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Chapter7:Legal Issue

Professional Nursing

Definition of Law: Standard or rule of conduct established and enforced by government. Designed to protect the rights of the public.
Litigation: process of bringing and trying a lawsuit
Plaintiff: person bringing suit
Defendant: person being accused of a crime. Presumed innocent until proven guilty.
Public Law: government is directly involved. Regulates relationships between individuals and government. Public law affects society as a whole and is mostly made up of the laws passed by Congress.
Private Law: Civil law. Private laws are enforced by citizens only. Regulates relationships among people. The government does not involve itself in enforcing private laws.
Criminal Law: law—concerns state and federal criminal statutes. Defines criminal actions (e.g., murder, theft)
Constitution Law: serve as guides to legislative bodies. Things like right to privacy, who gets to vote. Found in the US constitution or amendments
Statutory Law: enacted by a legislative body. Laws “on the books” No texting while driving
Administrative Law: empowered by executive officers. Regulates state agencies, Taxes, EPA
Common Law: judiciary system reconciles controversies, creates body of common law. Common law looks at previous cases and develops laws based on precedents
A body of law known as common law: has evolved from accumulated judiciary decisions. Most law involving malpractice is common law.
Nurse Practice Acts: Nurse Practice regulations that guide nursing education and proactive. The mission of the Massachusetts Board of Registration in Nursing is to protect the health, safety and welfare of the citizens...cont
Nurse Practice Acts cont': of the Commonwealth through the fair and consistent application of the statutes and regulations governing nursing practice and nursing education.
Standards: The American Nurses Association developed standards of care that guide nursing practice. The LAW REQUIRES NURSES PRACTICE SAFE / COMPETENT CARE at THE LEVEL OF CARE THAT WOULD BE RENDERED BY A COMPARABLE NURSE IN A SIMILAR CIRCUMSTANCE.
Standards cont': The Reasonable and prudent nurse. YOU ARE RESPONSIBLE FOR KNOWING / PROVIDING STANDARD OF CARE
Accreditation: Schools of nursing are accredited by nursing education organizations. Regis is accredited by NLNAC.
Licensure: Only graduates of accredited schools may sit for licensure.
Certification: Certification goes beyond licensure and usually is in a specialty area.
The state nurse practice act: is the most important law affecting nursing practice. Each nurse practice act protects the public by broadly defining the legal scope of nursing practice.
Reasons for Licensure Suspension: Drug or alcohol abuse Fraud, deceptive practice Criminal acts, previous disciplinary actions Gross or ordinary negligence Physical or mental impairments including age
Major causes of litigation: For Staff Nurses Medication errors Delegation Failure to warn Product liability Protective/Reporting laws Informed consent Privacy & Confidentiality
Major causes of litigation: For Nurse Managers Delegation Duty to orient, educate and evaluate Failure to warn Staffing Issues Product liability Protective/Reporting laws Informed consent Privacy & Confidentiality Policies and Procedures Employment laws
Professional Liability Insurance: nurses are advised to carry their own insurance. Liability insurance coverage usually defrays all costs of defending a nurse, including the cost of retaining an attorney.
Professional Liability Insurance: cont' Nursing faculty/nursing students are also vulnerable to lawsuits. Insurance can be obtained through ANA, the National Student Nurse’s Association, and through private insurance companies.
CRIME: wrong against a person or his or her property as well as the public.
Misdemeanor: punishable by fines or less than 1 year imprisonment.
Felony: punishable by imprisonment for more than 1 year.
TORT: a wrong committed by a person against another person or his or her property; tried in civil court. (Intentional or Unintentional)
Example: (tort) a nurse falsely imprisons a patient by an unauthorized use of restraints. False imprisonment is an intentional tort.
Intentional Torts: Assault and battery Defamation of character Invasion of privacy False imprisonment Fraud
Unintentional Torts: Negligence Malpractice
4 Elements of Liability: 1.Duty 2.Breach of Duty 3.Causation 4.Damages
Duty: responsibility to provide safe, competent care. accurate assessments, alert responsible professionals to change in status/condition, competent execution of safety measures.
Breach of Duty: the failure to execute and document use of safety measures. (i.e. confused patient), failure to execute and document safety measures (i.e. bedrails, assisted in ambulation, restraints).
Causation: Failure to use appropriate safety measures, causing the patient to fall while attempting to get out of bed and broke a hip.
Damages: Fractured hip, pain and suffering, lengthened stay, need for rehab.
A nurse fails to raise the bedside rails for an elderly, confused patient who then falls and fractures his wrist trying to go to the bathroom alone: Example of Causation - is the failure to use appropriate safety measures that results in injury to a person.
Negligence: Failure of a person to exercise the degree of care that an ordinary prudent person would exercise in similar circumstances to prevent injury to another person or property.
Malpractice: (a form of negligence) By a professional with a license. When a professional does not have or does not use the skills and knowledge commonly possessed by other members of the profession and thereby causes harm to the patient.
Standard of Care: (internal) nurse’s job description education expertise individual institutional policies & procedures
Standard of Care: (external) Nurse Practice Acts Professional Organizations (ANA) Nursing specialty-practice organizations (Emergency Nurses Association) Federal organizations & federal guidelines (Joint Commission, Medicare)
Legal Safeguards for Nurses: Informed consent Contracts Collective bargaining Competent practice Patient education Executing physician orders Documentation Whistle-blowing Adequate staffing
Legal Safeguards for Nurses: cont' Professional liability insurance Risk management programs Incident reports Joint Commission sentinel events Never events Patient bill of rights Good Samaritan Laws
Elements of Informed Consent: Disclosure, Comprehension, Competence, Voluntariness
Disclosure: patient/surrogate has been informed of the nature of the procedure, risks and benefits, alternatives and fact that no outcome is guaranteed.
Comprehension: patient/surrogate can correctly repeat in his own words that for which they are giving consent.
Competence: patient understands information needed to make this decision, is able to reason in accord with relatively consistent set of values, and can communicate a preference.
Voluntariness: patient is voluntarily consenting or refusing.
In all healthcare agencies: informed and voluntary consent is needed for admission, for specialized diagnostic procedures or medical surgical treatment, and for any experimental treatments or procedures.
Good Samaritan Law: Protect health practitioners when they give aid to people in emergency situations. Example: you come upon an accident and give emergency care without fear of legal suit, unless grossly negligent.
Created by: mr209368