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)