NSG 212 Exam 1

Behavioral Health

Ethical Principles

Bioethics: being ethical in healthcare setting,

Beneficence: do good.

Autonomy: making own decisions.

Justice: fairness.

Fidelity: adhering to standard.

Nonmaleficence: do no harm.

Veracity: tell the truth.

Morals

community or individually based. ethical

Ethics

generally accepted behaviors/actions. ethics should not override laws.

Common ethical dilemmas

• autonomy vs. involuntary commitment (forced meds)

• privacy vs. duty to report/warn

ANA ethical guidelines

guidelines on reporting incompetent, unethical, or illegal practices.

ANA code of ethics: reporting unethical, illegal, and incompetent or impaired nursing practices.

-talk to that direct person first, then higher authorities.

Nurses have the duty to warn\protect

• Kentucky nurses have a legal and ethical obligation to warn if a patient poses a threat to themselves or others.

• The duty to warn is based on the Tarasoff ruling, which emphasizes the need to protect potential victims.

• Asses and predict a pt danger of violence toward another

• Identify specific individual(s) being threatened

• Identify appropriate actions to protect victim(s)

Nurses have the duty to intervene

• Nurses have a legal and ethical obligation to advocate for patient safety.

• They must intervene if they witness unsafe practices or conditions.

Nurses have the duty to report

-Elder abuse: age 65+

-Dependent adult abuse

-Child abuse: federal laws governing confidentiality apply to most providers of drug abuse and alcohol treatment, prohibit any disclosure of pt without a court order

-Communicable diseases: to health department (COVID, flu, TB, STD, measles, hep, zika virus)

Restraint and Seclusion

-always try less restrictive measures first.

-must be ordered by DR -must be specific with time (can not be prn)

-assess pt and document q 15 min

-An emergency situation must exist

-pt must be immediate risk of harm to self or others (exception: pt requests seclusion

-must be document: behavior leading to restraint/seclusion, time pt is placed in and released from restraint/seclusion

Standard of care

• Duty: measured by the Standard of Care.

• Breach of Duty: conduct that exposes a patient to unreasonable risk of harm.

• Substandard institutional policies do not absolve the individual nurse of responsibility to practice on the basis of professional standards of nursing care.

QSEN

six competencies.

1. Patient centered care

2. Quality improvement

3. Safety

4. Informatics

5. Teamwork and collaboration

6. Evidence based practice

Voluntary & Involuntary admission/commitment

• Voluntary admission/commitment

• Involuntary admission/commitment (judicial determination, administrative determination, agency determination *in addition 2 DR must certify the pt’s mental health status justifies detention and treatment

Nurse Practice Act

states specifically what a nurse can do.

Statutory Law

written laws. (ex. Nurse Practice Act, HIPPA)

Common Law

laws derived from court hearings. (ex. duty to warn)

Civil law

tort laws.

Criminal Laws

ex. nurse taking narcotics from med cart, stealing pt’s belongings

Negligence and Malpractice

unintentional torts.

• Negligence: failure to provide proper care. (ex. leaving your pt in a dirty brief)

• Malpractice: negligence as a professional