Doctrine of Charitable Immunity/Good Samaritan Act-1900s
originally provided immunity from prosecution for hospitals, churches, and schools.
Health care risk management
a systematic approach to the prevention of financial loss, evolved in the 1970's to decrease liability exposures, integrate risk reduction strategies, and create a risk-free environment.
4 primary principles to guide ethical decisions when it come to clients rights-ANA-1985
right to autonomy, right to beneficence, right to veracity, principle of fidelity.
Ethical dilemmas most frequently encountered by nurses on a daily or weekly basis
cost containment, end-of-life care, informed consent, incompetent, unethical, illegal practices of colleagues, access to care.
when the nurse thinks he/she knows what is best for the clients, often imposing their own methods for care and treatment decisions.
Chally/Loriz-1998-6 step ethical decision-making model for nurses when confronted with ethical dilemmas
clarify the ethical dilemma, gather additional data, identify options, make a decision, act/carry out the decision, evaluate the impact
Identify 3 ethical dilemmas the nurse may confront during participation in clinical research
informed consent, documentation of research protocols, client's right to full disclosure
The reason for the Bill of Rights for Registered Nurses-2001
recidivism, right to safe environment, right to advocate freely on behalf of their clients and themselves, right to provide safe ,quality client care
conduct that falls below the standard of care established by law for the protection of others
Factors that contribute to the increased number of malpractice cases against nurses
delegation of duties to UAPs, early DC of clients without proper referral to outpatient care, increased workloads, technology requiring technical skills, increased autonomy and responsibility in advanced nursing skills, better-informed consumers, expanded legal definition of liability
client falls, failure to follow physician's orders, medication errors, improper use of equipment, failure to remove foreign objects, failure to provide sufficient monitoring, failure to communicate
to improve the quality of care provided at healthcare institutions in the US, grant accreditation, hold institutions accountable for ensuring a safe environment
such an event may result in unanticipated death or major loss of function not related to the client's illness or condition such as suicide or rape in the institution
1995- ANA House of Delegates
approved a policy titled "Privacy and Confidentiality Related to Access to Electronic Data"
Failure of duty to warn
Tarasoff decision-1976-Tarasoff v. Regents of UOC, may be emphasized in cases involving sexual abuse and pedophilia
Bill of Rights for Psychiatric-Mental Health Clients
receive treatment, refuse treatment, probable-cause hearing within 3 court days of ADM from involuntary detention if found sane in a court of law (writ of habeas corpus), privacy and confidentiality, communicate freely with others, have personal privileges, maintain civil rights, religious freedom and education, maintain respect, dignity, and personal ID, maintain personal safety and assert grievances, be transferred with continuity of care, access own records, obtain explanation of costs and services, obtain aftercare
1990-Patient Self-Determination Act
gave clients with diagnosis of psychiatric disorders the right to formulate APDs (advanced psychiatric directives)
Voluntary psychiatric hospitalization
have the right to refuse treatment prescribed and may initiate DC at anytime, attending may write AMA (against medical advice)
Involuntary psychiatric hospitalization
client poses threat to himself or others may be admitted and detained for at least 72hrs
After 72hrs, what happens to a client who doesn't sign the voluntary ADM form?
opinions by 2 psychiatrists completed and court hearing set
a minor /anyone under 18, who has not been court-ordered to receive treatment has a right to this at the time of ADM
OBRA of 1987 (Omnibus Reconciliation Act)
state that a long-term care facility must not admit as of 1/1/89 any new residents needing active treatment for mental illness or mental retardation
PASARR/preadmission screening and annual resident review
screening document determining whether client requires active psychiatric treatment(for long-term care facility)
plea asserting that because of mental impairment/mental retardation, defendant couldn't form the specific mental state required for a particular offense-found guilty of lesser offense
Guilty but mentally ill
plea used by individuals who exhibit clinical symptoms of DSM-IV-TR pstchiatric disorders-pyromaniac
specialized area of mental health that involves evaluation of an individual's competency and mental condition at the time of an alleged crime
Role of the forensic nurse
staff nurse in ER or corrections, nurse scientist, nurse investigator, expert witness, independent consulting, nurse specialist, health educator, client advocate, counsrlor
Ethical dilemma for the forensic nurse
because of duty to the legal system and not the client could conflict wit the issue of confidentiality