Legal Issues in Psychiatric/Mental Health Nursing

The legal parameters of professional and practical nursing are defined within each state by the state’s:

Nurse Practice Act

What act concerns the patients right to Confidentiality and privacy

Health Insurance Portability ad Accountability Act (HIPAA)

What kind of data does HIPAA protect?

Protected Health Information (PHI)

Under HIPAA, individuals have the right to…

1. Access their medical records

2. Have corrections made to their medical records

3. Decide with WHOM their medical information may be SHARED

How should a nurse document with the possibility of being called to testify in cases in mind?

• OBJECTIVE

• nonjudgemental

• Care plans that are specific in their prescriptive intervention

• describes interventions and their subsequent evaluation

ALL SERVE BEST INTEREST OF THE CLIENT

What are the two exceptions to the right to confidentiality and privacy?

1. Duty to warn

2. Suspected child or elder abuse

What is the nurses role in the Duty to warn?

We have the duty to the client and to individuals who are being threatened by that client

Take whatever steps necessary to protect the intended victim from harm

IT IS THE DUTY OF THE NURSE TO REPORT INFORMATION TO THE PSYCHIATRIST AND TO OTHER TEAM MEMBERS

DOCUMENT

What is the rational for the doctrine of informed consent?

The preservation and protection of individual AUTONOMY in determining what will and will not happen to the person’s body

What is the staff nurses role in obtaining informed consent?

A nurse may sign the consent for AS A WITNESS for the client’s signature

Be a client ADVOCATE

• Ensure client has adequate information

• Ensure the individuals cognition is not impaired

• Ensure the individual has not been pressured or coerced

If the individual has impaired cognition that interferes with decision-making, they have a right to a..

Legal Representative

Individuals have the right to freedom from restraint and from seclusion EXCEPT in:

Emergency situations

The deliberate and unauthorized confinement of a competent person with the intent to prevent them from leaving the hospital

False imprisonment

Seclusion or restraint is discontinued at the:

EARLIEST possible time

Orders for restraints must be renewed every _ hours for adults and every _ hours for adolescents ages 9-17

4

2

An ____ _____ ______ must be conducted withtin 1 hour of initiating restraint or seclusion

in-person evaluation

False imprisonment includes the use of what that interfere with the client’s ability to leave the facility?

Threats

Medications

Individuals who are ______ admissions may sign out of the hospital at any time unless it is determined that they are harmful to themselves or others

Voluntary

What are three reasons that a person may be involuntarily commited?

1. Danger to self (suicidal intent)

2. Danger to others (aggressive, violent, homicidal)

3. Unable to take care of basic needs (“Gravely disabled”)

When a individual displays behavior that is clearly dangerous to themselves or others

TIME-LIMITED

Emergency Commitment