Black Chapter 4

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advocate
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a person who acts on behalf of another person
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doctrine of informed consent
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refers to the full disclosure of the facts the patient needs to make an intelligent (informed) decision before any invasive treatment or procedure is performed
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laws
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the reference of a rule, principle, or regulation established and made known by a government to protect or restrict the people affected
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liable
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legally responsible
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nonmaleficence
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ethical principle meaning “to do no harm.”
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standards of care
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those acts that are permitted to be performed or prohibited from being performed by a prudent experience, and conditions existing at the time of the duty to give care
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legal aspects of nursing
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scope of Nursing Practice standards of care compliance with licensing requirements
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local, state, or federal legislations
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who controls legal responsibilities
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laws in nursing
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they provide protection for all members of heatlh care system
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statutory law
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developed by federal, state and local govt
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common law
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developed in response to specific legal questions brought before the court and usually follow precedent (previous rulings on an issue)
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civil law
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-conduct violates a person’s rights -conduct is detrimental to that individual
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criminal law
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-the law involves public offenses (such as robbery, murder, assault) -the law’s purpose is to punish for the crime and deter and prevent further crimes -conduct at issue is offensive to society in general -conduct at issue is detrimental to society as a whole
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civil litigation
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-lawsuit in a civil court -begins when the plaintiff contacts an attorney
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liability
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-a legal responsibility -a nurse can be charged with civil or criminal liability depending on particular circumstances surrounding the case
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standards of care
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-acts that are permitted to be performed or are prohibited from being performed -give direction to the practicing nurse, defining what should or should not be done for pts
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scope of nursing practice
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-each LPN/LVN must be familiar with their scope of practice -the nurse cannot use ignorance as an excuse! -every nurse needs to know what they can and cannot do while providing nursing care -it is your responsibility to seek additional instruction and supervision when faced with an unfamiliar practice or procedure
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Nurse Practice Acts
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define and limit the scope of nursing practice. each individual is responsible for knowing their state’s practice act.
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licensure
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-approval of board, applicant can take NCLEX -once a license is granted, it can be suspended or revoked for unprofessional, unethical, immoral and/or criminal conduct
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interstate compact
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-allows multistate practice of nursing -nurse must be licensed in home state, privileges are then granted to practice in other states that have signed the interstate compact -must follow applicable rules
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malpractice
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legal action that a nurse can be charged with for failing to meet the “Standards of Care”, does not always have to be intentional . occurs through omission or commission
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commission
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liable for DOING an act
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omission
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liable for NOT DOING an act
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requirements of malpractice action
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nurse practice with specialized care caused pt injury 1. nurse assumed duty of care 2. breached duty by failing standards of care 3. failure was proximate cause of injury 4. injury is proven
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Major causes of negligence
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1. failure to follow standards of care 2. failure to use equipment in a responsible manner 3. failure to communicate 4. failure to doccument 5. failure to asses & monitor 6. failure to act as patient advocate
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malpractice insurance
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-the nurse may want to purchase individual coverage even if the employing institution carries insurance provides more protection for the nurse while on and off duty most institutions’ policies cover only liability if the nurse is on duty and acting within proper capacity
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Patient’s Bill of Rights
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developed by the American hospital Association (AHA) in 1972 whose goal is promote public’s understanding of their rights and responsibilities as consumers of health care
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HIPAA
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-federal regulation -duty to protect confidentiality of all health information Health Insurance Portability and Accountability Act of 1996
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informed consent
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-a person agrees to allow a particular tx based on full disclosure of the facts needed to make an intelligent (informed) decision -the pt has the right to accept or reject the proposed care -consent must be voluntary without being coerced -given by capacity and competence to understand -pt provided with enough info to be ultimate decision-maker
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civil battery
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unlawful touching of another person without informed consent; an intent to harm is NOT necessary
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confidentiality
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both legal & ethical concern -private info of pt is protected -only info pertained to pt’s treatment & welfare is disclosed
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What nurse can and cannot do with confidentiality
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the law prescribes when a health care professional must report certain information to authorities ex: certain communicable diseases, gunshot wounds, signs of abuse (be alert to signs of abuse in children and elderly) -the health care professional is protected from liability when acting in good faith -the report should be given to a supervisor or directly to the police, according to the agency policy -Older Adult Consideration -info required by third-party
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Preventing Legal problems in Nursing
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-meet standards of care -promote positive interpersonal relationships – communications with other health professionals, pt, families -follow the standards of care and adhere to the scope of practice -practice in safe setting
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Good Samaritan Law
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-provides immunity from liability in certain circumstances -encourages assistance in emergencies occurring outside of a medical facility by providing protection against liability EXCEPT in cases of gross negligence
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ethics
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-values that influence a person’s behavior -an individual’s feelings and beliefs about what is right and wrong
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Development of Ethical Principles
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-values clarification -cultural considerations
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values clarification
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the process of self-evaluation that helps a person gain insight into individually held values -nurse should encourage pt to make own decisions based on their values and not that of the nurse -nurse should assess own values
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National Federation of LVN/LPN Code of Ethics
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-provide health care without a discrimination -maintain a high degree of professional and personal behavior -take an active role in the development of the LPN/LVN profession -know and function within scope of practice of LVN -maintain pt confidences
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Unethical behavior
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-failing to perform the duties of a competent, caring nurse -each member of the nursing profession has a duty to report behavior that does not meet the established standards -follow proper chain of command -explain facts as clearly as possible -follow proper chain of command -explain facts as clearly as possible
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advance directive
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specifies what life-saving txs he or she does or does not wish to have
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living will
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becomes effective when the pt is incapacitated and governs what medical txs are done
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health care proxy
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(durable power of attorney) -enables a person to make decisions regarding medical tx if the pt is unable to make them -a proxy is another person who will speak for the pt on their behalf decision making
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refusal to treat
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-cant refuse treatment based on decisions of patient -nurse does not have to participate in the procedure but can’t refuse to provide care after procedure -do not abandon the pt, as for another assignment -the nurse DOES NOT have the legal right to refuse to care for a person with infectious disease -standard precautions should be applied to every pt & therefore you are at no greater risk for infection from one pt than from another -if a nurse has a religious belief regarding abortion, it is the nurse’s responsibility to report to supervisor and explain moral dilemma
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NCSBN
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National Council of State Board of Nursing
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NCSBN Model Nurse Practice Act & Model Nursing Administration Rules (2011)
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document guides states in developing/ revising nurse practice acts have power to clarify provisions of nurse practice act
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administering care without informed consent
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assault & battery charges
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delegation
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giving someone authority to act for another
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5 rights to ensure deilgation
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1. right task 2. right circumstances 3. right person 4. right direction/ communication 5. right supervision/ evaluation
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Who can delegate?
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LPN cannot make assessment or admit patient can only finish part of assessment
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NCLEX-RN
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-National Council Licensure Examination for Registered Nurses tests critical thinking and nursing competence taken to license nurses to protect health, safety, & welfare of public
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State board of Nursng
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responsible for nurse practice act in state -publish rules & regulations that expand law -revise to keep up with health care developments
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Power of State board of Nursing
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clarify provisions of nurse practice act has the power to license and discipline nurses
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What is the most common reason nurses are disciplined by State board of nursing?
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practicing while impaired
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negligence
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failure to act as a reasonably prudent person would act in the same circumstances
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assault
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threat or attempt to make bodily contact with another person without consent
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battery
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impermissible, unprivileged touching of a person
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expert witness
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individual called to testify in court because of a special skill/ knowledge in a certain field
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Nurse practice act
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statute that defines nursing practice 1. defines practice of professional nursing 2. sets education & other requirements for licensure 3. determines legal titles & abbreviations 4. provides for disciplinary action

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