Hutton lecture
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| Differentiate between responsiblity and accountability. | * Responsibility is a state of obligation to do something w/i one's power or control
* Accountability is a state where one is subject to the obligation to report, explain, or justify some action
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| Differentiate between intentional and unintentional torts. | * Intentional torts require intent to do harm, but harm isn't necessary for liablity
* Unintentional torts require harm, but not intent.
* Intentional torts do not require expert witnesses, b/c there is no standard to compare actions to.
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| List 5 examples of Intentional Torts and 2 examples of Unintentional Torts. | Intentional:
* assault & battery
* defamation of character
* invasion of privacy
* false imprisonment
* fraud
Unintentional:
* Negligence
* Malpractice
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| What is the threat or attempt to make bodily contact with another person without their consent? | Assault
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| What is the willful, angry, violent, or negligent touching of another person's body or anything attached to that person? | Battery
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| Who might be someone to call when faced with an ethical dilemma, such as the absence of an MD, etc. | PCC, ER
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| The making of derogatory remarks about another person, diminishing their character | Slander: defamation of character
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| Written derogatory remarks about another person | Libel: defamation of character
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| Intrusion by a person into the personal affairs of another individual | Invasion of privacy
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| 4 examples of invasion of privacy: | * eavesdropping upon a private conversation
* unauthorized intrusion on childbirth
* taking of photos w/o consent
* displaying x-rays/papers w/ the client's name on them
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| Unjustified detention or prevention of movement of another person w/o proper consent | False imprisonment
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| What type of document can a client sign to relieve health providers from liability when the client is leaving despite the detriment to his/her health? | Against medical advice; absence without authority
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| The willful & purposeful misrepresentation that could cause harm or has caused loss or harm to a person or property | Fraud
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| Performing an act that a reasonable prudent person under similar circumstances would not do: or failing to perform an act that a reasonably prudent person would do under similar circumstances | Negligence
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| A violation of professional duty, a failure to meet standards of care, or a failure to use skills & knowledge of other professionals in the same situation | Malpractice
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| The purpose is to define professional accountability to the public; establishes general & specific guidelines for practice. | Standards of care
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| Who develops standards of care & where might we find these laid out? | * Developed by professional organizations & institution policies
* Found in textbooks: Kozier, Davis, Lewis
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| The main purpose of this is to guarantee minimum standards for licensure & credentialing; defines the legal scope of nursing practice. | Nurse Practice Act
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| What to remember about delegation? | 1. Nurses can delegate tasks, but not the nursing process (assessment, etc)
2. Nurses must monitor the outcome of the delegated tasks for deviations & whatnot
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| What tasks can nurses delegate? | * bathing
* comfort care
* V/S
* sometimes dressing changes (but must look at & assess)
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| Who has the power to decide whether nursing students sit for their board exams? | State Board of Nursing
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| List 4 powers of the State Board of Nursing. | * examine & license
* regulate & define nursing practice
* approve nursing educational programs
* investigate & discipline nurses
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| Who can file a complaint to the State Board of Nursing? | anyone
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| Who is liable for a student nurse's errors? | * student
* instructor
* school of nursing
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| Who must perform as a professional nurse would, up to the point in their experience... and after mastering a skill will be held accountable? | student nurse
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| What statute permits a client to make own health care choices; requires facilities to recognize advance directives, offer to complete an advance directive, & the right to refuse treatment? | The Patient Self-Determination Act
* health care surrogate
* living will
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| Who may be responsible for ensuring the patient has consented to a medical procedure? | the nurse, doctor, health care team
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| When is consent unnecessary? | In emergency situations
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| Reasons for Negligence that may result in malpractice lawsuits: | * improper technique or negligent performance
* untimely management of care/ follow-up of complications
* failure to act as a pt advocate
* failure to use equipment responsibly
* failure to follow standards of care
* failure to communicate
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| Reasons for Negligence that may result in malpractice lawsuits: | * meds administration errors
* failure to assess & continue monitoring
* failure to document
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| 6 elements that must be present for a nursing malpractice case to be proven: | 1. duty: nurse had responsibility for client
2. breach of duty: standard of care was neglected
3. foreseeability: nurse's act must be correlated directly with injury
4. causation: harm occurred as a result of nurse's action
5. harm/injury
6. damages
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| List some legal safeguards: | * stay up to date on knowledge: nursing journals!
* stay w/i legal boundaries
* follow agency policies/procedures
* use evidence-based practice
* evaluate team assignments
* develop good rapport w/ HC team
* be sensitive to client issues
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| List some legal safeguards (part 2): | * avoid double shifts
* complete incident reports on yourself & your colleagues
* malpractice insurance
* Good Samaritan Act
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| This provides a defense for those who provide services in an emergency, but does not protect a nurse from a lawsuit, if harm is caused. | Good Samaritan Act
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| Nurses are/are not required to stop in an emergency situation? Authorized to provide ___ life support. | are not; basic
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| Who is required to stop for an emergency? | paramedics, firefighters, police officers
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| Executing physician orders is a legal responsibility of the Nurse Practice Act unless... | you anticipate injury will occur if the order is carried out.
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| Telephone orders: protocol, things to remember: | * Must have a second RN verify the order
* Must spell out the order
* Must read back the order
* Must remind physician of patient you are speaking of
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| When does a nurse question an order? | * if the order is ambiguous
* if it contradicts normal practice
* if it is contradicted by client's condition
* if client questions the order
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| When questioning a doctor's order, what should you keep in mind/prepare to question? | * Must have sound reason or know enough to question
* Explain why you question the order
* NOTIFY MD
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| 3 expectations during your clinical experience that will minimize liability. | * Conduct a thorough assessment of your pt at the beginning of your shift
* Continue to reassess your pt thru/o shift, esp after med admin or procedures
* follow up w/ findings: communication & documentation are essential
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| When are insulin injections administered? | before breakfast
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| What lab values tell you clearly whether someone is dehydrated or not? | BUN-creatinine ratio
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| Litigation is another word for ____. Who is considered a litigator? | * lawsuit
* participating lawyers in lawsuits
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| The result of a trial: a judge renders a ____, while a jury renders a ____. | decision; verdict
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| Skills and learning commonly possessed by members of a profession: legal guidelines for nursing practice | standards of care
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| External standards of care include: | * nurse practice acts
* professional organizations
* nursing specialty-practice orgs.
* federal orgs. and guidelines
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| Internal standards of care include: | * job description
* education
* expertise
* individual institution's policies & procedures
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| Enduring beliefs or attitudes about the worth of a person, object, idea, or action: guide one's behavior | Values
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| Interpretations or conclusions that people accept as true: based more on faith than fact: may or may not be true | Beliefs
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| Mental positions (emotions) or feelings toward a person, object, or idea (such as acceptance, openness, compassion). | Attitudes
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| The right to self-determination... occurs when the nurse respects patient's rights to make decisions about their own health care. | Autonomy
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| A systematic inquiry into the principles of right & wrong conduct, of virtue & of good & evil as they relate to conduct; expected standards of moral behavior of a group described by group; based on a body of knowledge | Ethics
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| Private, personal standards of what is right & wrong in conduct, character, & attitude; may arouse feelings of guilt, hope, shame; use of "ought", "should", "right", "wrong", "good" or "bad" | Morality
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| What word describes truth telling? | Veracity
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| What word means to treat all people fairly & equally | Justice
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| What word means to be faithful to agreements & promises? | Fidelity
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| What word means to "do no harm"? | Nonmaleficence
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| Who establishes the Nursing Code of Ethics? List 7 Moral Principles found within the code. | * ANA
* Autonomy
* Beneficence (promote good)
* Nonmaleficence
* Veracity
* Justice
* Fidelity
* Value neutrality
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| What are 3 characteristics of a code of ethics? | * shared by members of a group
* reflects members' moral judgment over time
* serves as a standard for their professional actions
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| Which statute promotes autonomy? | Self-Determination Act
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| An ____ expresses and defends the cause of another. | advocate
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| Why is the nurse's responsibility as client advocate important? | * Clients may be too weak to cut thru hospital bureaucracy to get adequate care
* Client may be incompetent & nurse must consider health care surrogate or family's decision-making
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| What is the overall goal of client advocacy? Describe 3 ways of implementing this goal. | * Overall goal: to protect client's rights
* INFORM clients about rights: give info relevant to decision-making
* SUPPORT client's decisions
* MEDIATE b/w client & other health care providers
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| List 6 steps involved in the ethical decision-making process. | * Identify the problem
* Gather data
* Collaborate with HC team
* Discuss options
* Make decision
* Evaluate effectiveness of decision (reassess)
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| What is the main function of an ethics committee? | The main fxn is to provide a safe place to discuss ethical dilemmas b/w providers, patient, & family
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| How does one gain access to the ethics committee? | * Must first speak to nurse manager about situation
* Must request access to speak with the committee
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