Legal Implications in Nursing Practice
Terms
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- Regulatory or Administrative Law
- Decisions made by administrative bodies such as State Boards of Nursing when they pass rules and regulations. I.e.- The duty to report incompetent or unethical nursing conduct to the State Board of Nursing.
- Assault
- Any intentional threat to bring about harmful or offensive contact. No contact is nescessary. Includes threats and the act of threatening a client to give consent.
- Malpractice
- Criteria: (1) the nurse owed a duty to the client (2) the nurse did not carry out that duty, (3) the client was injured, (4) the nurse's failure to carry out the duty caused injury.
- National Organ Transplant Act of 1984
- Prophibits the purchase or sale of organs.
- Felony
- A crime of a serious nature that has a penalty of imprisonment for greater than 1 year or even death.
- Incident Report or Occurence Report
- Provides a database for further investigation in an attempt to determine deviations from standards of care and corrective meausres needed to prevent it from happening again. This report is seperate from medical reports. Never document in the client's medical record that an occurrence report was completed.
- Spires vs Hospital Corporation of American
- A wife claimed there was poor client care related to insufficient RN staffing as a result her husband died. If a nurse is assigned to care for more clients than reasonable they need to tell the supervisor and make a wirrten protest to the nursing administrators.
- Ch. 23 Legal Implications in Nursing Practice
- Standards of care
- The Uniform Determination of Death Act
- States that health care providers can use either cardiopulmonary definition or the whole-brain definition to determine death.
- Bouvia vs Superior Court
- Client has the right to refuse medical treatment. This case allowed the discontinuation of the clien't feeding tube.
- Required Request Laws
- Most states have laws which mandate thst at the time of admission to a hospital, a qualified health care provider has to ask each client over age 18 whether the client is an organ or tissue donor.
- Americans With Disabilities Act (ADA)
- The statute protects the rights of handicapped individuals in the workplace, in educational institutions, and throughout our society.
- Health Insurance Portability and Accountability Act of 1996 (HIPPA)
- Law provides rights to clients and protects employees. It protects individuals from losing their health insurance when changing jobs by providing portability.
- Unifrom Anatomical Gift Act
- An individual who is at least 18 years of age has the right to make an organ donation. Donors need to make the gift in writing with their signature.
- Confidentiality
- How health care providers treat client private information once it has been disclosed to others.A sacred trust. HIPPA requires nurses to avoid discussing clients in public hallways.
- DNR Order "do not resuscitate"
- Developed in 1976 and was the frist order to withhold treatment instead of deliver treatment. It should be written. If a client does not have a DNR order the health care provider needs to make every effort to revive the client.
- Mental Health Parity Act
- A statute that forbids health plans from placing lifetime or annual limits on mental health coverage that are less generous than those placed on medical or surgical benefits.
- Darling vs Charleston Community Memorial Hospital
- An 18yr old with a fractured leg had a leg amputation because of negligence. The nursing staff was held liable for failing to adhere to the standards of care. Part of standard of care now a nurse must go over a physician's or health care provider's head to make sure that a client is appropriately treated,
- Misdemeanor
- Is less serious crime that has a penalty of a fine or imprisonment for less than 1 year.
- Roe vs Wade
- the U.S. supreme Court ruled that there is a fundamental right ro privacy, which includes a woman's decision to have an abortion. Up until the third trimester the state allows abortion.
- Common Laws
- Result from judicial decisions made in courts when individual legal cases are decided. I.e- Informed consent and the client's right to refuse treatment. The nurse most frequently encounters common laws involving negligence and malpractice.
- Slander
- One verbalizes the false statment.
- Civil Laws
- Protect the rights of individual persons within out society and encourage fair and equitable treatment.
- Invasion of Privacy
- There are four types of this tort: intrusion on seclusion, appropriation of name or likeness, publication of private embarrassing facts, and publicity placing one in a false light in the public's eye.
- Center for Medicare and Medicaid Services
- State that clients have the right to be free from restraints.
- Public Health Laws
- Protection of the public's health, advocating for the rights of people, regulating health care and health care financing, and ensuring professional accountability for the health care provided. Laws include reporting suspected abuse and neglect, such as child abuse or domestice violence, reporting communicable diseases, and ensuring clients have received required immunizations.
- Emergency Medical Treatment and Actice Labor Act
- This Act provides that when a client comes to the emergency departnment or the hospital, an appropraite medical screening occurs within the hospital's capacity. If there is an emergency condition it must be stabilized before transfor.
- Federal Nursing Home Reform Act (1987)
- Gave residents in certified nursing homes the right to be free of unnecessary and inappropriate restraints.
- Risk Management
- A system of ensuring appropriate nursing care that attempts to identify potential hazzards and eliminates them before they occur. The steps involved include identifying possible risks, analyzing them, acting to reduce risks, and evaluating the steps taken.
- Libel
- The written defmation of character.
- Battery
- Any intentional touching without consent. A battery always includes an assualt such as a nurse threatening to give a client an injection, if the client actually gives an injection it is battery.
- Statutory Law
- State legislatures and the U.S congress create Statutory laws. They can be civil or criminal. I.e.-The Nurse Practice Acts and the federal statue the ANA.
- Durable Power of Attorney for Health Care (DPAHC)
- A legal document that designates as person or persons of one's choosing to make health care decisions when the client is no longer able to make decisions on his or her behalf.
- The Patient Self-Determination ACT (PSDA)
- Requires health care institutions to provide written information to clients concerning the client's rights under state law to make decisions, including the right to refuse treatment and formulate advance directives.
- United Network for Organ Sharing (UNOS)
- Has a contract with the federal government and sets policies and guidelines for procurement of organs.
- Informed Consent
- A person's agreement to allow something to happen, such as surgery or an invasive diagnostic procedure, based on a full disclosure of risks, benefits, alternatives, and consequences of refusal. Failure to claim a consent results in battery.
- CPR "cardiopulmonary resuscitation"
- An emergency treatment provided without client consent. Health care providers perform CPR unless there is a DNR order in the client's chart.
- The Oregon Death with Dignity Act
- First satute that permitted ohysicians or health care provider-assisted suicide. ANA states this act "violates the code of nurses".
- Privacy
- The right of clients to keep information about themselves from being disclosed.
- Standards of Care
- The legal guidelines for nursing practice and provide the minimum acceptable nursing care.
- Advance Directives
- 1. Living Wills 2. Durable powers of attorney for health care. Both are based on values of informed consent.
- Negligence
- Conduct that falls below a standard of care.
- False Imprisonment
- It is the tort of unjustified restraining of a person without legal warrants.
- Malice
- The person publishing the info. knows it is false and publishes it anyways with reckless disregard as to the truth.
- Criminal Laws
- Prevent harm to society and provide punishment for crimes.
- Tort
- A civil wrong made against a person or property
- Involuntary Admission to A psychiatric Unit
- Occurs when an individual files with the court within 96 hours of the client's initial detention. The judge determines the client is a danger to self or others and grants involuntary detentionand the client can be detained for 21 more days.
- The Join Commission Guidelines for Restraints
- (1) only to ensure the physical saftey of the resident or other residents, (2) when less restrictive interventions are not successful, and (3) only on the written order of a physician or health care provider.
- The Nurse Practice Acts
- Describe and define the legal boundries of nursing practice within each state. I.e. Americans with Disability Act
- Defamation of Character
- publication of flase statements that result in damage to a person's reputation. The statements must be published with malice.
- Bragdon vs Abbott
- Even asymptomatic HIV constitutes a disability within the meaning of the ADA. ADA protects an HIV-positive individual who doesn not have acquired immunodeficiency syndrome (AIDS).
- Living Wills
- Represent written documents that direct treatment in accordance with a client's wishes in the event of a terminal illness or condition. The client is able to declare what medicall treatment he wants or doesn't.
- American Nurses Association
- Developed standards for nursing practice. They are developed for every state by the Nurse Practice Act