LPD Exam 3

Accountability

Accountability means nurses are answerable for their actions, decisions, and the effect those actions have on clients and others.

Nurse Administrator Core Responsibilities (Remember  S.H.C.H.R.L.N.)

 Safety, Quality & Risk Management, Health Advocacy, Clinical Care Delivery, Healthy Work Environment, Resource Management, Legal & Regulatory Compliance, Networking & Collaboration

LPN/LVN Education

certificate, diploma, associate degree

RN Education

diploma, Associate Degree (ADN), Bachelor of Science in Nursing (BSN)

BSN key points

(1) BSN nurses often have greater leadership opportunities. (2) Nurse administrators must have at least a BSN and active RN license.

State Boards of Nursing

Issuing nursing licenses, renewing licenses, suspending/revoking licenses, enforcing Nurse Practice Act, regulating nursing education, defining scope of practice

License can be disciplined for

practicing without a license, expired license, substance abuse, felony conviction, negligence, practicing outside scope

eNLC

One multistate license

eNLC allows practice

In person, telehealth, other Compact States. Must follow laws of the state where the patient is located.

Requirements vary by state

Continuing Education (CE), Practice hours, Portfolios, Competency activities

Purpose of continuing competency

protect the public, Maintain nursing competency

Magnet Recognition awarded by

ANCC - Recognizes hospitals with nursing excellence.

Five Components of Magnet Recognition

Transformational Leadership, Structural Empowerment, Exemplary Nursing Practice, Innovation/New Knowledge, Quality Outcomes

Magnet status lasts

4 years.

Pathway to Excellence Promotes

Positive work environment, Staff satisfaction, Evidence-based practice

Pathway to Excellence can be earned by

Hospitals, Long-term care facilities

Licensure-Minimum is

a legal requirement to practice, granted by State Board of Nursing

Certification

Shows excellence in specialty, granted by  Professional organizations (ANCC)

Nurses influence healthcare by

Joining nursing organizations, lobbying legislators, educating the public, participating in Political Action Committees (PACs)

Professional advocacy includes

participating in nursing organizations, lobbying legislators, educating the public, and influencing healthcare policy. Collective action strengthens the nursing profession's voice.

Current advocacy topics

Workplace violence, safe staffing, access to care, APRN reimbursement, nursing education funding

Manager responsibilities

Staffing, hiring, interviewing, orientation, mentoring, scheduling, retention

HIPAA

Protects privacy and confidentiality.

EMTALA

Emergency treatment regardless of ability to pay.

ADA

Protects people with disabilities.

PSDA requires facilities to

Inform patients of advance directives, respect patient healthcare decisions

UAGA

legally protects an individual’s decision to be a donor and prohibits sale of organs

NOTA

National Organ Transplant Act

MHPAEA

Mental Health Parity and Addiction Equity Act ensures that health plans provide mental health and substance use disorder benefits on par with medical and surgical benefits

Criminal

Against society/government (e.g., Falsifying records, drug diversion. Punishment–Jail, fines

Civil

Against another person (e.g., Torts)

Negligence

Failure to use reasonable care. (E.g., Forget bed alarm → patient falls)

Malpractice

Professional negligence.(e.g., Medication calculation error causes death.)

Invasion of Privacy

Sharing confidential information

Libel

Written defamation

Slander

Spoken defamation

Assault

Threatening harm (No touching)

Battery

Touching without consent

False Imprisonment

Holding a competent patient against their will

Good Samaritan Laws protect nurses who

Provide emergency care, outside employment, act reasonably, stay within competency

Preventing Malpractice always

Follow standards of care, practice within scope, communicate, document thoroughly, know facility policies, use equipment correctly

Standards of Care come from

Nurse Practice Act, ANA, specialty organizations, Joint Commission, facility policies, evidence-based practice

Never perform skills

Outside legal scope & outside competence

If unsafe assignment

Use Chain of Command

Impaired Coworkers

Report immediately to supervisor.

Signs of impairment include

alcohol odor, slurred speech, bloodshot eyes, mood swings, frequent absences, poor pain control documentation, missing narcotics, frequent wasting without witness

Mandatory reporting must report

Child abuse, elder abuse, vulnerable adult abuse, communicable diseases

Report according to

State law, facility policy

Federal law requires

Qualified specialists discuss donation.

Nurse role in organ donation

Support family, Answer questions, Emotional support

Always do the following for telephone and verbal orders

Read back, verify medication, verify dose, verify route, verify frequency

Provider needs to _________ in telephone and verbal orders

sign per facility policy (usually 24 hours) (Can be electronic or wet ink)

Incivility

Rude behavior (e.g., Dirty looks, teasing, insults)

Lateral Violence

Peer → Peer (e.g., Gossip, sabotage, withholding information, bullying)

Supervisor → Employee

Repeated abuse of power

Cyberbullying/Online harassment

Even off duty may violate policy.

Managers should

Model respect, zero tolerance, encourage reporting, prevent retaliation, open communication

Utilitarianism

Greatest good for greatest number. Focus is outcome

Deontology Focus

Duty; "What is morally right?"

Autonomy

Patient chooses.

Beneficence

Do good.

Nonmaleficence

Do no harm.

Fidelity

Keep promises.

Justice

Treat fairly.

Veracity

Tell the truth.

26. Ethical Dilemmas exists when

More than one correct answer, conflict between moral principles, no scientific answer alone

27. Ethical Decision-Making Steps

(1) Identify dilemma, (2) State problem, (3) Consider option, (4) Choose best ethical option, (5) Implement, (6) Evaluate

According to UDDA, death occurs when either

irreversible loss of circulation AND breathing OR irreversible loss of all brain function, including brainstem

Epinephrine

vasopressor; used in cardiac arrest (maintain HR and BP). Administration– IV, intracardiac, intraosseous, intrathecal. 1 MG Q3-5 mins. 2-10 mcg/min via continuous infusion for BRADYCARDIA

Epinephrine adverse effects

restlessness, tremor, arrhythmias, chest pain, tachycardia

Epinephrine contraindications

hypersensitivity to adrenergic amines or bisulfate

Factor 10a inhibitors (-xaban medications)

direct oral coagulants for atrial fibrillation. Ensure to place the patient in bleeding precaution. Monitor for bleeding, back/flank pain, bloody stools, petechiae

Apixaban

Inform provider of all prescription, OTC, and herbal medications (bleeding/interactions). Avoid contact sports and activities with a high risk of injury due to increased bleeding risk

Factor 10a inhibitors (-xaban medications)

direct oral coagulants for atrial fibrillation. Ensure to place the patient in bleeding precaution. Monitor for bleeding, back/flank pain, bloody stools, petechiae

Apixaban

Inform provider of all prescription, OTC, and herbal medications (bleeding/interactions). Avoid contact sports and activities with a high risk of injury due to increased bleeding risk