Leadership and Management Exam 1 – Flashcards
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Purpose of the law -Purpose? -Defines what? -How does it help nurses to know the law?
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-The primary purpose of law and legislation is the protect the patient and the nurse -Defines the scope of acceptable practice and protect individual rights -Nurses who are aware of their rights and duties in legal matters are better able to protect themselves against liability or loss of professional licensure
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Constitution
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-A system of fundamental laws or principles that govern a nation, society, corporation, or other aggregate of individuals -Establishes a basis of governing
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Statutes -Definition? -Example?
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-Laws that govern -At federal, state, local levels--Legislative bodies ie. Congress, state legislatures, city councils make these laws -ie. 51 Nurse Practice Acts--define/limit the practice of nursing
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Administrative agency -Definition? What do they do? -Example?
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-Given authority to act by legislative bodies and create rules and regulations that enforce statutory laws -ie. State Boards of Nursing--they implement and enforce Nurse Practice Act with rules and regulations and conducting investigations/hearings
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Court decisions
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-Judicial or decisional laws made by the courts to interpret legal issues that are in dispute. -Can set the precedent for the future
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Types of laws and courts
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-Criminal, civil, administrative
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Criminal Law -Charge by who? -Guilt must be proved...? -Consequences?
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-Charges: Generally filed from state or federal attorney -Guilt must be proved: Beyond a reasonable doubt -Consequences: Incarceration, probation, fines, death
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Civil Law -Charged by who? -Guilt must be proved...? -Consequences?
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-Charges: One individual sues another for money -Guilt must be proved: Based on a preponderance of evidence -Consequences: Monetary damages ie. Malpractice
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Administrative Law -Charge by who? -Guilt must be proved...? -Consequences?
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-Charges: Individual is sued by a state or federal agency -Guilt must be proved: Clear and convincing standard -Consequences: Supervision or loss of license ie. Board of Nursing--Dealing with your license. Disciplinary hearing if there is a complaint about your practice
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Negligence vs. Malpractice
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-Negligence: Omission to do something a reasonably prudent person with similar training would have done in similar circumstances. (Could also be doing something the reasonable person would NOT do) -Malpractice: Failure of a professional person to act in a reasonably prudent manner AKA: Professional negligence
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Professional Negligence: What elements must be present?
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-Duty to Care -Failure to meet standard of care -Foreseeability of harm -A direct relationship between the failure and the injury can be proven -Injury **Being ignorant is not a justifiable excuse, but not having all the information in a situation may impede one's ability to foresee harm
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What are Nurse Practice acts?
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-Law defining nurses' scope of practice -Defines each type of nurse—LPN, RN, advanced practice nurse -Gives permission for Board of Nursing to exist
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Who creates the Nurse Practice acts?
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-Legislators—some may be health care professionals, but a lot are not
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What are Nursing rules and regulations?
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-Specific -Administrative law
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Who created Nursing rules and regulations?
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Board of Nursing
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Avoiding Malpractice
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-Interacting with patient on a personal level--being both caring and professional --> less likely to be sued -Practice within your scope -Observe Policies and Procedures -Utilize evidence based practice -Patient rights and welfare come first -Be aware of relevant law and legal doctrines and combine such with the biological, psychological, and social sciences that form the basis of all rational nursing decisions -Practice within the area of individual competence -Specialty certification
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Malpractice Insurance
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-AKA as "Professional Liability Insurance" -Does having this insurance prevent you from being sued? -No -Doesn't my employer cover me? -You get your own insurance -Your employer can choose to support you or not if you are sued, depending on a the case -If you are covered by your company, there can be limitations -Where do you get this type of insurance? http://www.anainsurancesite.com/Home.aspx http://www.nso.com/
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Institute of Medicine Report"To Err is Human" 1999
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-IOM (congressionally charted independent organization) -The IOM asks and answers the nation's most pressing questions about health and health care. This report says: -Errors are part of the human condition -Health system need redesign to make mistakes less likely to happen
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Joint CommissionHealthcare in the Crossroads 2005
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-Prevent Injuries -Improve Communication -Examine mechanisms for injury compensation (p. 102, Marquis & Huston 8th edition)
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Types of liability
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Vicarious, joint, product, personal
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Vicarious liability
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-Employers are held liable for the nurse's acts
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Joint liability
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-The nurse, physician, and employing organization are held liable
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Product liability
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-Failure of a certain kind of equipment
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Personal liability
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-Each person is liable for his or her own conduct
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Types of immunity
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Charitable, governmental
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Charitable immunity
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-A nonprofit hospital cannot be sued by a person who has been injured as a result of a hospital employee's negligence -Some states have this -Exception to vicarious liability
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Governmental immunity
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-If state or federal government employs the nurse, government cannot be held liable for the negligent acts of their employees while carrying out government activities -Exception to vicarious liability
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Tort -Definition? -Types?
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-Legal wrongs committed against a person or property, independent of a contract -Two types: intentional and unintentional
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Intentional tort -Definition? -Examples?
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-Direct invasion of someone's individual rights -Assault, battery, false imprisonment, invasion of privacy, slander/libel
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Unintentional tort
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-Professional negligence
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Patient Self-Determination Act
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-Requires health organizations receiving federal funding to provide education for staff and patients on issues concerning treatment and end-of-life issues -Info on advance directives (written instructions regarding desired end-of-life care); durable power of attorney (health care proxy for someone)
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Health Insurance Portability and Accountability Act (HIPAA)
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-Right to confidentiality -Unauthorized release of information or photos in medical records may make the person who discloses the info civilly liable for invasion of privacy, defamation, or slander -Nurses to be aware of where they are discussing information and who they are disclosing it to -Two parts: -Administrative Simplification Plan--restructuring the coding of health info to simplify the digital exchange of info among health-care providers and to improve the efficiency of health-care delivery -Privacy rules--**these rules attempt to balance the need for the protection of personal health info with the need for disclosure of that info for patient care
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Good Samaritan Laws
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-Nurses are NOT required to stop and provide emergency services as a matter of law although most health care workers feel ethically compelled to stop if they believe they can help -These laws suggest that health care providers are typically protected from potential liability if they volunteer their nursing skills away from the work place--generally emergencies -Actions must not be grossly negligent or out of scope of practice
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Emergency Medical Treatment and Active Labor Act (EMTALA)
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-Ensures public access to emergency services regardless of ability to pay. -Section 1867 of the Social Security Act imposes specific obligations on Medicare-participating hospitals that offer emergency services to provide a medical screening examination (MSE) when a request is made for examination or treatment for an emergency medical condition (EMC), including active labor, regardless of an individual's ability to pay. -Hospitals are then required to provide stabilizing treatment for patients with EMCs. If a hospital is unable to stabilize a patient within its capability, or if the patient requests, an appropriate transfer should be implemented.
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Board of Nursing
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-Given power from the State legislature in 1911 -Mission: Safeguard the health, safety and welfare of Tennesseans by requiring that all who practice nursing within this state are qualified and licensed to practice. -3 functions: licensure, education, practice
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Professional licensure
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-A legal document that permits a person to offer special skills and knowledge to the public in a particular jurisdiction when such practice would otherwise be unlawful -**Privilege NOT a right -Your number is yours and no one else's -Establishes standards of entry into practice -Defines a scope of practice -Allows for disciplinary action--ie. securing license by fraud, going against Nurse Practice Act, unprofessional/illegal conduct, malpractice, abusing alcohol/drugs
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Institutional licensure
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-Some believe hospitals or another health care agency should provide licensure to shift the burden. -Proponents of this believe this would allow: -More effective use of personnel -Greater flexibility -Drawbacks: -Lack of standards for the profession -Most professional nursing organizations disagree with this bc they think that it will decrease the quality of nursing care
