essentials of nursing leadership & management, 4th edition
TRANSCRIPT
Essentials of Nursing Leadership & Management, 4th EditionEssentials of Nursing Leadership & Management, 4th Edition
CHAPTER 3
NURSING PRACTICE AND THE LAW
Essentials of Nursing Leadership & Management, 4th EditionEssentials of Nursing Leadership & Management, 4th Edition
GENERAL PRINCIPLES
Essentials of Nursing Leadership & Management, 4th EditionEssentials of Nursing Leadership & Management, 4th Edition
Meaning of Law
Statutory law Common law Administrative law
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Sources of Law
The Constitution Statutes Administrative
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Types of Law
Criminal law Civil law
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Criminal Law Criminal acts are considered offenses
against the state Three categories of criminal law
Felony Misdemeanor Juvenile
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Civil Law Usually involve the violation of one
person’s rights against another’s rights Tort Quasi-intentional tort Negligence Malpractice
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Other Laws Relevant to Nursing
Good Samaritan laws Confidentiality Slander and libel False imprisonment Assault and battery
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STANDARDS OF PRACTICE
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Nursing Standards
Established as guidelines for the profession to ensure quality of care
Also used as criteria to determine whether appropriate care has been delivered
Essentials of Nursing Leadership & Management, 4th EditionEssentials of Nursing Leadership & Management, 4th Edition
Types of Standards
Internal standards Organizational standards Accepted state and national standards Nurse Practice Acts Patient Care Partnership
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Internal Standards
Developed by institutions Institutional policies Maintained in policy and procedure
manuals
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Boards of Nursing
Develop the Nurse Practice Acts along with state legislatures
The courts have upheld the authority of the boards of nursing to regulate standards
With the expanded role of nursing, it is important to clarify the distinction between nursing and medicine
Essentials of Nursing Leadership & Management, 4th EditionEssentials of Nursing Leadership & Management, 4th Edition
Uses of Standards in Nursing Negligence or Malpractice
Standards are used as a guide State, local, or national standards Institutional policies that alter or adhere to the
nursing standards of care Expert opinions on appropriate standards of care Available literature substantiating current
standards
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INFORMED CONSENT
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Informed Consent
Without informed consent many medical procedures could be considered battery
Consent to treatment by the client gives the health-care personnel the right to deliver care without fear of prosecution
Essentials of Nursing Leadership & Management, 4th EditionEssentials of Nursing Leadership & Management, 4th Edition
Informed Consent
The physician obtains the consent Gives the client the information States the risks and advantages
The nurse may be involved in the process by gaining signatures on the appropriate forms
Essentials of Nursing Leadership & Management, 4th EditionEssentials of Nursing Leadership & Management, 4th Edition
Helpful Hints A mentally competent adult has voluntarily
given consent The client understands exactly what he or
she is consenting to The consent includes the risks, alternative
treatments, and outcomes The consent is written
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STAYING OUT OF COURT
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Prevention
Keep yourself informed about new information related to your area of practice
Insist that the health-care institution keep personnel informed of all changes in policies and procedures and in the management of new technological advances
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Prevention
Always follow the standards of care or practice for your institution
Delegate tasks and procedures to appropriate personnel
Identify clients at risk for problems such as falls or the development of decubiti
Essentials of Nursing Leadership & Management, 4th EditionEssentials of Nursing Leadership & Management, 4th Edition
Prevention Establish and maintain a safe environment Document precisely and carefully Write detailed incident reports File incident reports with appropriate
personnel and departments Recognize client behaviors that may cause
problems
Essentials of Nursing Leadership & Management, 4th EditionEssentials of Nursing Leadership & Management, 4th Edition
COMMON CAUSES OF NEGLIGENCE
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Common Causes of Negligence
Client falls Equipment injuries Failure to monitor Failure to communicate Medication errors Medical errors
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AVOIDING MEDICATION ERRORS
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Medication Errors Right drug Right dose Right route Right time Right client Right documentation
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APPROPRIATE DOCUMENTATION
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Tips for Credible Documentation
Contemporaneous Accurate Truthful Appropriate
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COMMON ACTIONS LEADING TO MALPRACTICE SUITS
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The 6 Fs Failure to appropriately assess a client Failure to report changes in client status Failure to document in the client record Failure to obtain informed consent Failure to report a coworker’s negligence Failure to provide adequate education
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The 2 Big Bad Ones
Altering or falsifying a record Violation of an internal or external standard
of practice
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If a Problem Arises
When served with a complaint, immediately contact legal counsel
Never sign any documents without legal counsel
Notify your malpractice carrier if covered; notify your institution immediately
Keep all correspondence: written and verbal
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END-OF-LIFE DECISIONS
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End-of-Life Decisions
DNR orders Advance directives The “living will” Durable power of attorney Health-care surrogate
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Mandatory Overtime
Increased demand due to nursing shortages
Physical and mental fatigue Increased physical and emotional stress Decreased concentration
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Licensure
In the United States, granted through the state government via state boards of nursing (NCLEX-RN)
Essentials of Nursing Leadership & Management, 4th EditionEssentials of Nursing Leadership & Management, 4th Edition
Qualifications for Licensure
Graduation from an approved nursing program
English proficiency Disclosure of criminal conviction
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NCLEX-RN Examination
Computerized Adaptive Testing (CAT) Minimum and maximum number of
questions Regulated length of time to complete the
examination
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NCLEX-RN Examination
Based on client needs and the nursing process
Multiple choice and alternative item formats Fill in the blank Drag and drop
Essentials of Nursing Leadership & Management, 4th EditionEssentials of Nursing Leadership & Management, 4th Edition
Preparing for the NCLEX-RN
Review courses Review books Videos DVDs
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Moving?
Endorsement Multistate licensure
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Disciplinary Action State boards of nursing Major Issues:
Falsifying documents Felony Drugs or alcohol Functioning outside the scope of practice Abuse
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Conclusion Nurses need to be aware of the Nurse
Practice Act in their states Nurses need to familiarize themselves with
their institutions’ standards of care Nurses need to understand the most
common causes of negligence Nurses need to document accurately and
appropriately