Leadership ATI 3

who identifies a clients right

the american hospital association in the document "The patient care partnership

who governs a clients right in a long term care facility

resident rights"
under statutes that govern the operation of these facilities

clients rights

-be informed about all aspects of care and take an active role in the decision-making process
-accept, refuse or request modification to the plan of care
-receive care by competent individuals who treat the client with respect

what is the patient self-determination act

it stipulates that on admission to a facility all client MUST be informed of their right to accept or refuse care
competent adults have the right to refuse care and leave the hospital

what should the client be informed of after refusing a procedure

-possible complications
-possible permanent physical or mental impairment or disability
-possible complications that could lead to death

what should the nurse do if the client refuses to signs the AMA form

document that the client refused to sign the form

what does advocacy refer to in terms of nursing

the nurses role in supporting clients by ensuring that they are properly informed, that their rights are respected, and that they are receiving the proper level of care

specific roles the nurses plays as a client advocate

-inform the client of their rights
-have adequate information on which to base health care decisions
-mediate on the client behalf when the actions of other's are not in the client's favor
-assist client with health care decisions DO NOT CONTROL OR DIRECT

essential skill associated with advocacy

caring
autonomy
respect
empowerment

what is included in informed consent

-the reason the treatment or procedure is needed
-How the treatment or procedure will benefit the client
-the risks with surgery
-other options
-the risks if they don't do it

what is the nurses role in the informed consent

to witness the client's signature on the informed consent form and to ensure that informed consent has been appropriately obtained

when is consent required

for all care given in the facility

what is an example of implied consent?

when a nurse is doing a TB test and the pt holds out her arm

when is written consent required

for an invasive procedure
surgery

individuals authorized to grant consent for another person include

parent of a minor
Legal guardian
court-specific representative
spouse
emancipated minors

what is the purpose of advance directives

to communicate a client's wishes regarding end-of-like care should the client become unable to do so

what is a living will

a legal document that expresses the client's wishes regarding medical treatment in the event the client becomes incapacitated and is facing end-of-life issues

what is the durable power of attorney?

a legal document that designates a health care proxy who is an individual authorized to make health care decisions for a client who is unstable
in addition to the living will

who rights the DNR/AND

the provider HE MUST DISCUSS WRITING THE ORDER WITH THE FAMILY PRIOR TO!!!

overall what are the nurses role with advance directives

providing written info regarding advanced directives
documenting the client's advance directive status
ensuring that the advance directives are current
informing all members of the healthcare team of the client's advanced directives

what are the specific rights outlined under HIPAA

-clients have the right to obtain a copy of their medical record and correct errors or omitted information
-provide written information about how medical information is used and hos it is shared with other entities
-right to privacy and confidentiality

when is it ok to copy a clients records

transfer from a hospital to an extended care facility
exchange of documentation between a general practitioner and a specialist during a consult

is it ok to use a public board to display the clients name and diagnosis

HECK NO :)

is it ok to give out health care information to family members and people that call on the phone

nope because they are not authorized
-if individuals can provide a CODE then they can receive the information

when is it NOT ok to do a change of shift report at the bedside?

when the pt has a roommate

is walking rounds ok?

no because visitors and family members can overhear

why are tape rounds not ok?

because a nurse should not hear about a patient that they are not taking care of

what is the health information system used for

to manage administrative functions and clinical functions (clinical information system)

what are different actions to help with maintaining HIPAA

-logging off from the computer before leaving the workstation
-never sharing a user ID or password with anyone
-Never leaving a client's chart or other printed or written PHI where others can access it
-shredding any printed or written client information

DOs with protecting yourself from a HIPAA violation

become familiar with facility policies about the use of social media and adhere to then
avoid disclosing any client info online and that no one can overhear you discussing a client
report any violations to the nurse manager
maintain professional boundarie

DONTs with protecting yourself from a HIPAA violation

do not take or share photos or videos of a client
post a belittling or offensive remake about a client, employer or coworker

what are different laws under the federal regulation umbrella

HIPAA
ADA
the mental health parity act
the patient self-determination act
the uniform anatomical first act and the national organ transplant act

what is criminal law

a subsection of public law
relates to the relationship of an individual with the government
broke up into a felony or a misdemeanor

a nurses who falsifies a record to cover up a serious mistake may be found guilty of breaking what

a criminal law

what are civil laws

protect the individual rights of people
one type is a tort law

what are the three different types of tort laws

unintentional torts
quasi-intentional torts
intentional torts

unintentional torts (examples)

negligence
malpractice

quasi-intentional torts (examples)

breach of confidentiality
defamation of character

intentional tors (examples)

assault
battery
false imprisonment

authority of the board of nursing

to adopt rules and regulations that further regulate nursing practice
can issue and revoke a nursing license
set standards for nursing programs and further delineate the scope of practice for RNs, LPNs, and APNs

where can you access the law and rules governing nursing practice in a state

that state's board of nursing website

what are Good Samaritan Laws

protect nurses who provide emergency assistance outside of the employment location. THE NURSE MUST PROVIDE A STANDARD OF CARE THAT IS REASONABLE AND PRUDENT

is it ok to practice with an expired license

HECK NO!!!!!!!!!!!!!

where are nursing standards of care located

the nurse practice act
ANA
National Association of Practical Nurse Education and Services
AACN
oncology nurses society
ostomy and continence nurses society
Health care facilities policies and procedures

if there is an answer that ends with according to institutional policy is it going to be right

yeap
it is very important that nurses are familiar with their institution's policies and procedures and provide client care in accordance with theses policies

what are common negligence issues that prompt malpractice issues

failure to..
-follow standards of care
-use equipment in a responsible and knowledgeable manner
-communicate effectively and thoroughly with the client
-document

what are the five elements necessary to prove negligence

-duty to provide care as defined by a standard of care (the nurse should do this)
-breach of duty (the nurse does not do this)
-foreseeable harm (the omitted act may cause harm)
-breach of duty has potential to cause harm
-harm occurs

ways nurses can avoid being liable for negligence

-following standards of care
-giving competent care
-communicating with other health team members
-developing a caring rapport with clients
-fully documenting

if a nurse suspects another nurse to be under the influence what should her initial action be

report it to the nursing manager

where would a nurse recently found to be under the influence work

in non critical area
would not administer controlled substances

what are clues that a nurse may be abusing drugs

-preferring to work the night shift where supervision is less or on units where controlled substances are more frequently given
-frequent requests to leave the unit or leave early from the shift
-nurse "forgetting" to have another nurse witness her wastin

who does a nurse report a communicable disease to

the local heath department or the state health department

why is it necessary to report certain diseases?

to ensure appropriate medical treatment
monitor for common-source outbreaks (HEP A)
Plan and evaluate control and prevention plans (immunizations)
identify outbreaks and epidemics
determine public health priorities based on trends
educate the community on

who regulates organ and tissue donation

federal and state laws

what is the nurses role in organ donation

for answering questions regarding the donation process and for providing emotional support to families

what does federal law require health care facilities to provide in relation to organ donation

a specialist that is in charge of asking the family and provide information on the donation

if a verbal or telephone medication order is done how long does the provider have to sign the order

24 hours

what is incivility

an action that is rude, intimidating, and insulting
teasing, joking, dirty looks, uninvited touching
(Gretchen(minus touching))

what is lateral violence

horizontal abuse
occurs between individuals who are on the same level
verbal abuse, undermining activities, sabotage, gossip, withholding information and ostracism

what is Bullying

seen with the bully is higher in rank. abuse of power makes the recipient feel threatened, disgraced, and vulnerable
****showing favoritism for another nurse and denying another nurse opportunities

ethics

based on an expected behavior of a certain group in relation to what is considered right and wrong

morals

the values and beliefs held be a person that guide behavior and decision-making

autonomy

the ability of the client to make their own decisions

Beneficence

the care that is in the best interest of the client

Fidelity

keeping one's promise to the pt about care that was offered

Justice

fair treatment in matters related to physical and psychosocail care and the use of resources

Nonmaleficence

the nurses obligation to void causing harm

veracity

the nurses duty to tell the truth

what are the nurses responsibilities when there is an ethical dilemma

advocating for the pt
identify and report ethical situations

steps in the ethical decision making process

1. identify if the situation is an actual ethical dilemma
2. stat the ethical dilemma and surrounding issues and individuals involved
3. list and analyze all possible options for resolving the dilemma, and review implications of each option
4. Select an o

how is death determined under the uniform determination of death act

-irreversible cessation of circulatory and respiratory function
-irreversible cessation of all function of the entire brain (including the brain steam)