Ethics Legalities Copy

7/31/2019 Ethics Legalities Copy

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Professional Negligence

Negligence: the omission to do something that a reasonable and

prudent person in a reasonable situation would or would not do

Prudent: the average judgment, foresight, intelligence and skill

expected of a person of similar training or experience

Malpractice: failure of a person with professional training to act in a

reasonable and prudent manner


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Five components necessary for professional

negligence to occur:

1. Standard of care

2. Failure to meet standard

3. Foreseeability of harm

4. Correlation b/t care and harm must be proven

5. Actual patient injury must occur


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Reducing the Risk:

Know the law

Document everything Refrain from negative comments

Question authority

Stay educated

http://www.nurseweek.com/features/00-05/malpract.html


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Claims Against Nurses

Inadequate charting.

Inadequate communication w/ HCP orsupervisors about changes in pt condition

Leaving potentially harmful items within patient

reach


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Claims Against Nurses

Unattended pt falls

Inaccurate counting of operative instruments &sponges

Misidentifying patients for medications, surgeries& tests


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Incident Reports

Incident reports cant be used in court, unless they (lawyers and

what not) find out that it exists. They are intended for internalshit only, within the hospital, monitoring trends, prevention offuture occurrences, etc.

Dont put them in the chart! You can document the fall, whatyou did to make it better, but not that you filled out the actual

incident report form. Dont tell the pt or family that youre filling one out! Youre not

keeping them from any information about the incident, yourejust not telling them about the form

Dont document on pts chart that you filled one out!

Notify nurse management teams and what not when you fill itout.

Remember, there is no law about having to fill out an incidentreport. Its just the hospitals policy to keep tabs on all the shitthat goes wrong inside its walls


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Incident Reports

Unusual / unexpected incidents

Do

Document incident information, treatment & follow up

on chart Notify Nsg Management & Risk Management

DO NOT

Leave copy on chart Discuss with pt / family

Document form completion in chart


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Intentional Torts

Assault & Battery

Assault is the behavior that makes a person fearful of harm

Battery is an intentional physical contact with a person thatcauses injury

False Imprisonment Any unlawful confinement within fixed boundaries, can be

physical, emotional, or chemical

Defamation of character (slander)

Communicating to a 3rd party information that can hurtcharacter, self esteem, blah blah blah. Being truthful reducesrisks of being charged with this

Invasion of privacy


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Types of Consent

Informed consent

Implied consent

Pt unable to consent

Treatment is in patients best interest

Express consent

Witness pt signature

Assure pt received information


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Informed Consent

Language pt understands

Patient competency

Requires full disclosure (procedure process,

risks and benefits)


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Medical Records

Although the patient owns the information in

the medical record, the actual record belongs to

the facility that originally made record & is storing

it


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Causes of License Suspension

Professional negligence

Practicing nursing w/o a license

Obtain license by fraud

Felony convictions


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Legal Responsibilities of a

Nurse Leader

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Malpractice for Nurse Leader

Assignments

Pt assignments

Delegation

Supervision

Orientation & Education

Evaluation

Staffing 18


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The Patient

Self-Determination Act

Requires health care organizations that receive

federal funding to provide education for staff and

patients on issues concerning treatment and end-of-life

issues. (They have to ask about Advanced Directives

and what not on admission and inform them about it)


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Whistleblower Act

To prevent employers from taking retaliatory

action against nurses such as suspension,

demotion, harassment or discharge for

reporting improper patient care or businesspractices


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Good Samaritan ActGenerally, a nurse is not liable for injury that

occurs as a result of emergency treatment,

provided that:

Care is provided at the scene of emergency

The care is not grossly negligent


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Health Insurance Portability and

Accountability Act

Protects the privacy of health information

Administrative Simplification plan

All related to electronic medical records, simplifying

exchange of info and what not, by 2014 all hospitalshave to have this

Privacy Rules


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Diverse Workforce

Title VII (Civil Rights Act-1964): Protects againstdiscrimination based on race, color, creed, national

origin, religion or sex

Age Discrimination in Employment: no

discrimination over age 40

American with Disabilities Act: no

discrimination against physical or mental impairment

regarding hiring


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Joint Commission

Independent not for profit organization that

accredits and certifies healthcare organizations

Purpose: continuously improve health care for the

public, in collaboration with other stakeholders, by

evaluating health care organizations and inspiring

them to excel in providing safe and effective care

of the highest quality and value

http://www.jointcommission.org/AboutUs/


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Joint Commission

National Patient Safety Goals

Improve accuracy of patient identification

Improve the effectiveness of communication

among caregivers

Improve the safety of using medications

Reduce the risk of healthcare associated

infections

http://www.jointcommission.org/AboutUs/


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Joint Commission

National Patient Safety Goals cont.:

Accurately and completely reconcile medications

across the continuum of care

Reduce the risk of patient harm resulting from falls

Prevent healthcare associated pressure ulcers

The organization identifies safety risks inherent inits patient population

Universal protocolhttp://www.jointcommission.org/AboutUs/


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Centers for Medicare & Medicaid

Works closely with TJC to maintain patient

safety

Reimburses according to meeting standards of

care

Healthcare-associated infections

Hospital-acquired conditions

http://www.cms.gov/


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References

Potter, P. A., & Perry, A.G. (2009) Fundamentals of Nursing (7th ed.).

Canada: Mosby.

Smeltzer, S. C., & Bare, B. G. (2008). Brunner & Suddarth's textbook of

medical-surgical nursing (11th ed.). Philadelphia, PA: Lippincott

Markkula Center for Applied Bioethics. http://www.scu.edu/ethics

Texas Engineering Extension Service (TEEX), Center for Disease Control

and Prevention (CDC), The Texas A&M University System (TAMUS), &

National Emergency Response and Rescue Training Center (NERRTC).

(2003). Integrated Health and Medical WMD Training Program.

(Original work published 2001, Texas Engineering Extension Service

(TEEX), College Station, TX.

Marquis, B. & Huston,C. (2009) Leadership roles and management

functions in nursing (6th ed). Philadelphia, PA: LIppincott


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