legal & ethical

  1. The study of conduct and character

    Concerned with what is good or valuable
  2. principles of health care ethics are?
    • Autonomy
    • justice
    • fidelity
    • beneficence
    • nonmaleficence
  3. Agreement to do no harm. This principle promotes a effort to consider the potential harm even when it necessary to promote health
  4. refers to taking positive active steps to help someone. (best interest of the client is more important than self-interest)
  5. refers to agreement to keep promises. This promotes your obligation as a nurse to follow thru with the care offered to the patient (can not abandon the patient)
  6. refers to a person’s independence. This represents a respect for the patient’s right to determine a course of action (surgical consents)
  7. refers to fairness. What constitutes fair is not always clear. You will often refer to this principle when discussing issues of health care (organ transplants-scarce resource)
  8. It is a set of ethical principles that all members of the profession generally accept
    code of ethics
  9. A profession’s ethical code states the group’s?
    expectations and standards of behavior
  10. serve as guidelines to assist nurses and other professional groups when conflict arises about correct practice or behavior
  11. advocate for the safety, health and rights of the patient
  12. always a part of nursing code of ethics-now protected under HIPAA
  13. A nurse assumes responsibility and accountability for ?
    all nursing care delivered
  14. ability to answer for one’s own actions. You are accountable to self, the client, the profession, the employing institution and society.
  15. refers to the ability to form an opinion or draw sound conclusions.
  16. refers to the execution of duties associated with a nurses particular role.
  17. The responsible nurse demonstrates characteristics of
    reliability and dependability
  18. the nurse is held responsible for giving a medication?
    safely and responsible
  19. Although your codes will vary with some emphasis they all have the same basic principles of
    responsibility, account, confident, competence, judgment, and advocacy
  20. a personal belief about the worth of a given idea, attitude, custom or object that sets standards that influence your behavior. They vary among people, reflect cultural and social influences, develop and change over time
  21. Some people’s values are so strong that they consider them ?
    facts, not opinion
  22. is useful for increasing awareness of the differences between one’s own values and the values of others, especially client values
    values clarification
  23. when the right thing to do is not clear OR when members of the health care team cannot agree on what the right thing is.
    ethical dilemma
  24. ethical dilemmas almost always occur in the presence of?
    conflicting values
  25. The responsibility for decision making rests with who?
    the client and their family
  26. how do you process an ethical dilemma?
    ethics committee
  27. ethics committee are generally made up of who?
    social workers, clergy, nurses, doctors, resp therapist, and administrators
  28. An ethics committee will serve several purposes such as:
    education, policy recommendation, and case consulting and review.
  29. who can request an ethics review?
    any health care provider or family member
  30. thier are 7 stages to determine if you have an ethical dilemma and take to ethics committee. what stage is this: Is this an ethical dilemma? Scientific data alone cannot resolve the issue
    stage 1
  31. thier are 7 stages to determine if you have an ethical dilemma and take to ethics committee. what stage is this: Gather all information relevant to the case. Complete assessment of the case is critical. An overlooked fact can sometimes solve the problem.
    stage 2
  32. thier are 7 stages to determine if you have an ethical dilemma and take to ethics committee. what stage is this: Examine and determine your values and opinion about the issue. You must distinguish between personal opinion and the facts of the case to proceed.
    stage 3
  33. thier are 7 stages to determine if you have an ethical dilemma and take to ethics committee. what stage is this: State the problem clearly. Develop a statement that all involved in the discussion will understand. This is the groundwork for the negotiations.
    stage 4
  34. thier are 7 stages to determine if you have an ethical dilemma and take to ethics committee. what stage is this: Consider the possible courses of action. Come up with a list of outcomes that can assist the group with their decisions.
    stage 5
  35. thier are 7 stages to determine if you have an ethical dilemma and take to ethics committee. what stage is this: Negotiate the outcome
    stage 6
  36. thier are 7 stages to determine if you have an ethical dilemma and take to ethics committee. what stage is this: Evaluate the action- This is an ongoing process.
    stage 7
  37. Nursing shortage-Difficult working conditions. This affects patient outcomes.
    Managed care-emphasis is on decreasing time patient is in the hospital.
    End of life issues-This is a big one! Remember Terri Schiavo?
    Cultural/Religious sensitivity-Blood transfusions is a big one you will encounter.
    Legal vs. Ethical-Health Care Provider-assisted suicide.
    ethical issues in nursing
  38. give an example of have managed care can cause ethical issues
    more teaching falls on the bedside nurse- what if the patient has not fully mastered a skill but the insurance wont approve more days??
  39. what questions do you need to awnser about end of life issues that cause ethical dilemmas?
    Is this going to increase their quality of life- or just prolong suffering
  40. created by legislative bodies. Example would be the Americans Disability Act.
    statutory law
  41. created by judicial decisions. Example would be informed consent that is now a standard of care.
    common law
  42. prevents harm to society and provides punishment for crimes.
    criminal law
  43. is a serious offense has a penalty of imprisonment for greater than one year or even a sentence of death.
  44. is a less serious crime that has a penalty of a fine or imprisonment for less than one year.
  45. protect individual rights.
    Civil laws
  46. is a civil wrong or injury for which the court provides money damages
  47. would be assault and battery.
    Intentional tort
  48. is the intentional threat to bring about harm or offensive contact
  49. is intentional touching without consent.
  50. The best way to avoid being liable for negligence is to always follow
    • standards of care
    • •Carefully document discharge instructions
    • •Know your hospitals policy and procedures for things
    • •Document head to toe assessment on admission
  51. state law that is the legal guideline for minimally safe and adequate nursing practice. Defined by the State Board of Nursing of each state. These standards were established to protect the public. The nurse is responsible for following the NPA in the state in which they practice.
    nurse practice act
  52. professional organization that develops standards for nursing practice-general and specialties,
  53. accredited agency for hospitals (safety, restraints, infection control, etc)
    The Joint Commission (TJC)
  54. Centers for Disease Control-infection control
  55. Policies and Procedures of your employing agency WILL NOT override the?
    nurse practice act
  56. •Your hospital will have more specific procedures related to things as dressing changes, placing NGT’s etc. These will be what is referred to if you are involved in a law suit- so be sure to be aware of ?
    the institutions policies
  57. protects the rights of the disabled
  58. prevents “patient dumping” Restraints
  59. conduct that falls below the standard of care
  60. professional misconduct or unreasonable lack of skill
  61. Both negligence and malpractice are
    unintentional torts.
  62. med errors or mistakes with a piece equipment or falls can all be considered?
    negligence or malpractice
  63. •Remember the five rights of medications- Where does this leave you if you harm a patient? You didn’t follow the standard of care
    •RN’s are responsible for knowing how to work all equipment that you come in contact with such as CPM, IV poles, kangaroo pumps, pulse ox’s, syringe pump, PCA pump,
  64. Provides for a defense when a nurse is sued.
    It includes the payment of judgment or settlement and attorney fees.
    May be covered by your employer but will not cover you if you are working outside that facility or for volunteer work.
    Make sure you know how much is allowed for attorney fees- you may need to increase the amount.
    Malpractice Insurance
  65. What constitutes malpractice??
    • Duty- you have a duty to provide care expected of a nurse.
    • Breach- the duty or standard of care was not followed. The patient’s attorney must prove that you were negligent.
    • Cause- means that your breach of duty led to the patient being harmed.
    • Harm- consist of actual physical damage and the resulting cost of treatment. This includes the trauma and emotional stress.
  66. •Sources are IV infiltration, pt injury, burns from equipment, not using aseptic technique, giving an incomplete report
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legal & ethical