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TL - Legal
Legal Aspects of Nursing HESI
| Question | Answer |
|---|---|
| What provides the laws that govern the practice of nursing in every state? | Nurse Practice Acts |
| What are the rules according to Nurse Practice acts regarding assigning responsibilities? | Responsibility is commensurate with the person’s education/training/ability/experience. Supervise assigned responsibilities. RNs do sterile or invasive techniques or supervise them. |
| Act involving the injury or damage to another (other than breach of contract) for which you can be sued (Civil liability rather than breaking a law). | Tort |
| What kind of torts are there? | unintentional and intentional |
| How are unintentional torts categorized? | negligence, malpractice |
| That’s not the way a reasonable and prudent nurse would do it. | Negligence – reasonableness is the measuring rod |
| Professional misconduct or unreasonable lack of skill | Malpractice |
| What are the four elements that are necessary to prove negligence or malpractice? | Duty, Breach of Duty, Injury or Damage, Causation - Basically, it was your job; you blew it; the patient was hurt; and it was your fault. |
| What role do hospital policies play in determining negligence or malpractice on the part of a nurse? | Generally, courts rule against nurses who violate hospital policies. |
| An act involving injury or damage to another (except breach of contract) resulting in civil liability, (the victim can sue) instead of criminal liability | Tort |
| Define tort. | an act that causes damage or injury to another, that gives that individual the right to sue you (civil liability) but it is not a crime |
| Negligence by a professional person | Malpractice |
| Professional misconduct or lack of skill in carrying out professional responsibilities | Malpractice |
| Define malpractice | A professional person is negligent, professional misconduct, lack of skill in carrying out professional responsibilities |
| What roles do hospital policies play in negligence and malpractice? | They are designed to protect against liability. If the nurse adheres to policy it is unlikely that the court will hold her responsible. Hospitals can be held liable for poorly formulated or implemented policies. |
| What roles do incidence reports play in cases of negligence and malpractice? | They alert the administration to possible liability cases and need for investigation. They do not protect the nurse against being sued. |
| What kind of torts are there? | intentional and unintentional |
| What are unintentional torts? | negligence and malpractice |
| What four elements must exist to prove negligence or malpractice? | Duty, breach of duty, damage or injury, causation |
| What kind of Torts are assault and battery? | Intentional |
| Define assault | mental or physical THREAT (without touching) |
| Define Battery | Touching without consent (with or without intent to cause harm) |
| Encroachment or trespassing on another’s body or personality | Invasion of privacy |
| Define invasion of privacy | encroachment or trespassing on another’s body or personality |
| What is it called if treatment is physically forced on a mentally competent adult? | battery |
| Confinement without authorization | false imprisonment |
| Define defamation | divulgence of privileged information/communication |
| Willful and purposeful misrepresentation | Fraud |
| What is it called if the nurse tells a client a placebo will provide therapeutic effects? | fraud |
| An act contrary to a criminal statute, punishable by the state, committed against the state, usually with intent | Crime |
| Name 8 ways to commit or be involved in a crime. | break a law; omit action w legal obligation to act; conspire with someone else to commit crime; help someone else commit a crime; ignore law; using more force than required for self-defense; searching property w/o a warrant; fail to report child abuse |
| Define voluntary admission. | client admits himself to an institution for treatment and retains civil rights |
| Define involuntary admission. | Someone other than the client applies for the client to be admitted to an institution |
| What are the time frames, included rights, and requirements for involuntary admission? | certification by HCP that client is danger to self or others; right to legal hearing within a certain number of hours; commitment limited to 90 days; extended commitment usually not beyond 1 year |
| How does emergency admission work? What rights does the client have? What is the role of the court? | Any adult may apply for emergency detention of another, but judicial approval is required to hold a person >24 hrs. Client can file habeas corpus. The court determines the sanity and alleged unlawful restraint of the person. |
| Name some legal and civil rights the hospitalized client retains. | right to own clothes, personal items, and small amounts of cash and a place to store them; to see visitors daily; to use the phone in privacy; to receive/send unopened mail; refuse shock/lobotomy |
| What is determined at a competency hearing? | a person’s ability to make responsible decisions about self, dependents, or property |
| Name five things that a person deemed incompetent cannot do. | vote, make contracts or wills, drive a car, sue or be sued, hold a professional license |
| Since the client deemed incompetent has the legal status of a minor what does the court do? | appoints a guardian |
| Who can initiate a competency hearing? | the state or the family |
| Define insanity when used as a legal term. | an accused person is not criminally responsible for an unlawful act because they are mentally ill |
| What does it mean when a person is incompetent to stand trial? What happens then? | A person cannot understand the charges against them. They are sent to a psychiatric unit until they are determined to be competent. Then they stand trail and serve sentence if convicted. |
| Who is responsible for explaining a surgical procedure to a client? | The person doing the surgery. The nurse makes sure the operative permit is signed, but if the client is unclear about the procedure the responsibility for explanation lies with the surgeon. |
| What are the rules regarding patient identifiers for the administration of medications, taking blood, or giving blood products? | Use at least two identifiers. Do not use the patient room number as an identifier. |
| What is required prior to any surgical procedure no matter how minor? | surgical permit/consent |
| What are the legal requirements of a surgical permit? | Written/witnessed, voluntary, informed |
| Define informed consent. | the operation has been fully explained to the client including possible complications/disfigurements, removal of organs/parts of the body, alternative treatments |
| Who can give consent for an operation? | mentally competent adults and emancipated minors; permission to operate on a minor child or incompetent/unconscious adult must be obtained from a responsible family member or guardian |
| Explain how consent works for medical (non-surgical) treatment. | does not require written consent; okay if client has been fully informed and voluntarily consents; If emergency treatment is needed to save life or limb and patient is not able to provide informed consent (unconscious) emergency law allows treatment |
| When verbal consent is obtained for medical treatment what documentation is necessary? | An explanation of how and why verbal consent was obtained, witnessed and signed by two persons, and placed in the client’s record or chart |
| Who can give written or verbal consent for medical treatment? | alert, coherent, competent adults; parents or legal guardians; a person in loco parentis |
| What rules apply to minors in regards to consent for medical treatment? | minors > 14yrs must agree to treatment along with parents/guardians; Emancipated minors can agree to treatment themselves |
| Explain the purpose of the “Good Samaritan” act and the associated nursing responsibility. | Protects health practitioners against malpractice claims for care provided in emergency situations. The nurse is required to perform in a “reasonable and prudent” manner |
| What does the nurse require in order to carry out a medical procedure for a client? | A prescription or order from a health care provider or physician |
| Although telephone orders are not encouraged, what process is required by the Joint Commission in order to promote accuracy if an order is given by telephone? | Read-back of critical values; write the verbal order or critical value on the chart or record in the computer then read it back to the health care provider |
| What is the nurse’s responsibility if the nurse believes that a health care provider’s prescription is wrong? | inform the HCP; record that the HCP was informed and their response; inform the nursing supervisor; refuse to carry out the prescription |
| What is the nurse’s responsibility if the nurse believes the HCP prescription was made in poor judgment? | Record that the HCP was informed that the order was questioned; carry out the order |
| Why does the nurse carry out the order even though the nurse questions the HCP judgment? | nursing judgment cannot be substituted for HCP or physicians judgment |
| What is the nurse’s responsibility when asked to carry out an order for which the nurse lacks training or experience? | Inform the HCP/physician; refuse to carry out the order |
| Who is liable if the nurse carries out an order for which the nurse lacks appropriate training/experience? | If the HCP/physician is not informed the nurse bears sole responsibility; if the HCP/physician is informed the HCP/physician and the nurse are liable |
| What must the nurse do if the amount of drug given to a client requires adjustment? | Check with the physician/obtain an order for the new amount |
| Who can be assigned to do a sterile dressing change? | a licensed nurse such as an RN or LPN |
| What circumstances justify restraint of a client? | emergency, limited time only, for the purpose of protecting the client |
| What are the nursing responsibilities in regards to restraints? | notify HCP immediately of restraint, document facts/rationale, exhaust all reasonable alternatives first, apply restraints correctly, check for impaired circulation and other injuries frequently, remove ASAP, Document reason, monitoring, and removal |
| What is unlawful use of restraint called? | false imprisonment |
| What is the purpose of HIPPA? | to protect the privacy of patient records |
| What kinds of organizations do HIPPA laws pertain to? | HCPs, health plans, health clearing houses and business partners who in engage in computer transmitted health care claims, payment/remittance, benefit or eligibility information, or who disclose personal health information with patient identifiers |
| Explain patient rights in regards to their records. | Patient information cannot be released w/o written patient approval; HCPs must explain how information will be used; Patients must have access to their records, receive copies, and request changes to inaccuracies |
| What happens if HCPs make unauthorized disclosure of patient information? | civil penalties can be assessed as high as 25000 dollars/year; criminal penalties at $50,000 and 1 year prison to $250, 000 and 10 years prison |
Created by:
Perseverandovercome
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