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HS Unit 3 Exam- Ch2 Legal & Ethical Aspects of Nursing

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icorojo's version from 2018-04-07 13:55

OVERVIEW OF LEGAL SYSTEM

Question Answer
Lawsprescribe proper behavior in society; sanction acceptable behavior and prohibit unacceptable behaviors
Laws assign fundamental legal duties and also provides protection for all members of the health care system
Laws: 2 primary categoriescriminal and civil laws
Criminal lawsare maters that involve the needs of the public and are charged by agents that represent either federal or state government
Criminal laws: conduct at issue is offensive to society in general
Criminal laws: conduct is detrimental to society as a whole
Criminal laws: purposeis to punish for the crime and deter and prevent further crimes
Criminal laws: involvespublic offenses (robbery, assault, murder, etc)
Criminal laws: resolved with a finding of guilt or innocence
Civil laws are between individuals and charged by an individual or agency
Civil laws: conduct at issueviolates a PERSON's rights
Civil laws: conduct isdetrimental to the individual
Civil laws: involvesan offense that is against an individual
Civil laws: purposeis to make the aggrieved person whole again, to restore them to their previous status
Laws: 2 ways establishedStatutory and Common law
Statutory lawdeveloped by federal, state, and local governments
Common lawdeveloped in response to specific questions brought before the court and usually follow precedent (previous rulings on an issue)
Statutory and Common law bothplay important roles in defining the rights and responsibilities of the PT and the nursing professional
PT has the right to expectthe nurse to act in the PT's best interest by providing care that meets and is consistent with the established legal standards and principles
memorize

NEGLIGENCE & MALPRACTICE

Question Answer
Negligence refers to the absence of due care
Negligence: definedfailure to act as a responsible prudent person would act in the given situation
Negligence: examplesMeds errors, PT falls, use of restraints, equipment injuries, etc
Malpractice refers toprofessional negligence
Malpractice occurswhen a licensed professional fails to provide services as per standards set by the governing body
Malpractice: 4 key elements1.Duty 2.Breach of duty 3.Harm 4.Proximate cause of harm
1. Duty: refers tothe established relationship between PT and the nurse
2. Breach of duty: is failure to perform the duty in a reasonable, prudent manner
3. Harm has occurredthis does not have to be physical injury
4. The breach of duty was the proximate cause of harmthe occurrence of harm depended directly on the occurrence of the breach
Nursing responsibilities include actions taken as well as omitted
To avoid being charged with malpracticepractice within the rules and regulations, the standards of care, and the employing agency's policies and procedures
Nurses must be awareof their scope of nursing practice and the standards of care that constitute professional duties
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KEY TERMS

Question Answer
Assaultan intentional threat to cause bodily harm to another; does not have to include actual bodily contact
Batteryunlawful touching of another person without informed consent
Competencya legal presumption that a person who has reached the age of majority can make decisions for themselves unless proved otherwise (if they have been legally declared incompetent)
Libela malicious or untrue WRITING about another person that is brought to the attention of others
Slandermalicious or untrue SPOKEN words about another person that are brought to the attention of others
Malpracticeprofessional negligence; failure to meet a legal duty, thus causing harm to another
Negligencethe commission (doing) of an act or the omission (not doing) of an act that a reasonably prudent person would have performed in a similar situation
Torta type of civil law that involves wrongs against a person or property; torts include negligence, assault, battery, defamation, fraud, false imprisonment, and invasion of privacy
Euthanasialetting a person die
Discretionability to make responsible decisions
Honestfree from fraud or deception
Integritythe quality of being honest and fair
Dependabilityable to be trusted to do or provide what is needed
Compassionsympathetic consciousness of others' distress together with a desire to alleviate it
False Imprisonmentrefers to restraining an individual or restricting an individual's freedom
DNRdo not resuscitate; an order written in a PT's chart that explicitly and unequivocally states that CPR should not be initiated if a PT is found in cardiac arrest
Health care proxya legal document in which a PT appoints an agent to legally make healthcare decisions on behalf of themselves, when he/she is incapable of making and executing the healthcare decisions stipulated in the proxy
Confidentialityprotects the right of PT to expect that details of their medical conditions should be divulged only to those who need to know them for medical purposes.
PT Self-Development/ PT Self ManagementPT recognizes and takes control of their conditions; PT with chronic condition makes day-to-day decisions about self-managing their illnesses
Invasion of Privacyinvolves a PT right to be left alone and remain anonymous if he/she chooses
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LEGAL RELATIONSHIPS

Question Answer
Accountabilitybeing responsible for one's own actions
Liabilitylegal responsibility
When a nurse accepts a PT care assignmentthe nurse-PT relationship is initiated; nurse assumes responsibility for the PT's care
Nurse-PT relationship: failure to provide careto the expected level of expertise gives rise to legal liability
Nurse-PT relationship: nurse accepts the role of advocate for the PT
Advocateis one who defends or pleads a cause or issue on behalf of another
A nurse advocate hasa legal and ethical obligation to safeguard the PT interests
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REGULATION OF PRACTICE

Question Answer
Standards of caredefine acts whose performance is required, permitted, or prohibited
Standards of care coupled + Scope of nursing practice give directions to the practicing nurse; defines what can and cannot be done to PT's
Nurse Practice Actthe laws that formally define and limit the scope of nursing practice
Every nurse is obligated toknow and follow the established standards of care
Failure to adhere to the standards of care gives rise to legal liability
Nursing liability fallsinto several areas: practice, monitoring, and communication (BOX 2-4 p25)
Institutions have the rightto establish policies and procedures for nursing within the nurse practice act
It is the nurses responsibilityto know the specific nurse practice act(s) in the state he/she practices in
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PT'S RIGHTS

Question Answer
PT Bill of Rightsdeveloped in 1972 by the American Hospital Association (AHA)
PT Bill of Rights: goalis to provide the public an understanding of their rights and responsibilities as consumers of health care
PT Bill of Rights: 2003 modified versionis called The Patient Care Partnership: Understanding Expectations, Rights, and Responsibilities
Other PT rights adopted in 1980Mental Health Patient's Bill of Rights & Pregnant Patient's Bill of Rights
PT Self-Development Actrequires that institutions maintain written policies and procedures regarding advance directives (including the use of life support if the PT is incapacitated), the right to accept or refuse Tx, and the right to participate fully in health care related decisions.
HIPAA of 1996Health Insurance Portability and Accountability Act took effect in 2003; established the duty of the health care provider to protect the confidentiality of all health information
HIPAA: Health care institutions are obligated to uphold PT rights
HIPAA: Rights tohave care without prejudice
HIPAA: Rights to betreated with respect and dignity at all times
HIPAA: Rightsto privacy and confidentiality
HIPAA: Rights to personal safety
HIPAA: Rights to completeinformation about one's own condition and Tx
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PT BILL OF RIGHTS SUMMARY:

Question Answer
1. PT can expecthigh-quality hospital care
2. PT can expect a cleanand safe environment
3. PT can expect involvementin their care and the decision-making process
4. PT can expect protectionof privacy
5. PT can expect helpwhen leaving the hospital
6. PT can expect help with billing concerns
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INFORMED CONSENT

Question Answer
Informed Consentpermission obtained from the PT to perform a specific test or procedure
Informed Consent Doctrinea legal doctrine that requires the PT to fully understand any proposed Tx and consent to it; this document gives the competent adult the choice to accept or reject any Tx modalities
Consent MUSTbe obtained before any invasive Tx or procedure
Failure to secure consentmay result in civil liability for battery
Civil battery(also called technical battery) is the unlawful touching of a person; an intent to harm is not necessary
Informed consent is the dutyof the physician or nurse practitioner who is performing the procedure or Tx to provide the needed info to the PT
Nurses can onlyWITNESS the PT signing the contract
Nurses should alsoclarify PT understands the info provided; any unanswered questions PT has about procedure or Tx is the responsibility of the treating provider **NOT THE NURSE***
*Informed Consent CANNOTbe delegated to a nurse
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CONFIDENTIALITY

Question Answer
Confidentiality refers toprivate info to be accessed only on a need-to-know basis
Nurses have a duty to protect info about a PT regardless of how the info is kept
Failure to maintain PT confidentialityrisks legal liability and both civil and criminal filings may result
HIPAAset rules and limits on who can look at and received health care info
Confidentiality: exampleon a PT care unit only those health care personnel directly involved in an individual's care should be able to access that PT's info
memorize

MEDICAL RECORDS

Question Answer
Medical recordsare NOT public documents and the information they contain must be kept secure
In a lawsuit, both partiesare permitted to use the PT's medical record to argue facts of the case
All entries in the medical recordMUST be permanent, accurate, and legible
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INVASION OF PRIVACY

Question Answer
Legal concept of invasion of privacy involvesa PT's right to be alone and remain anonymous if he or she chooses
Consent of Txdoes not waive the right to privacy
Using any PT info(name, photograph, specific facts regarding illness, etc) without authorization is a violation of the PT's legal rights
SafeguardPT's right to privacy at all times
Nurses should protect PT from unnecessary exposurewith the use of drapes; closing of doors; using available signage to restrict admission to rooms during procedures as needed
Legal liabilitymay occur if the PT's rights are violated
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REPORTING ABUSE

Question Answer
Health care professionals arerequired by law to report any potential abuse; mandated reporters
Health care professionals are protectedfrom liability when acting in good faith to report mandated info (ex. gunshot wound, certain communicable disease)
federal Child Abuse Prevention Treatment Act of 1973made reporting of child abuse MANDATORY
It is the responsibility of the nurse toknow the signs of abuse and the procedures for reporting suspected cases
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AVOID LAWSUIT

Question Answer
The best defense against a lawsuit is toprovide compassionate, competent nursing care
Nurse-PT relationship should be based ontrust and respect
Use ofopen and honest communication
Following the standards of care and the policies and procedures of the facility adhering to scope of practice for LPN/LVN
Proper documentationin medical records is an important factor in assessment of liability; ***IF IT ISN'T CHARTED, IT WASN'T DONE***
memorize

INSURANCE

Question Answer
Claims made policyprovides protection when the claim for nursing or negligence is made while the policy is in force
Occurrence basis policyprotects against claims made about events that occurred during the policy period or extended coverage period
Disciplinary Defense Insuranceor license protection insurance provides specific coverage (p.30) in the event a nurse is brought before the Board of nursing for disciplinary actions/problems with licensure
memorize

ETHICAL ASPECTS

Question Answer
Ethicsvalues that influence a person's behavior and the individual's feelings and beliefs about what is right or wrong
Advanced Directives aresigned and witnessed documents that provide specific instructions for health care Tx in the event that a person is unable to make these decisions personally at the time they are needed
Advanced Directives: 2 typesliving wills and durable powers of attorney
Patient Self-Determination Act (PSDA; 1991): requireshealth care institutions to provide written info to PT concerning the PT Bill of Rights under the state law to make decisions, including the right to refuse Tx, and formulate advance directives
Living willwritten document that directs Tx in accordance with a PT wishes in the event of a terminal illness or condition
Durable Power of Attorney for health caredesignates an agent, surrogate, or proxy to make health care decisions on the PT behalf based on the PT wishes
memorize

ETHICAL DEVELOPMENT

Question Answer
Valuesare personable beliefs about the worth of an object, an idea, a custom, or an attitude
Values varyamong people and cultures; they develop over time and undergo change in response to changing circumstances and necessity
Value clarificationis the process of self-evaluation that helps gain insight into personal values
Ethical dilemmasare situations that do not have a clear right or wrong answer; they are complex, confusing, and often frustrating situations that call for careful rational analysis
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ETHICAL PRINCIPLES

Question Answer
1st, most fundamental principle isrespect for people
Autonomyrefers to freedom of personal choice, a right to be independent and make decisions freely
Beneficencemeans doing good or acting for someone's good
Nonmaleficencemeans to do no harm
Justicethe concept of what is fair
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REFUSAL TO TREAT

Question Answer
Refusal to treat arises when a PT's care requires a nurse to do something that conflicts with his or her personal moral beliefs
Do NOT abandon the PTinstead ask for another assignment
Nurse CANNOTrefuse to care for a PT because she/he disagrees with the decisions the PT makes
Nurse does not have to participate in the procedure, but CANNOT refuse to provide care after the procedure (ex. abortion)
Nurse does NOThave the legal right to refuse care for a PT with an infectious disease
PT has the rightto receive care and the nurse has the responsibility to provide care
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DNR

Question Answer
After consultation with PT familythe Physician writes the DNR order in the medical record
PT is usuallyincapacitated with little hope for recovery
Nurse has the dutyto follow the DNR order written in the chart
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