Practice Issues; Ethical and Legal Principles Flashcards
Physician Orders for Life-Sustaining Treatment (POLST)
addresses vague language in a patient’s end of life care directives, such as “life support” and “no heroics”
Three phases of policy making
- Formulation
- input of information, ideas, and research from key people, organizations, and interest groups
- identification of the purpose and outcomes
- selection of strategies
- identification of needed resources - implementation
- dissemination of information about the adopted policy and putting it in place as a plan of action - Evaluation
- policies may be amended or rewritten to adjust for circumstances over time in an incremental manner
Physician-assisted suicide vs euthanasia
Physician-assisted suicide: making the means of death available to the patient
- legal in some states in the United States
Euthanasia: physician actually administers the method of death
- illegal throughout the United States
Orem’s theory of nursing practice
Focuses on professional and technological operations
1. The nurse diagnoses the patient and determines why nursing is needed
2. Designs the nursing system and plans for delivery of care
3. Production and management of nursing systems, labeled planning, and controlling
Nightingale’s theory of nursing
Based on creating a restorative environment
Abdellah’s theory of nursing
Based on the delivery of nursing care for the whole person, including the spiritual, physical, and emotional needs
Rogers’ concept of nursing
Focuses on the maintenance of health, prevention of illness, and the care and rehabilitation of disabled clients through the “humanistic” science of nursing
durable power of attorney
makes decisions not he patient’s behalf while the patient is still alive
Does not apply if the patient has died
advance directive
written statement of a patient’s intent regarding medical treatment
healthcare directive
type of advance directive that may (or may not) include a living will and/or specifications regarding durable power of attorney in one or two separate documents
living will
written compilation of statements that specifies which life-prolonging measures one does and does not want to be taken if he/she becomes incapacitated
durable power of attorney
A significant other is granted the ability to act as a proxy/agent/attorney-in-fact of the patient in making healthcare decisions should the patient become incapacitated.
Responsible for articulating the patient’s advance directive
strongest method to evaluate teaching
returned demonstration
Injuries that should be transferred to a tertiary facility
Major maxillofacial injuries
Severe Le Fort fractures:
- Le Fort 1: floating palate
- Le Fort 2: Floating maxilla
- Le Fort 3: floating face
most powerful data collected from a patient
subjective data
Health related information that must be reported to the Department of Health in most states
Criminal acts and injury from a dangerous weapon
Diseases: gonorrhea, chlamydia, syphilis, HIV, TB, COVID-19
Animal bites
Suspected or actual child or elder abuse
Level of physical exam documentation: A limited examination of the affected body area or organ system
problem focused
Level of physical exam documentation: A limited examination of the affected body area or organ system and any other symptomatic or related body area(s) or organ system(s)
expanded problem focused
Level of physical exam documentation: An extended examination of the affected body area(s) or organ system(s) and any other symptomatic or related body area(s) or organ system(s)
detailed
Level of physical exam documentation: A general multi-system examination, or complete examination of a single organ system and other symptomatic or related body area(s) or organ system(s)
comprehensive
Type of Medicare: Covers inpatient hospitalization, SNF services, home health services, and/or hospice associated with the inpatient event
Medicare A
Type of Medicare: Most people qualify to receive this benefit at 65 years of age
Medicare A
Type of Medicare: Covers physician services, outpatient hospital services, lab and diagnostic procedures, medical equipment, and some home health services
Medicare B
Type of Medicare: Supplemental medical insurance requiring recipients to pay a premium
Medicare B
Type of Medicare: NPs and CNSs receive 85% of physician reimbursement for services provided in collaboration with a physician
Medicare B
Type of Medicare: Medicare pays 80% of the patient’s bill for physician services and the patient pays 20%
Medicare B
Type of Medicare: Formerly known as “Medicare+Choice”, now known as “Medicare Advantage”
Medicare C
Type of Medicare: Patients entitled to Medicare A and enrolled in Part B are eligible to receive all of their health car services through one of the provider organizations under this Part (e.g. HMOs, PPOs, etc.)
Medicare C
Type of Medicare: Limited prescription drug coverage. Co-pay on each prescription is required
Medicare D
To qualify to be a Medicare provider, an NP must…
Hold a state license as an NP
Be certified as an NP by a recognized national certifying body
Hold at least an MSN degree
Sentinel event
Unexpected occurrences involving death or serious physical or psychological injury, or the risk thereof
Credential, Licensure, or Certification?: Encompasses required education, licensure, and certification to practice as an NP (e.g. degree, diploma)
credential
Credential, Licensure, or Certification?: Establishes minimal levels of acceptable performance
credential
Credential, Licensure, or Certification?: Necessary to ensure that safe health care is provided by quality individuals, and to comply with federal and state laws relating to advanced practice nursing
credential
Credential, Licensure, or Certification?: Acknowledges the scope of practice of the NP
credential
Credential, Licensure, or Certification?: Mandates accountability
credential
Credential, Licensure, or Certification?: Enforces professional standards for practice
credential
Credential, Licensure, or Certification?: Establishes that a person is qualified to perform in a particular professional role
licensure
Credential, Licensure, or Certification?: Granted as defined by rules and regulations set forth by a governmental regulatory body (I.e. state board of nursing)
licensure
Credential, Licensure, or Certification?: Establishes that a person has met certain standards in a particular profession which signify mastery of specialized knowledge and skills
certification
Credential, Licensure, or Certification?: Granted by nongovernmental agencies (e.g. AACN, ANCC)
certification
nonmaleficence
the duty to do no harm
utilitarianism
The right act is the one that produces the greatest good for the greatest number
beneficence
The duty to prevent harm and promote good
