Nursing Fundametals study guide ATI

• Hospital policy and the Nurses Practice Act of each state determine the conditions of

Licensed Nursing Practice

• Nurses are legally mandated to report suspected child abuse to the proper authorities
• Incident reports are not placed in a patients chart
• Do not chart that an incident report has been filed.
• It is the responsibility of the health care provider to advise a client of any risks involved

in their decision to refuse care. This statement is relevant in clients’ situations when they decide to leave the facility against medical advice (AMA)

• Advanced directives are intended to allow patients to have more control over health

care decisions at the end of life.

• The two main types of advanced directives are Living will and Durable Power of

Attorney.

• Lawsuits involving civil wrongs are called torts.
• Examples of intentional torts are assaults, battery, defamation, false imprisonment,

and outrage, invasion of privacy and wrongful disclosure of confidential information.

• An unintentional tort is called negligence.

• Negligence is an unintentional failure of a nurse to perform an act that a reasonable person would or would not perform in similar circumstances; can be an act of omission or commission.

• Negligence occurs when injury results from the failure of the wrongdoer to exercise

care.

• Intentional torts are lawsuits wherein the defendant is accused of intentionally causing

injury to the plaintiff.• Malpractice is any professional misconduct that is an unreasonable lack of skill or fidelity in professional duties.• Actions such as not inserting a Foley catheter correctly, not taking appropriate steps to decrease client’s temperature, not reporting unusual or worsening condition of the client to his or her physician, not preventing falls can all lead to malpractice suits.• Libel is a written communication that injures a person’s reputation • Slander is an oral communication that injures a person’s reputation • Assault is an unjustifiable attempt to injure or touch another person. It can be physical or verbal • Battery refers to touching another person unlawfully or carrying out threatened physical harm • A durable power of attorney transfers all rights that the individual normally has regarding health care decisions to the designated agent • Confidentiality rules indicate that only those who are directly associated in caring for a patient can have access to a patient’s information • Faxing or e-mailing of patient information can be done if a written consent is obtained from patient.• Informed consent is not required in emergency situations.• Doctor orders to question are: (1) Ambiguous orders (2) Orders the client question (3) Orders when the client condition has changed (4) Orders which does not match with your experience or licensure requirement. (5) Doctors must cosign verbal orders.• When you observe a client’s behavior as culturally based, the nurse should assess the client’s interaction with others (family and friends) to help understand the meaning of behavior.

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Legal Aspect of Nursing:

• Regulation of nursing practice • Establishment and authorization of regulatory agency

How to protect your licensure:

• Do not let any one else borrow it.• Do not copy it unless you write “COPY” across it. In some states, it is illegal to copy your license • If you lose your license report immediately, take appropriate step to obtain a duplicate • Be sure that the board of nursing is notified if you change your address • Practice nursing according to the scope and standards of practice in your state • Know your state law so you will not do anything which could cause you to be disciplined by removal or revoking your license

Reporting act: These are conditions which when they occur must be reported to the appropriate authorities. These vary from state to state. They are • Child and elderly abuse • Gun shot wounds • Communicable diseases • Ophthalmic neonatorium • Phenoketouria • Criminal acts

Informed Consent Requirements:

• Capacity- age (adult), competence (can make choices and understand consequences) • Voluntary- freedom of choice without force, fraud, deceit, duress and coercion.• Cannot sign informed consent if client has been under the influence of a drug, for example alcohol or has been pre-medicated.• The nurse’s signature as a witness on a consent form indicates that the nurse observed the informed client or client’s authorized representative voluntarily sign the consent form. It does not mean that the nurse informed the client about the surgical procedure, because that is the responsibility of the physician.

Good Samaritan Laws:

This is enacted by individual states to encourage health care providers (professional) to assist at the scene of accidents and emergencies. The Good Samaritan Laws contain the following

elements:

• Care must be provided in good faith • Care given must be gratuitous- no compensation is made for care rendered • Higher standard of care may be required of health care worker due to higher level of expertise • Nurse will be expected to provide care at the level of ordinary nurses in similar circumstances • Do not cover a person who is soliciting for business or representing an agency • Do not cover the care rendered in an emergency room situation • Care provided should not be willfully or wantonly negligent

Liability:

• There are two types of liability; individual and vicarious liability

Individual liability:

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• Every body is liable to his or her action or conduct • Liability may be shared by another person or group, for example Doctors and fellow nurses or a facility such as a hospital.

Vicarious liability:

• Liability under the Nurse Practice act, which defines the standard of care a nurse, is expected to perform. For example, wrongfully administering a medication which would result in physical harm to a client.

Criminal law: these are wrongdoings against society as a whole

• Its punishment is usually prison term or fine.

Examples of Criminal Law:

• Violation of the nursing practice act • Murder • Manslaughter • False imprisonment • Narcotic’s violations • Assault and battery

Civil laws: these are wrong doing against private individual or a group; compensation is usually for the victim(s)

Examples of Civil Law:

Torts- These are intentional or unintentional civil wrongs. Examples of torts are: Negligence: unintentional harm to another that occurs through failure to act in a reasonable and prudent manner Malpractice: This is a professional practice that injures somebody through failure to meet the proper standard of care; malpractice is the offense of the professional.

Elements of malpractice suit:

• Professional must owe a duty of an established nurse-client relationship.• A professional must breach the duty by doing something wrong • Harm must occur to client • Direct cause and effect relationship between the breaches of duties • Formability- a professional could reasonably expect injury to occur as a result of the breach of duty • Invasion of privacy is a violation of one’s constitutional right to non- publicity and exposure to public view.

Nursing implication:

• Intervene when patient or client’s dignity or privacy is affected or violated. Proper ways covering of physical body during procedures is necessary. M • Medical records must be released only with written clients consent • Release of medical records should only be limited to care givers “need to know” • Client’s belongings must be protected and may not be searched without specific authorization. Have a client’s inventory sheets where all clients’ belongings are recorded and signed by the clients.

Defamation:

• These could be written or oral communication to a third person concerning matters that may injure an individual’s reputation

Assault: