Vocational Nursing EXAM3 CH3

Why is identifying your own values and ethics important in nursing care?

Why is identifying your own values and ethics important in nursing care?

Ensures that you provide patient-centered, ethical care by aligning personal beliefs with professional responsibilities.

List ways to provide ethical nursing care

Requires that you treat your patients with respect, dignity, honesty, and compassion.

What does it mean to advocate for a patient, and why is it important?

It means supporting and defending a patient’s rights and needs, ensuring their voice is heard in decision-making, which is crucial for their well-being.

• It is important for you, as the patient’s advocate, to report unethical behavior that could cause harm to the patients.

What types of laws affect nurses and their practice?

• Constitutional

• Statutory

• Case or Judicial

• Criminal

• Civil

Explain how the following statutory laws like HIPAA, HITECH Act, Nurse Practice Act, and Licensure laws impact nurses?

• HIPAA mandates patient information confidentiality via Privacy and Security Rules.

Both protect patients' health information from being seen or accessed by anyone other than those giving care or those given permission by the patient.

• HITECH Act facilitated shift towards EHRs and established breach notification rule.

• NPAs and licensure laws establish nursing scope of practice in each state.

• Licensure laws ensure nurses pass NCLEX examination and meet state-specific requirements.

Identify two situations that must be reported under mandatory reporting laws

• Certain communicable diseases to the CDC

• Suspected or actual child abuse to the proper authorities

What are five areas of civil law (torts) that affect nurses?

• Malpractice

• Negligence

• False imprisonment

• Assault and Battery

• Sexual harassment

The Good Samaritan Law protects nurses who volunteer to assist in an accident from legal liability.

Name four legal documents nurses are responsible for and their significance

• Patients health record: Helps healthcare providers understand patient needs. Ensures uniform information among care team.

• Informed consent: It ensures patients understand what’s happening to their body and gives them the power to make decisions about their care.

• Advance directives:  It ensures the patient’s choices are followed, even if they’re unable to speak for themselves.

• Incident reports: It helps the healthcare team learn from mistakes or accidents to prevent them from happening again and to ensure safety.

What are the professional responsibilities of nurses and nursing students?

• Accountability

• Securing professional liability insurance

• Following standards of care

• Establishing professional boundaries

• Being competent

• Continuing their education

What are the five rights of delegation?

• The right task: The delegatee can perform the task according to the facility's policies and procedures and has had training to do so.

• Under the right circumstances: The patient must be stable. If the patient's condition changes, the delegatee must inform the licensed nurse who can then reassess the situation.

• To the right person: The delegatee has the knowledge and skills to perform the task.

• With the right directions and communication: Clear instructions and agreement required.

• Under the right supervision and evaluation: Licensed nurse must provide necessary monitoring, evaluation, intervention, and feedback.

Some activities cannot be delegated. Nurses cannot delegate nursing judgment, critical decision making, or care for an unstable patient unless this is within the delegatee's scope of practice in the NPA for that state.

Common signs of Abuse

• physical

• Sexual

• Emotional

• Neglect

• Domestic/Partner

Most common reasons for Lawsuits Against LPN/LVNs

• Medication-related errors

• Treatment and care-related errors

• Patient abuse-related errors

Least common reasons for Lawsuits Against LPN/LVNs

• Conduct-related errors

• Assessment-related errors

• Scope of practice-related errors

• Documentation-related errors

Legal Aspects of Documentation

• Never document something that you did not actually do

• Do not document anything before it is actually done

• Never document anything less than the full truth

To document under any of these circumstances constitutes fraud!

The standard accepted in a court of law is "If it's not charted, it wasn't done."

The following people are required to provide their signatures on the informed consent form:

• The health-care provider

• The patient or custodial parent or legal guardian (stepparents cannot sign in most states)

• A witness

Nurses may only sign a consent form as a witness to the patient's signature. Your primary role is to make certain that informed consent has been obtained.

Laboratory and Diagnostic Connection: Confidentiality of Test Results

You cannot discuss any kind of test results with family members or partners of the patient, even if the results could affect them.

All test results must be treated with confidentiality.

Discussing such results without obtaining the patient's permission is a violation of HIPAA.

Reporting Unethical Behavior

The authority to which you report unethical behavior differs from state to state, so you must be familiar with your own state laws. Most unethical behaviors are reported to your immediate supervisor and the Board of Nursing.

Examples of unethical behaviors that you should report include the following:

• Nursing impairment due to alcohol, drugs, or severe fatigue.

• Diversion of patient medications for personal use but charting them as administered to patient.

• Abuse or mistreatment of patients.

• Fraudulent documentation.

• Non-licensed practice.

• Incompetence, failure to follow orders, and non-compliance with necessary actions.

• Practice outside the individual's scope of practice

Abandonment

Premature cessation of patient care without adequate notice

Advance directive

Written documents that provide guidelines for making medical decisions in the event a person becomes incapacitated and is unable to make their wishes known

Assault

Threatening a patient or showing intent to touch a patient without permission

Battery

Intentional or wrongful physical contact without consent that causes injury

Ethics

Values that influence your behavior

Negligence

Patient injury resulting from a nurse’s failure to meet their responsibility to the patient

 Empathy

The ability to intellectually understand another’s feelings

Informed consent

Voluntary agreement made by a well-advised, mentally competent patient to be treated by a healthcare provider or institution

Value

Your belief of something’s worth

Advocate

To stand up for the patient’s best interest

Standards of care

Statements of actions consistent with minimum safe professional conduct under specific conditions

Malpractice

Nurse’s action fails to meet the standard of care and results in patient injury

Civility

Treating others with courtesy, politeness, and respect, even if you disagree with what they think or believe

Center for Disease Control and Prevention (CDC)

The federal agency that supports health promotion, prevention of disease, and helps healthcare professionals respond to disease outbreaks and illness

HIPAA (Health Insurance Portability and Accountability Act)

The law that contains both the Privacy Rule and the Security Rule

 Incident Report

A form to be completed in the event of an unusual occurrence or an accident

Good Samaritan Law

The law that provides legal protection to voluntary caregivers at sites of accidents and emergencies

Emancipated Minor

Someone younger than 18 years old who is considered an adult because they are self-supporting, married, a parent, or in the military

Who owns a hospitalized patient's medical records?

The hospital

Which type of hospital in the United States requires that you shred any notes that are written while caring for the patient before you leave the facility?

Government Hospitals

Which health-care provider is identified as the patient's advocate?

The nurse