NUR 212 Exam 2

legal issues includes – -right -responsibilities -scope of nursing practice what is the function of the National concil of state board of nursing (NCSBN) – -developing licensure, assessment exams *(NCLEX)* -offers continuing education opportunities vie E-learnign -important source of data, research about nursing practice -works w BONs to promote uniform regulation of nursing practice what is the function of the state Board of Nursing (BON) – -over sees admin of licensure examination -monitors educational standards for nursing education programs -defining professional standards -examining, renewing licensues of duly qualified applicants -monitoring compliance with state laws and maintaing continuing competency how many states are currently a part of the nurse licensure compact - 34 states what is credentialing - formal identification of professionals who meet predetermined standards of professioanl skill or competence american nurses credentialing center includes – -subsidiary of *ANA* -provides programs to certify nurses in specialty practice areas -recognizes healthcare organizations for nursing excellence through Magent Recognition Program -accredits providers of continuing nursing education, nursing specialty programs what federal organization and guidelines affect nursing standards of care – -the joint commission (JCO) -centers for medicare & medicaid services (CMS) what is statutory law - violations are crimial offenses and are punishable by fines or imprisonment what is state statues - NPA and BON rules and regulations penalties that may be imposed - -formal reprimand -peroid of probation -fines -limiting, suspension, revoking license federal statues related to nursing and health care include - mandate a minimum standard of care in all settings that receive federal funds (medicare/medicaid) what are the 8 federal acts - 1. federal false claims act 2. federal prep act 3. ADA 4. controlled substance 5. EMTALA 6. HIPPA 7. patient safety & quality 8. patient self determination act what is the federal false claims act - -makes it an offence to submit a false claim to the government for payment of health care services -"whistle blowers" report false or fraudulent claim what is the emergency medical treatment and active labor law (EMTALA) - - prohibits refusal of care for indigent and uninsured clients seeking medical assistance in emergencies -prohibits transfer of unstable clients, including women in active labor, from one facility to another what is the americans with diabilities act of 1990 (ADA) - prohibits discrimination against persons with sensory disabilities by removing barriers that might prevent the same opportunities available to persons with sensory disabilities what is the patient self-determination act of 1990 - under this law clients have the right to participant in their own healthcare decisions, right to accept or refuse medical/surgical treatment, the right to prepate a direct advance what is the health insurance portability and accoutability act of 1996 (HIPAA) - privacy act what is the patient safety and quality improvement act - this law permits a provider to disclose non-identifiable client data to a qualifies patient safety organizatoin for analyzing med errors what is the controlled substance act (CSA) - -this act places all substances which were in some manner regulated under exisiting federal law into one of five schedules -this placement is based on substances medical use, potential for abuse, safety or dependence liability what is the federal prep act - this law, passed in dec 2005, limits legal liability for losses relating to the manufacture, testing, development, distrubution, administration, and the use of medical countermeasures against chemical, biological, radiological, and nuclear agents of terrorism, edidemics, and pandemics what penalties may be imposed regarding the NPA - -issuing a formal reprimand -establishing a period of probation -levying fines -limiting, suspending, or revoking the nurses license A nurse educator is teaching a group of nursing students about the function of the state boards of nursing. which 6 elements will the educator include in the teaching session? (Select all that apply) - -define professional standards of care -investigates violations of nurse practice act -sanction violators of the nurse practice act -suspending/revoking licensees -defines scope of practice for the various nursing licensures -offers free online continuing educational traning to nurses what are the components of the NPA - -licensure requirements -enforces nursing laws -scope of practice which is NOT a component of the nurse practice act - definition of nursing (through ANA not NPA) BONs required to respect nurse right to right process - ensure that nurse is informed of all allegations, nurse has opportunity to respond and defend against allegations, matter is heard by fair impartial body understaffing may result in - corporate negligence is mandatory overtime legal - depends on state (16 states require mandatory overtime) what does the NCBON state about overtime - NCNA regulates overtime what is disclousure statues mandate reporting - -certain types of health information and vital statistics (including births, deaths) -some states require reporting of abortions, neonatal deaths what is mandatory reporting - legal requirement to report a act, event, or situation that is designated as reportable by state or local law health professionals must report the following under penalty of fine or imprisonment for failing to do so - 1. infant and child abuse 2. elder abuse 3. communicable diseases primary HCP are mandated to report injuries or illness caused by or suspected to be caused by - -bullet wounds, gun powders burns, other injuries arising from discharge of gun or firearm -poisioning -knife or another sharp/pointed instrument if provider suspects that a criminal act may have been involved -any wound injurt or illness resulting in bodiley harm as a result of suspected criminal act or act of violence -infectious diseases caused by tuberculosis, HIV/AIDS, E coli which healthcare issues must the nurse report to the state? - a client diagnosed w hepatitis B nurses are mandated to report domestic abuse. True or false - false (only child/elder abuse NOT domestic) what is the whistleblower protection act of 1989 - establishes some protections for employees who report gross misconduct by their employers to federal authorities what does the whistleblower protection act include - -additional protection vary by state -to qualify, the whistleblower must *first* make every effort to resolce the issue via the employers internal reporting procedures -employee does not qualufy unless employer has threatened/engaged in retaliation against employee as result of the complaint -simple error or disconduct does not qualify -the activity or policy must violate a state or federal law or rule -employer must be aware that it is a violation -employee must give employer written notice, appropriate time to correct problem whistle blower protection act (brief) - -first make effort to resolve issue within the internal reporting procedures -must be threatened/engage in retaliation -must violate state or federal law -simple error or misconduct doesnt quality -employer must be aware -employer must be given appropriate time what is good faith immunity - -healthcare workers are protected from civil, criminal liabilities when suspected abuse reported in good faith -NOT considered violation of HIPPA in these circumstances what is common law - created through cases heard and decided in federal and state appellate courts, also known as decisional or judge made law common and case law provide courts with guidelines for deciding - future cases what does civial law include - negligence and malpractice what is gross negligence - reckless act that reflects a conscious disregard for the clients welfare what is punitive damage - court may award special damages meant to punish the nurse for outrageous conduct what are the 5 elements essential to prove negligence or malpractice - -duty -breach of duty -foreseeability -causation -injury/harm commission vs omission - commission- doing something wrong omission- failing to do the right thing what is a "reasonable person" - nurse will be compared to another nurse (expert witness) what is res ipsa loquitur - the thing speaks for itself (does not require expert witness) what are the 3 elements of res ipsa loquitur - 1. type of injury did not occur except for negligence 2. activity was under complete control of defendant 3. plaintiff did not contribute to his own injury what is the nursing student role - -liable if actions cause harm to client, as is the instructor, hospital, college/university -expected to perform as a professional when rendering care -must discern student nurse role from work as CNA -must adhere to program, facility, and code of conduct guidelines what type of liability may lead to the hospital or facility being named in a lawsuit involving a student nurse - vicarious liability what is criminal law - the act deemed so reckless that results in serious injury or death to the client what are defenses against claims of negligence - -emergency situations -governmental immunity -ANA code of ethics and american medical association code of medical ethics what is a sentinel event - UNEXPECTED occurrence involving serious consequences -not all sentinel events are d/t errors -not all errors cause sentinel events what is disclosure - legal principle mandated by HIPPA and essential component of national patient safety movement occurence based vs claims made insurance - occurence based- covers incidents that occured while policy was in effect, regardless of when the claim was made (BEST option) claims made- provide coverage if incident occured and claim made during active policy period what type of liability requires nurses to assume responsibility for client harm or injury that is a result of negligent acts - persaonal liability The nurse is NOT permitted to deliver care if they lack the _____ and ___ to act competently - knowledge and training A nurse should ______ and _____ with the supervisor to determine a plan for safely caring for a client - communicate and collaborate what are the risk management roles - -review incident reports and facilitate sentinel events -data analysis -practice guidelines (determine EBP, NPA) what are the personal liabilities with extended work hours and short staffing - - nurse should not accept any assignment for which they may be unsafe due lack of sleep, fatigue, or prolonged work hours -no more than 12 hours in a 24 hour time period or 60 hours in a 7 day period -certain activities that still must be carrired out regardless of staffing personal liability for charge nurses - -first responder in emergencies -triage of clients and allocations of staff and equipment -delegation of client care tasks -supervision of orienteers, float staff, and subordinates -reporting performance deficits in team members -supporting or invoking the chain of command process when indicated how do risk managers minimize risks - -negoatiate facility's malpractice insurance -identify areas in which incident reports commonly occur -implementing safety processes/EBP to minimize likelihood of incidents risk manager roles review _____ and faciliate _____ - review incident reports and facilitate sentinel events incidents reports are used for - adverse events, sentinel, and near miss events describe events ______, avoid subjective comments or personal opinions - objectively always STOP and QUESTION - -any orders that a client/family questions -orders when clients condition has changed -questions and record verbal orders to avoid miscommunication -any order that is illegible, unclear, or incomplete which action must the nurse first take following a med error - 1. assess the client 2. notify the provider 3. call the charge nurse 4. complete incident report 5. notify next of kin what are the 6 principles of documentation according to the ANA - -documentation characteristics -documentation entries -education and training -policies and procedures -protection system -standardized terminology