What is the primary purpose of the Nurse Practice Act?
Who governs or regulates this act?
- Protect the patient and nurse by defining the scope of practice and protect individual rights through statutes (laws that govern or regulate).
- The state board of nursing regulates by writing rules and conducting investigations.
This term is meant to setup practice information, advisories, and guidelines provided by the BRN to ensure ongoing communication of competency standards.
General Practice Acts: talks about abndonment of patients if communication and hand off is poor.
What are the two types of Statutory Law and their subtypes?
- Criminal Law: felony and misdemeanor
- Civil Law: Intentional and Untintentional Torts
Explain types of criminal criminal vs. civil case
Burden of proof?
- Criminal: when a nurse faces charges for crimes committed against an individual or society
- examples: murder, rape, theft, etc.
- Burden proof: beyond a reasonable doubt
- Civil Case: one individual sues another for money
- - Burden of proof: judge or jury must believe that it was more likely than not that the accused individual was responsible for the injuries of the complaint.
What is an administrative case?
When a nurse violates the state nurse practice act, the BRN may revoke license or other discipline.
What is a tort?
- legal wrong committed against a person or property
- Unintentional: professional negligence, conduct that falls below standard of care.
Describe assault, simple assault, and battery
What kind of tort are they described as?
- Assault: threatening
- Simple assault: threat with no physical contact
- Battery: intentional and wrongful physical contact
Part of intentional tort
List other examples of intentional torts
- False imprisonment
- Invasion of privacy
- Defamation: communication to a third part with false info
- Slander: defamation that is spoken
- Negligence: omission to do something that a reasonable would do--or as doing something that a reasonable person would not do.
- Malpractice: failure of a person with PROFESSIONAL training to act in a reasonable and produent manner.
What are the 5 elements of malpractice?
- 1. Standard of care (not established)
- 2. Breach of duty (standard of care violated)
- 3. Foreseeability of Harm
- 4. Failure to meet standard of care Must have the potential to injure the patient
- 5. An actual patient injury must have occured
How can you avoid foreseable harm on a patient in a malpractice case?
- Anticipating risk of patient injury.
- Ignorance is not an excuse, but lack of info may have a negative effect on the ability to foresee harm.
What are the 5 ways to avoid malpractice claims?
- Practice within scope
- Observe policies and procedures
- Practice within the area of individual competence
- Always put patient rights and welfare first
How can a malpractice case be won by a plaintiff?
When it is determined by a jury/judge that standard of care was not met.
What is vicarious liability?
When an employer is held responsible for the nurses' act
The nurse is liable for his or her own conduct, or negligence, through this type of liability
Match: This type of liability is when the employer is liable when the employee makes an error, through follow ups with incident reports and that corrective action was taken
This type of liability has to do with adequate hiring, supervising, respondeat superior, and maintaining safe workplace
When can an incident report lose its confidentiality?
If it is inadvertently disclosed to patient, OR subpeonaed in court.
T or F: when creating an incident report, it should be documented with the chart of the patient through their EMR and EHR.
False: no entry should be documented in the chart that there is any existence of an incident report.
What must the nurse do when looking at a physician's orders?
- Assess order to see if they are in client's best interest
- Because nurse is held liable if it is not safe for the patient and they did not refuse to carry out this order
What is patient self-determinaction act?
- Patient's right to refuse care
- Provide education for staff and pts on issues concerning treatment and end of life issues
T or F: the good samaritan laws covers nurses who are not paid, like at a volunteer clinic or summer camp, and performs emergency services.
Living will vs. POLST
- Living will: not pertaining to a CPR event, but delegating treatment and how they want to be handled if they become comatose
- POLST: The purpose of this policy is to define a process for skilled nursing facilities to follow when a resident is admitted with a Physician Orders for Life Sustaining Treatment
This act requires EDs to provide appropriate medical screening to anyone seeking treatment for a medical condition (regardless of citizenship, legal status, etc.).
Emergency Medical Treatment and Active Labor Act
What are the 4 patient rights? (pt. bill of rights)
- Invasion of privacy
- Informed consent
- Right to refuse treatment
When can another person, spouse or other family member, sign for the patient?
- Spouses or other family members cannot sign unless:
- 1. there is an approved guardianship
- 2. approved conservatorship
- 3. they hold a durable power of attorney
- 4. Or if patient is a minor, parent or guardian must give consent
With a minor, when can informed consent be provided if parents or guardians aren't available?
- In an emergency, sometimes two physicians can invoked implied consent
- Nurses acts as a patient advocate
This discrimination law requires an annual or lifetime dollar limit on mental health benefit to be no lower than any such dollar limit for other group health plans.
Mental Health Parity Act
Who do you wanna notify if you get subpoenaed?
Can a patient refuse a feeding tube, if they are not eating, but remain competent?