Topic 6 - Legal Issues

What are the three branches of the American Legal System

-Judicial Branch

-Executive Branch

-Legislative Branch

What are the functions of the judicial branch?

-resolves disputes

-amends the common law

-interprets statutory law

What are the functions of the executive branch?

-implements laws through government agencies

What are the functions of the legislative branch?

-makes statutory law

-delegates authority to government agencies to create rules and regulations to meet the intent of statutes (administrative law)

What are state boards of nursing (SBNs)?

the regulatory bodies by which nursing practice acts are administered and enforced

What is the function of an SBN?

publicizes rule and regulations that expand the law; giving full meaning to the nursing practice act in each state.

What is the purpose in state nursing associations?

usually instrumental in lobbying their state legislators for appropriate updating of nursing practice acts

What are the objectives of nursing practice acts?

1.Defines the standards and scope of professional nursing

2.Describes the authority, power, and composition of the board of nursing

3.Defines educational program standards

4.Sets the minimum educational qualifications and other requirements for licensure

5.Determines and protects the legal titles and abbreviations nurse may use

6.Provides for disciplinary action of licensees for certain causes

What does the NCSBN Model Nursing Practice Act (2012) urge the inclusion of?

1.A clear differentiation between advances and generalist nursing practice.

2.Authority for boards of nursing to regulate advanced nursing practice, including authority for prescription writing

3.Authority for boards of nursing to oversee unlicensed assistive personnel (UAP)

4.Clarification of the nurse’s responsibility for delegation to and supervision of their personnel

5.Support for mandatory licensure for nurses while retaining sufficient flexibility to accommodate the changing nature of nursing practice.

What are the three functions of SBNs similar to those of the federal and state governments?

-Executive (authority to administer the nursing practice act)

-Legislative (authority to adopt rules necessary to implement the act (note that rules are different from laws, which are made by state's legislative body)

-Judicial (authority to deny, suspend, or revoke a license or to otherwise discipline a license or to deny an application for licensure)

What is the most common reason nurses are disciplined by SBNs?

Practicing while under the influence of alcohol or other substance, often narcotics

What is the goal of SBNs?

To return nurses who have been identified as having a problem with drugs and/or alcohol use safely back into practice

What exam must a student pass to be an RN?

NCLEX-RN

•Computer adaptive testing (CAT)

•Minimum # of questions is 75

•Maximum # of questions is 256

What allows nurses to practice in different states without having to take anothher licensing exam?

-Endorsement

-National Licensure Compact (NLC)

True/False: Excessive documentation can harm RNs in a malpractice suit?

True

What is the primary legal concenr of health care professionals?

Malpractice

What is the #1 form of malpractice?

Negligence

What is the most important question in a malpractice case?

"Was the prevailing standard of care met?"

Whar are standards of care?

the minimum level of prudent care based on the ethical principle of non-maleficence ("do no harm")

Box 6.2 Standards of Care Case Study

1. Hospital policy indicated that an interpreter should have been called for communication with family.

2. Hospital policies and orientation competency guidelines, completed by this nurse, indicated that flushing of an IV line was a required step in the process.

3. Local schools of nursing indicated that flushing of an IV line was part of basic skills training, and current textbooks about fundamentals of nursing confirmed this content.

4. Other nurses in local EDs were interviewed, and all reported that flushing of an IV line before infusion was standard practice.

5. The company manufacturing the IV tubing had visual and written instructions on the box indicating proper use of the product, including flushing of the line.

Six major categories of negligence that result in malpractice lawsuits (Box 6.3)

1. Failure to follow standards of care

2. Failure to use equipment in a responsible manner

3. Failure to communicate

4. Failure to document, including failure to note in the patient's medical record

5. Failure to assess and monitor

6. Failure to act as a patient advocate

Who can nurses delegate to?

Techs, LPNS, other RNs

What are the three major conditions of informed consent?

-disclosure

-capacity

-voluntariness

Why was the Health Insurance Portability and Accountability Act (HIPAA) of 1996 enacted?

Arthur Ashe and Bill Clinton

What is a Legal Nurse Consultant?

an experienced nurse who brings expertise from their professional nursing education

and clinical experience to the evaluation of standard of care, causation, damages, and other medically related issues in medicolegal cases or claims.

How can a nurse protect themselves from legal problems?

-Practice in a Safe Setting

-Communication with Other Health Professionals, Patients, and Families

-Meet the Standard of Care

-Carry and Understand Professional Liability Insurance

-Promote Positive Interpersonal Relationships

What are the 4 documents a nurse should own?

1. A copy of the nursing practice act of the state in which you practice.

2. Nursing's Social Policy Statement: The Essence of the Profession.

3. Nursing: Scope and Standards of Practice

4. ANA's Code of Ethics for Nurses with Interpretive Statement