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legal ch 4
Legal Principles Potter and Perry
| Question | Answer |
|---|---|
| Name the 3 type of laws that govern nursing. | Statutory law, Administrative Law, and common law |
| Who enacts the Nurse Practice Acts? | state legislature |
| What agency functions under administrative law and regulates the paractice of nursing through rules and regulations derived from the Nurse Practice Act? | State Boards of Nursing. |
| What are court decisions written by judges deciding a litigated case called? | common law |
| Informed consent is an example of what kind of law? | common law |
| What are the 2 kinds of statutes? | Criminal or civil |
| What are the 2 kinds of Criminal law? | felony or misdemeanor |
| What is a felony? | A serious offense that has a penalty of imprisonment for greater than a year or even death. |
| What is a misdemeanor? | A less serious crime that has a penalty of less than a year or a fine |
| What kind of law would a nurse break by misuse of a controlled substance? | Criminal law |
| What is the purpose of civil laws? | Civil laws protect individual rights. |
| What is a Tort? | A civil wrong for which the court compensates by money damages. |
| Differentiate between assualt and battery. | Assualt = threaten to harm Battery = unwanted touching |
| What are the 2 types of torts and examples of each? | intentional = assault and batteryand unintentional = Negligence - malpractice |
| Define Malpractice. | Malpractice is defined as professional misconduct or unreasonable lack of skill. |
| In a malpractice suit what standard is used to determine if a nurse performed as any "reasonably prudent nurse"? | Nursing standards |
| What are legal guidelines for minimally safe and adequate nursing practice? | Nursing standards |
| What defines the scope and practice of nursing practice and expanded nursing roles, education requirements and differentiation between nursing and medical practice? | Nurse Practice Acts |
| What are some other professional organizations that define standards of nursing care? | American Nursing Association, JCAHO, Nursing Specialty organizations |
| What does the ANA do? | develop standards for nurisng practice, policy staements and similar resolutions and describe the scope, function, and role of nurses as well as clinical practice standards |
| What does JCAHO require in regards to nursing? | That hospitals fulfill standards with regard to nursing practice, like having written policies and procedures |
| What do nursing specialty agencies do? | Define the standard of care for nurses to be certified in specialty areas |
| What defines the standards of care for nurses at a particular institution? | Written policy and procedures of the employing institution found on most nursing units |
| Why is it important to know and follow the institutions written policies and procedures in the case of a law suit? | Becuase it is one of the standards that will be used to judge our performance. |
| How will standards of care from the various sources be utilized in the case of a lawsuit? | To measure whether nursing actions were appropiate and reasonable according to the standards |
| How can we stay current on any new rules, regulations, or case law? | Read the current nursing literature in our area |
| What defines the scope and practice of nursing practice and expanded nursing roles, education requirements and differentiation between nursing and medical practice? | Nurse Practice Acts |
| What are some other professional organizations that define standards of nursing care? | American Nursing Association, JCAHO, Nursing Specialty organizations |
| What does the ANA do? | develop standards for nurisng practice, policy staements and similar resolutions and describe the scope, function, and role of nurses as well as clinical practice standards |
| What does JCAHO require in regards to nursing? | That hospitals fulfill standards with regard to nursing practice, like having written policies and procedures |
| What do nursing specialty agencies do? | Define the standard of care for nurses to be certified in specialty areas |
| What defines the standards of care for nurses at a particular institution? | Written policy and procedures of the employing institution found on most nursing units |
| Why is it important to know and follow the institutions written policies and procedures in the case of a law suit? | Becuase it is one of the standards that will be used to judge our performance. |
| How will standards of care from the various sources be utilized in the case of a lawsuit? | To measure whether nursing actions were appropiate and reasonable according to the standards |
| How can we stay current on any new rules, regulations, or case law? | Read the current nursing literature in our area |
| Name the 9 most common negligent acts. | 1. medication errors w/injury 2. IV errors w/injury 3. Burns (equipment or spills) 4. falls 5. absence of asetpic technique 6. surgical items in patient 7. incomplete report for oncoming shift |
| Name the 9 most common negligent acts (continued). | 8. inadequate monitoring of pt.condition 9. failure to notify physician of significant changes in pt. status |
| How does the court define negligence? | Failure to use that degree of care that a reasonable person would use under the same circumstances |
| You owed the pt. a duty. You breached that duty. The patient was injured as a result of the breach. These circumstances provide framework for what charge? | Negligence |
| What is the patient's agreement to a procedure based on full disclosure of the risks, benefits, alternatives, and consequences of refusal? | Informed consent |
| What does informed consent documentation need to include? | patient and witness signature, date and time, verification of voluntary, fully informed signing |
| What is the nurse's responsibility in obtaining informed consent? | Obtaining a patient's informed consent is not our responsibility, but witnessing the pateint's signature is. |
| What do we do if the patient refuses treatment? | They need to understand the consequences of refusal. If they still refuse, written, signed, and witnessed refusal documentation is required. |
| What if the patient does not understand the the procedures? | Notify the physician or health care provider and the nurse supervisor. |
| What law limits liability and offers legal immunity if a nurse stops to help at the scene of an accident as long as acts without gross negligence? | Good Samaritan Law |
| According to the Good Samaritan law we are allowed to assist a minor at the scene of an accident even before obtaining a parent's consent within what limits? | The care provided must be within our level of expertise and once we take responsibilty for emergency care we need to stick with it until we can safely transfer care to a qualified individual (an EMT). |
| What must we have in order to practice in a state? | Licensure in that state |
| As student nurses who is responsible if we harm a patient? | We are responsible for all our actions that cause harm to patients. |
| Who shares liability if we are responsible as student nurses for injury to a patient? | our instructor, staff nurses working with us, the hospital or health care facility |
| What if we assigned a duty for which we are unprepared? | Refuse the duty |
| Can we perform things that we are learning at school while working as CNA? | No, only if they are included in the job description for a CNA. |
| When would we not carry out medical treatment ordered by a physician or health care provider? | When the order is in error, violates hospital policy, or is harmful to the patient. In these cases obtain further clarification fromt the provider. |
| What is the next step if the physician wants you to go ahead with an order that you think is potentially harmful to your patient? | Inform the nursing manager or supervisor and do not carry the order out if harm could come to the patient. |
| Why are written orders preferred to telephone orders? | Verbal or telephone orders leave possibilities for errors. |
| What if an emergency requires a telephone order? | The order needs to be written and signed by the provider as soon as possilbe within 24 hours. |
| Who can give consent for an autopsy? | The patient before death or a close family member after death |
| What is the order of priority for consent to an autopsy? | 1. patient in writing b4 death 2. durable power of attorney 3. surving spouse 4. surviving child, parent brother or sister in order named |
| What are some situations when we need to notify the coroner? | When reasonable grounds to believe death was due to violence, homicide, suicide, accident, or unusual or suspicious, sudden and unforseen and physician has not seen pt. in 36 hours. |
| If you are contaminated by a patient whose HIV status is unknown can you check their blood for HIV? | Only with the patient's consent. |
| What if you are required to care for more patients than is safe due to staff shortage? | Notify nursing supervisor. Document and keep a copy of the documentation for yourself. |
| What if you become overwhelmed by the demands on you due to staff shortage and you walk out on your job? | Could be charged with abandonment. |
| What would we need to let the nursing supervisor know if you are required to "Float". | If you lack experience in caring for the type of patients on the new unit. |
| What if you do not report a physician who illegally prescribes and dispenses controlled substances? | You are legally accountable for aiding and abetting the physician. |
| How do we keep track of each and every dose of controlled substances? | We carefully document dispensing, wasting and storage of controlled substances. They are only dispensed with a Doctors order and kept under lock and key. Only authorized personnel have access to them. |
| Give several examples of incidents that we are required to report or be held liable. | child, elder, spouse abuse, rape, gun shot wounds, attempted suicide, certain communicable diseases, unsafe or impaired professionals |
| Where do the standards of care that we are required to practice come from? | Nurse Practice Acts, guidelinse of professional organizations, written policies and procedures of employing institutions |
| What are our responsibilities when performing procedures or carrying out physicians or health care providers orders? | We are responsible to carry out procedures correctly and to exercise professional judgment when carrying out provider's orders. |
| What are four criteria of informed consent? | 1. consenter is competent and of legal age 2. consent is voluntary. 3. consenter understands procedure, risk, benefits and alternatives. 4. all questions are answered |
| Nurses are obligated to follow a doctor's order except when...? | They believe the order is in error, violates hospital policy, or could harm patient. |
| If you refuse to follow a doctor's order how should you do that? | Make a formal report explaining your refusal. |
| What are used to make quality improvements and provide risk management? | Occurance reports - do not go in patient's file |
| What kind of law is concerned with a person's private rights? | Civil law |
| Where would we find Florida state laws that affect the way patient care is performed in FL? | Florida Nurse Practice Act. |
| When making an occurance report do not....... | put a copy in the patient's record, include subjective information, assign blame |
| Who responsibility is it to obtain informed consent? | Physician or health care provider |
| What law grant's immunity to law suits if you stop to help in an emergency situation as long as there is not gross negligence? | The Good Samaritan Law. |
| What is defined as the degree of judgment and skill in nursing care given by a reasonable and prudent professional under similar circumstances? | Standards of Care |
| A patient who has already signed a consent for colon cancer surgery changes her mind. What does the nurse do? | Report the situation to the physician/provider and record it in the nursing notes. |
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Perseverandovercome
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