If the answer is negative, the health care provider discusses the option to make or refuse an organ donation and places such documentation in the patient’s medical record. Demonstrating accountability, and acting responsibly in professional practice, means that the nurse acknowledges when errors in professional practice occurs. If health care workers follow the directions of the living will, they should be immune from liability (, Health care information privacy is also protected by standards set by the Health Care Financing Administration (HCFA) for hospitals and health care providers who participate in Medicare and Medicaid (, Many legal issues surround the event of death, including a basic definition of the actual point at which a person is legally dead. If the patient subsequently develops complications as a result of your actions, you are immune from liability as long as you acted without gross negligence (Good Samaritan Act, 1997). II) Anger: the individual resist the loss and may “act out” to everyone and everything in the environment. In addition to federal statutes, the ethical doctrine of autonomy ensures the patient the right to refuse medical treatment. Negligence -conduct falls below standard of care i.e. Exceptions to the ability to access medical records apply to psychotherapy notes or when the health care provider has determined that access would result in harm to the patient or another party (Privacy Rights Clearinghouse, 2011). The nurse completes an incident report. Another intentional tort is defamation, which is the act of wrongfully hurting a living person’s good reputation. * Genital (Puberty through Adulthood) -want to be with peers. The act provides civil and criminal immunity to the hospital and health care provider who performs in accordance with the act. 21) How does the nurse works with narcotics? g) The form provides an accurate ongoing count of narcotics used and remaining. If the patient’s history and medical records indicate suicidal tendencies, the patient must be kept under supervision. Most states have adopted the Uniform Determination of Death Act (1980). What are side effects? An example of defamation is when a nurse makes false chart entries about a patient’s lifestyle or diagnoses. What does it means for the nurse to be a witness during the signing of the informed consent? * Be informed of med’s name, purpose, action, and potential undesired effects Incident reports assist administrative personnel in identifying hospital problems that contribute to medication errors. Assault Battery Malpractice Invasion of privacy Defamation of character The nurse observes the response to loss and then attempts to identify the family’s strengths in dealing with it. Those laws limit liability and offer legal immunity for nurses who help at the scene of an accident. Admission of a patient to a mental health unit occurs involuntarily or on a voluntary basis. Likewise, health care workers cannot discriminate against HIV-positive patients (Guido, 2010). DQ-3 What is the difference between an intentional and a quasi-intentional tort? The Patient Self-Determination Act (PSDA) (1991) requires health care institutions to provide written information to patients concerning their rights under state law to make decisions, including the right to refuse treatment and formulate advance directives. For example, if the patient gives consent for an appendectomy and the surgeon performs a tonsillectomy, battery has occurred. Each state providing for living wills has its own requirements for executing them. Be familiar with the policies and procedures of your employing institution regarding organ donation. f) The record is used to document the client’s name, date, time of medication administration, name of medication, dose, and signature of nurse dispensing the medication. b) prn Orders: the prescriber may order a medication when a client requires it. c) Purple discoloration of skin (livor mortis) in dependent areas from breakdown of red blood cells. These internal standards of care are specific and need to be accessible on all nursing units. 12) What are the perceptions of death according to the stages of development? What are peak and through level? • Discuss the nurse’s role in witnessing the informed consent process. Despair (Old Age). A judge may determine that the patient is a danger to self or others; then the judge will grant the involuntary detention, and the patient can be detained for 21 more days for psychiatric treatment. For example, respect the wish not to inform the patient’s family of a terminal illness. In general, courts define nursing malpractice as the failure to use that degree of skill or learning ordinarily used under the same or similar circumstances by members of the nursing profession (Box 23-2) (Austin, 2006). Malpractice is one type of negligence and often referred to as professional negligence. Even though the nurses attempted to contact the physician, this case holds that, when the physician fails to respond, the nurse must go over the health care provider’s head to make sure that he or she is appropriately treated. d) Report any measures taken by oneself, other nurses, or physicians at the time of the incident. In the privacy section of the HIPAA, there are standards regarding accountability in the health care setting (Carter, 2010). IV) Depression: the individual realizes the loss and the full impact of its significance is apparent. Battery. Usual questions concern witnesses, insurance experts, and which health care providers the plaintiff has seen before and after the incident. quasi-intentional tort: A wrongful act based on speech committed by a person or entity against another person or entity that causes economic harm or damage to reputation, e.g., a defamation of character or an invasion of privacy. The cardiopulmonary standard requires irreversible cessation of circulatory and respiratory functions. Be familiar with the DNR protocols of your state. 1. Following discovery phase of 1 to 3 years or longer, trial may last days to months. If the answer is affirmative, the health care provider obtains a copy of the document. An unintentional tort is what most torts are. A health care proxy or durable power of attorney for health care (DPAHC) is a legal document that designates a person or persons of one’s choosing to make health care decisions when the patient is no longer able to make decisions on his or her own behalf. Considering all consequences. Examples are assault, battery, invasion of privacy and defamation of character. • Explain the legal concept of standard of care. V) Acceptance: Physiological reactions cease, and social interactions resume. Adult: are confronted with the death of family members and friends of the same age. Although the courts will not force adults to undergo treatment refused for religious reasons, they will grant an order allowing hospitals and health care providers to treat children of Christian Scientists or Jehovah’s Witnesses who have denied consent for treatment of their minor children. There are essentially two standards for the determination of death. 7) What are the nurse’s responsibilities and actions after finding a patient injured from a fall? Gather in groups of same sex peers. Is coming to terms with the situation, rather than submitting to resignation or hopelessness. Check your understanding of unintentional torts with an interactive quiz and printable worksheet. 19) Outline the legal responsibilities for nurses when giving drugs. An example of a civil law violation for a nurse is negligence or malpractice. It allows employees to change jobs without losing coverage as a result of preexisting coverage exclusion as long as they have had 12 months of continuous group health insurance coverage (Carter, 2010). The role of the U.S. government in regulation of the pharmaceutical industry is to protect the health of the people by ensuring that medications are safe and effective. h) Do not photocopy the report since the copy could be subpoenaed in court. Standards are those actions that ensure safe nursing practice. Health insurance plans are free to eliminate coverage for certain specialties and impose limits on the amount of coverage that they will pay for certain illnesses. Nurses agree to responsibility for specific actions and accountability for the consequences. The practice of beneficence encourages the urge to do good for others. * Autonomy vs. Shame and Doubt (1 to 3yrs) The purposes of public health laws are protection of public health, advocating for the rights of people, regulating health care and health care financing, and ensuring professional accountability for care provided. Four types of medications orders are based on frequency and/or urgency of medication administration. A felony is a crime of a serious nature that has a penalty of imprisonment for longer than 1 year or even death. This act provides that, when a patient comes to the emergency department or the hospital, an appropriate medical screening occurs within the capacity of the hospital. Does the failure to document an admission nursing assessment equate with the fact that this nurse did no admission nursing … Log In or. * Must demonstrate accountability and responsibility, Make sure it’s the RIGHT medication, dose, client, route, and time. Value clarification is a process of self-discovery that helps a person gain insight into values. Nurses who apply restraints in violation of state and federal regulations may be charged with abuse, battery, or false imprisonment. These discomforts should be considered in light of the suffering that the disease itself might cause, and in light of the suffering that other treatments might cause. Message boards used in patients’ hospital rooms to post daily nursing care information can no longer contain information revealing the patient’s medical condition. This agent makes health care treatment decisions based on the patient’s wishes (Blais et al., 2006). 11) What are the physiological signs and symptoms of death? Informed consent not only requires that a person be given all relevant information required to reach a decision regarding treatment, but also requires that the person be capable of understanding the relevant information and does in fact give consent. Read the case study presented at the end of Chapter 5 (Guido p. 67). The American Nurses Association (ANA) have established widely accepted codes that nurses attempt to follow. An example of state statutes are the Nurse Practice Acts found in all 50 states (see Chapter 1). If an event falls into any of these categories, guide information through the public relations department of the institution to ensure that invasion of privacy does not occur. Witnesses’ depositions: Questions are posed to the witness under oath to obtain all relevant, nonprivileged information about the case. 3) What is malpractice? Defamation of character A nurse tells a coworker that she believes a client has been unfaithful to the spouse. Explain the legal concept of standard of care. The allegations in the lawsuits are that the health care provider failed to provide adequate supervision and safeguard the facilities. g) Keep a written account of the incident report for personal files. Advance directives include living wills, health care proxies, and durable powers of attorney for health care (Blais et al., 2006). Pharmacokinetics: is the study of how medications enter the body, reach their site of action, are metabolized, and exit the body. Some torts specific to nursing and nursing practice include things like malpractice, negligence and violations relating to … Choosing freely. Describe the nursing implications associated with legal issues that occur in nursing practice. The report is completed even though an injury does not occur or is not apparent. * Intimacy vs. Any health care professional who does not report suspected child abuse or neglect may be liable for civil or criminal legal action. Intentional Tort Example. The nurse documents only and objective description of what was actually observed, and follow up care that occurred, and does not specify in the medical record that an incident report was prepared. 2) The right dose. taking a stop sign In contrast, "an intentional tort is a deliberate invasion of someone's legal right. Be aware of legal definitions of death because you need to document all events that occur when the patient is in your care. The procedure, however, may require long periods of pain and suffering. Usually a panel of professionals conducts the hearing. Decisional capacity is the ability to make right choices for oneself as they relate to medical care. 3. explain a recent case involtional or quasi-intentional torts? Likewise, it is an assault for a patient to threaten a nurse (Guido, 2010). This sets it apart from other torts, including negligence. In most states Required Request laws mandate that, at the time of admission to a hospital, a qualified health care provider has to ask each patient over age 18 whether he or she is an organ or tissue donor. Unintentional Tort: A type of unintended accident that leads to injury, property damage or financial loss. The defendant. Example; “No, that can be so.” ( Anal (1 yr to 3 yrs) -toilet-training, prone to child abuse. The legal guidelines that nurses follow come from statutory law, regulatory law, and common law. Americans with Disabilities Act (ADA) (1990), National Council of State Boards of Nursing [NCSBN], 2005, The Americans with Disabilities Act (ADA) (1990), The Patient Self-Determination Act (PSDA) (1991), Health Insurance Portability and Accountability Act of 1996, Centers for Medicare and Medicaid Services (2007), Uniform Determination of Death Act (1980), Failure to assess and/or monitor, including making a nursing diagnosis, Failure to use proper equipment to monitor the patient, Failure to notify the health care provider of problems, Failure to follow the six rights of medication administration, Failure to ensure patient safety, especially patients who have a history of falling, are heavily sedated, have disequilibrium problems, are frail, are mentally impaired, get up in the night, and are uncooperative, Failure to follow policies and procedures, Failure to properly delegate and supervise. No actual contact is necessary. All nurses are responsible for knowing the provisions of the Nurse Practice Act of the state in which they work and the rules and regulations enacted by the State Board of Nursing and other regulatory administrative bodies. Statutory law is either civil or criminal. * Publication of private or embarrassing facts Definition. This intent can be transferred. An example of a regulatory law is the requirement to report incompetent or unethical nursing conduct to the State Board of Nursing. It is not a set of rules designed to interfere with conscientious decision making, and it does not suggest that a specific set of values should be accepted by all persons. A nurse may be requested to give evidence in a deposition; this appearance needs to be taken seriously (Scott, 2009). When a nurse administers a medication to a client, the nurse accepts the responsibility that the medication or the nursing actions in administering it, will not harm the client in any way. Negligence or malpractice: Term. * Industry vs. Inferiority (6 to 11yrs) These laws include reporting suspected abuse and neglect such as child abuse, elder abuse, or domestic violence; reporting communicable diseases; ensuring that patients in the community have received required immunizations; and reporting other health-related issues enacted to protect public health. A judge makes the determination of legal competency, and the health care provider and family usually make the determination of decisional capacity. Protocols in these instances list specific actions that health care providers will take when providing cardiopulmonary resuscitation (CPR). The statute stated that a competent individual with a terminal disease could make an oral and written request for medication to end his or her life in a humane and dignified manner. All states have Good Samaritan laws enacted to encourage health care professionals to assist in emergencies (Dachs and Elias, 2008). The statutes assume that all patients will be resuscitated unless there is a written DNR order in the chart. The man’s toes became swollen and discolored, and he developed decreased sensation. Choosing from alternatives. Treating physicians’ or health care providers’ depositions: Before subsequent treating, physicians’ or health care providers’ depositions are taken to establish issues such as those concerning preexisting conditions, causation, the nature and extent of injuries, and permanency. reflects decisions made by administrative bodies such as State Boards of Nursing when they pass rules and regulations. When options are complicated by family needs, hospice will try to work with the client wishes. A tort is a civil wrong made against a person or property. • List sources for standards of care for nurses. For example a new bone marrow transplant procedure may promise a chance at cure. Courts upheld the right to refuse medical treatment in the 1986 Bouvia v Superior Court case. One of the first and most important cases to discuss a nurse’s liability was Darling v Charleston Community Memorial Hospital. * Initiative vs. a) Protocol/Standing orders or routine medication orders: a standing order is carried out until the prescriber cancels it by another order or until a prescribed number of days elapse. He complained to the nursing staff many times. A boyfriend or girlfriend may decide to break off a relationship with you, leading to hurt feelings and genuine grief or pain. * The defendant owed the plaintiff a specific duty (in nursing malpractice cases, the standard of care). The reason for the development of different definitions is to facilitate recovery of organs for transplantation. Understanding the legal implications of nursing practice demands critical reasoning skills to protect the patient’s rights and the nurse from liability. Due process means that nurses must be notified of the charges brought against them and have an opportunity to defend against them in a hearing. School age (9-10): Understand that death in permanent. Also, the coroner can override the family decision over an autopsy. III) The person giving the consent must thoroughly understand the procedure, its risks and benefits, and alternative procedures. 15) What are the legal responsibilities after death? An individual who is at least 18 years of age has the right to make an organ donation (defined as a “donation of all or part of a human body to take effect upon or after death”). Tort is a branch of this civil law which can be further broken down into intentional, unintentional and quasi intentional tort. Defamation of character is the publication of false statements that result in damage to a person’s reputation. Answer: The nurse admits or denies each allegation in the petition. 1) What are intentional and unintentional torts? Give examples. * Development is very predictable. The easiest example of an intentional tort is a punch to the face, which is referred to as "battery." d) Discrepancies in narcotic counts are reported immediately. See also: tort Persons growth and develop throughout their lifespan. With this legal document the patient is able to declare which medical procedures he or she wants or does not want when terminally ill or in a persistent vegetative state. • Describe the nursing implications associated with legal issues that occur in nursing practice. Does this differ from the nurse managers role in preventing quasi-intentional torts? A medication error is any event that could cause or lead to a client receiving inappropriate medication therapy or failing to receive appropriate medication therapy. Also results if the patient gives consent for an action had not Adam. 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