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Legal implications in nursing


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Created by elected legislative bodies such as state legislatures and the u.s. congress?
Statutory law
Give an example of state statutes?
Nurse practice acts
found in all 50 states.
describes and define the legal boundaries of nursing practice within each state?
Nurse practice acts
Give an example of a federal statute enacted by the us. congress?
Americans with disabilities act (ADA)
Law that protects the ridhts of hankicapped individuals in the work place, in educational institutions, and throughout our society?
ADA: americans with disabilities act
Created by administrative bodies, such as state boards of nursing (pass rules and regulations)?
Regulatory law or administrative law
Give an example of a regulatory law?
The duty to report incompetent or unethical nursing conduct to the state board of nursing
created by judicial decisions made in courts when individual legal cases are decided?
Common law
Give an example of common law?
- informed consent
- clients right to refuse treatment
protects the rights of individual persons within our society and encourage fair and equitable treatment among people?
Civil law
prevent harm to society and provide punishment for crimes?
Criminal law
a crime of serious nature that has a penalty of imprisonment for greater than 1 year or even death?
a less serious crime that has a penalty of a fine or imprisonment for less than 1 year?
give an example of a misdemeanor in health care?
- Nurses misuse of a controlled substance
Legal guidelines for nursing practice?
Standards of Care
Nursing standards of care are defined by?
- Nursing practice acts
- State board of nursing
- federal and state laws regulating hospitals and other health care institutions.
- professional and specialty nursing organizations
- written policies and procedures of employing institutions
What does the nursing practice act establish?
- educational requirements for nurses
-distinguish between nursing and medical practice
- define the scope of practice
Rules and regulations are enacted by?
State board of nursing
Develop standards for nursing practice and policy statements?
American Nurses association(ANA)
Standards describe?
- Scope
- function- role of the nurse in practice
Give an example of standards for a community health nurse?
Requires that accredited hospitals have written nursing policies and procedures?
Name 7 federal statutory laws
- Americans with disabilities act (ADA)
- Emergency Medical treatment and Active Labor Act (EMTALA)
-Mental Health Parity Act (
- Advance Directives:living wills
- Uniform anatomical Gift Act
- Health insurance Portability and Accountability Act(HIPPA)
- Restraints
Law that protects the rights of diables people?
Americans with disabilities act (ADA)
When a client comes to the emergency room or the hospital, an appropriate medical screening must be done within the hospitals capacity, the client may not be discharged or transferred until the condition is stabilized?
EMTALA( emergency medical treatment and active labor act)
When transfering patient to another facility what are 3 things the nurse must be sure of?
- That the receiving facility agreed to the transfer, has space for the client, and has qualified personnell to receive the client
-medical records forward to receiving hospital
- the client must be transported by qualified personnell and transportation equipment
Law that forbids health plans from placing lifetime or annual limits on mental health coverage that are less generous than those palced on medical or surgical?
Mental health parity Act
When a patient is admitted to a psych ward involuntarily what are the Guidelines that take place?
1. petition must be filed with court within 96 hrs of initial detention
2. hearing must be conducted within 2 days of the filing
3. if judge determines the client is a danger to self and others the client can be detained for 21 more days for further treatment
Act that requires health care institutions to provide written information to clients concerning the clients rights under the state law to make decisions including the right to refuse treatment and formulate advance directives?
- PSDA: patient self-determination act
What is required for living wills or durable power of attorney to be enforced?
1. client must be legally incompetent
2. lack decisional capacity to make decisions regarding health care treatment
Legally competency determination is made by a ?
who determines when a patients decisional capacity has been compromised?
Physician and family
written documents that direct treatment in accordance with a client's wishes in the event of a terminal illness or condition?
Living will
designates an agent, surrogate, or proxy to make health care decisions if and when a client is no longer able to make decisions on his or her behalf?
durable power of attorney
Ethical doctrine of autonomy ensures?
ensures the right to refuse treatment
How should DNR order be handled?
1. should be written not given verbally
2. verbal consent requires two witnesses, one must be of a physician affiliated with hospital.
3. written consent requires two adult witnesses
4. if client lacks decisional capacity to give consent, a surrogate may give consent for the client
5. Md must review DNR orders every 3 days for hospitalized clients or every 60 days for clients in residential health facilities.
-ACt that says one must be 18 years of age to make an anatomical gift or organ donation?
Uniform Anatomical gift ACT
Limits the extent to which health plans may impose preexisting condition, and sets privacy standards?
HIPPA(health insurance portability and accountability Act
Restraints may be imposed under two conditions?
1. only to ensure the physical safety of the resident or other residents

2. only on the written order of a physicain, that specifies duration (24 hrs) and circumstances
Most frequent indications for restraints?
1. unanticipated risk of unjury to self(falls) or others
2. interference with treatment
3. clinically disruptive or disturbing behavior
Name 5 state(practice)statutory issues?
2.Good samaritan law
3.Public health laws
4.the uniform determination of death act
5.Physician-assisted suicide
a nurse must be notified of the charges brought against them and that the nurses have an opportunity to defend against the charges in a hearing.
Due process
Limits liability, offers legal immunity for nurses to help at the scene of an accident?
Good samaritan law
Protect public health,
advocates rights of people
regulates health care and health care financing
ensures professional accountability for the care provided
Public health laws
Nurses role regarding public health laws? suspected abuse and neglect (child/elderly)
2. report communicable disease
3. ensure that required immunizations have been received
Provides that either the cardiopulmonary definition or the whole brain definition may be use to determine death
The uniform determination of death Act
What is the reason for the development of different definitions?
for the recovery of organs for transplantation.
-event though the client may be legally brain dead the client's organs may be healthy for donation to other clients
A civil wrong made against a person or property?may be intentional or unintentional
negligence or malpractice(by RN or MD)
willful acts that vilates another's rights?
Name 4 intentional torts?
1. assault
2. battery
3. invasion of privacy
4. defamation of character
Malice: false info
slander: verbal
libel: written
Name 2 unintentional torts?
1. Negligence/malpractice
2. Consent
Name some forms of negligence?
1.failing to check pt arm band and giving meds to wrong pt.
2.IV errors, results in infiltrates or phlebitis
3. burns to pts caused by equip, bath , spills
4. falls
5. failure to use aseptic tech
6. error in sponge, instrument or neelde counts
7. failure to give report or give incomplete report to oncoming shift
8. failure to adequately monitor a pts condition
9. failure to notify physician or a significant change in pts status
Name guidelines for legal consent in an Adult?
1. any competent person 18 or older
2. any parent for his/her unemancipated minor
3. any guardian for his/her ward
4. any adult for tx of his/her minor brother/sister
5. any grandparents for a minor grandchild
Name guidelines for legal consent in an minor?
A. for his/her child and any child in his or her legal custody
For himself or herself in the following situations:
1. lawfully married or a parent (emancipated)
2.pregancy(exclu abortion
3. venereal disease
4. drug or substance abuse
Unemancipated minors may not consent to abortions without following which guidelines?
1. consent of one parent
2. self-consent being granted by court order
3. consent specifically given by a court
Who is held responsible when a student nurse harms a client or lacks of action?
1. student
2. instructor
3. hospital
4. university or educational institution

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