assault that occurs on hospital property

Question 19

• Right to vote and send and receive mail
• Right to practice religious freedom
• Right to refuse treatment (including medications)
• Confidentiality (exception: duty to warn and elder and child abuse)
• Care provided with respect, dignity and without discrimination
• Care in the least restrictive setting
  Receive an education for school age kids

Answer 19

civil rights of mentally ill pts (same with every other citizen)

Question 20

• Right to treatment and right to refuse treatment
• Right to informed consent-risks and benefits of treatment
• Right to the least restrictive measures
• Right to confidentiality

Answer 20

basic rights of mentally ill pts

Question 21

• Right to withhold consent
• Right to withdraw consent any time
• Must be honored, whether verbal or written
• Right to refuse medication or treatments
• The right to refuse can be overridden if the patient becomes a danger to self or others and it must be clearly documented why

Answer 21

medication and tx rights of mentally ill pts

Question 22

admission sought by patient/guardian thru written application

Answer 22

voluntary admission

Question 23

admission of individual without consent; a judicial or administrative/agency determination

Answer 23

involuntary admission

Question 24

what are the 3 criteria for involuntary hospitalization

Answer 24

• mentally ill
• danger to self or others
• unable to provide for basic necessities - food, clothing, shelter

Question 25

release that needs outpatient tx

Answer 25

conditional release

Question 26

release that has no requirements

Answer 26

unconditional release

Question 27

type of release where pts need to sign 5 day release form in which pts must be allowed to leave after 5 days

Answer 27

released AMA

Question 28

type of admission where person is demented/confused - usually lasts 24-96 hrs for observation, dx, tx - court hearing NEEDED before next discharge

Answer 28

emergency/temporary admission

Question 29

confining a person alone in a room or area, never PRN

Answer 29

seclusion

Question 30

how long can an adult or adolescent be in seclusion (how freq documentation)

Answer 30

adult = 4hrs adolescent = 2hrs q15min documentation

Question 31

how long after emergency restraints do you have to get a written/verbal order?

Answer 31

1 hour

Question 32

protects pt right to privacy and confidentiality

Answer 32

HIPAA

Question 33

what is the exception to HIPAA

Answer 33

duty to warn and child/elder abuse speculation

Question 34

the ethical responsibility of healthcare professionals that prohibits the disclosure of privileged information without the patient’s consent.

Answer 34

confidentiality

Question 35

when a pt reveals specific intent + specific person to injure/kill

Answer 35

duty to warn

Question 36

what did the tarasoff case result to?

Answer 36

duty to protect is added as exception to confidentiality, goes with duty to warn

Question 37

3 aspects associated with duty to warn

Answer 37

- Assessing and predicting a patient’s danger of violence toward another - Identifying specific individual(s) being threatened - Identifying appropriate actions to protect victim(s)

Question 38

name that liability issue: Fail to take action on suicide risks Fail to use restraints properly/monitor pt Miscommunication/med errors Violation of boundaries Misdx

Answer 38

patient safety

Question 39

name that liability issue: Voluntary acts to bring physical/mental consequence Recklessness No pt consent

Answer 39

intentional torts

Question 40

name that liability issue: Carelessness Foreseeability of harm

Answer 40

negligence/malpractice

Question 41

name that liability issue: Threat to use force Tx without consent Offensive touching

Answer 41

assault/battery

Question 42

name that liability issue: Intent to confine to specific area Improper use of seclusion/restraints

Answer 42

false imprisonment

Question 43

name that liability issue: Notifying parents of 21yr old that she is being treated on psychiatric unit

Answer 43

invasion of privacy

Question 44

name that liability issue: telling friends and instagram followers that patient is local mayor and bad patient

Answer 44

defamation of character/slander/libel

Question 45

name that liability issue: Unintended acts against another person that produces injury/harm

Answer 45

unintentional torts

Question 46

name that liability issue: Leaving controlled substance medications in patient room

Answer 46

negligience

Question 47

name that liability issue: Failure to follow up with patient teaching after finding orthostatic hypotension

Answer 47

malpractice

Question 48

when can you override the right to refuse medication (6 steps)

Answer 48

1. after court hearing 2. pt has serious mental illness 3. ability to fxn deteriorating/threatening behavior 4. tx > harm 5. person cannot make reasoned decisions 6. less restrictive services did not work