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the act of killing someone painlessly (especially someone suffering from an incurable illness)
Failure to meet the appropriate standard of care for avoiding unreasonable risk of harm to others.
A civil, not criminal, wrong. A negligent or intentional injury against a person or property, The injury can be physical, emotional, or financial.
Legal Issues of Nursing Practice
In the course of your activities both as a student and later as a licensed nurse, you are held responsible for maintaining established standards of nursing care.
falsification of medical records, insurance fraud, theft of narcotics, or practicing without a license.
Liability (an "act of comission")
A nurse may be liable if a client receives the wrong medication and is harmed (an "act of commission"). participation in an illegal abortion, participation in euthanasia ("mercy killing"), and practicing nursing without a license or beyond the legal limits of your nursing practice.
Liability (an "act of omission")
A nurse also may be liable if a client did not receive a prescribed medication and was harmed (an "act of omission")failure to perform a prescribed treatment, failing to report child or elder abuse, and failure to report a specified communicable disease or an animal bite.
A tort involves a breach of dutythat one person owes another
the duty of a nurse to care for a client.
intentional torts include
assault, battery, false imprisonment, invasion of privacy, and defamation.
Performing nursing procedures that have not been taught Failing to follow standard protocols as defined by the facility's policy and procedure manuals Failing to report defective or malfunctioning equipment Failing to meet established standards of safe care for clients Failing to prevent injury to clients, other employees, and visitors Failing to question a physician's order that seems incorrect
Malpractice is the improper, injurious, or faulty treatment of a client that results in illness or injury.
A nurse commits malpractice when his or her conduct deviates from the normal or expected standard of behavior
written agency policies and procedures, documented standards of care
Standards of practice are defined by the state's Nurse Practice Act
Assault is a threat or an attempt to do bodily harm
Telling the client that you are going to restrain him in bed if he tries to get out of bed without assistance is an assault.
Battery is physical contact with another person without that person's consent.
touching of a person's body, clothing, chair, or bed. A charge of battery can be made even if the contact did not cause physical harm. Giving an injection that the client refuses is battery
Informed consent (proctetion from the charge of battery)
Prior to any special test, procedure, or surgery, clients sign another consent.
Nursing Alert (witness)
The nursing student never serves as a witness to any legal papers or documents.Students do not obtain consent or witness consent forms.
means that tests, treatments, and medications have been explained to the person, as well as outcomes, possible complications, and alternative procedures.
Informed consent (emergency)
if an unconscious client is admitted to an emergency room and needs immediate surgical intervention before family can be located, some facilities allow for two physicians to sign an emergency consent.In some cases, a court order to administer treatment is obtained.
if the client is mentally ill, intoxicated, or endangering the safety of self or othersin this type of circumstance relies heavily on thorough documentation.
By law, a person cannot be restrained against his or her will unless the person has been convicted of a crime or a court order exists permitting restraint.
is the term given to malicious verbal statements that are false or injurious."That nurse is lazy," "The supervisor doesn't know what she is doing,"
Abandonment of care is a legal
professional has prematurely stopped caring for a client.f a home care client has an infection or stops taking medications, you may be found liable if you fail to report this information in a timely manner.
Invasion of privacy and confidentiality
Student nurses are often assigned research projects that contain a client's medical history and personal information. Rather than using client names or initials, it is more prudent to use code numbers.
(HIPAA) Health Insurance Portability and Accountability Act
. This legislation set national standards for the protection of health information for health plans, healthcare clearinghouses, and healthcare providers who conduct
Nurse Practice Act is written to include both registered and practical nurses.
Only individuals who are regulated by Nurse Practice Acts can legally be called nurses
today are written by the National Council of State Boards of Nursing.A facility cannot allow a nurse to practice without a license or beyond the legal definitions of practice of that state.
Key Concept (registered nursing)
Always practice within the limits of practical or registered nursing as you were taught. Use good common sense and judgment. Ask if you are unsure. Report any errors immediately. * Report any defective equipment immediately.
Cause for Revoking or Suspending a License
drug or alcohol abuse, fraud, deceptive practices, criminal acts, previous disciplinary action, and gross or ordinary negligence.
If you do not document a treatment or medication, legally the measure is considered not to have been donefor performing an illegal or negligent act
Do Not Give Legal Advice to Clients
Never attempt to advise a client on legal rights or financial matters.
Do Not Help a Client Prepare a Will
Never attempt to help a client prepare a will or any other legal document.
Nursing Alert (treatment)
Competent adults must speak for themselves. Another person cannot decide to withhold treatment, as long as the client is able to make decisions. If the client cannot talk, other means of communication may be used.
Key Concept (If no documents)
If no documented evidence exists to the contrary, the healthcare team uses all means available to keep a person alive. Without a living will or other advance directive
Three major types of advance directives exist
Living will Directives to physicians * Durable power of attorney for healthcare
The living will goes into effect only if the person becomes unable to make his or her own decisions regarding care. (don't need attorney)If a person has a living will, a copy is kept on file in the healthcare facility.
To preserve a client's rights, all healthcare workers need to be aware of the client's wishes regarding continuing, withholding, or withdrawing treatment in the event the person cannot make these decisions for himself or herself.
Directive to Physicians
In this case, the person directs the physician to be his or her decision-maker. The physician must also agree, in writing, to accept this responsibility.
Durable Power of Attorney for Healthcare
In this written document, a client names another person to make healthcare decisions for him or her should the client become unable to do so
Mental Health Advance Declaration
mental health advance declaration establishes specific guidelines for psychiatric care.the mental health declaration specifies an individual's wishes concerning intrusive mental health treatment
Children and some adults are considered vulnerable to deficient or harmful care. Reporting suspected child abuse or vulnerable adult abuse is mandatory in the United States and Canada
Key Concept No uniform definition
of clinical death exists in the United States. Each state has slightly different criteria.
Exceptions In all cases that may involve the determination of death
Marked hypothermia (core body temperature below 90°F [32.2°C], such as might follow a near-drowning episode) Severe depression of the central nervous system (CNS) after drug overdose with a CNS depressant, such as a barbiturate
The United Network of Organ Sharing (UNOS)
was established to ensure fairness in the receipt of donated organs.
Key Concept Even if a person designates himself or herself as a "donor
the next-of-kin usually must give permission after death. If you wish to be an organ donor, discuss your feelings with your family now.
Refusal of Treatment
The only time a person does not have the right to make the decision to refuse treatment is when the greater public interest would be in danger.
American Medical Association (AMA)
Other groups have also formulated statements about rights of the health consumer
The National Association for Home Care (NAHC)
has issued a Client Bill of Rights similar to that of the AHA.
Which of the following is the nurse's responsibility in obtaining informed consent?
Confirm that the signed consent is in the chart prior to the procedure.
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