healthcare law, ethics, advocacy

what is assault?

• an intentional act that creates an apprehension of imminent harmful or offensive contact

• ex: HCP threatens to retrain a pt who refuses treatment, creating fear of physical harm

what is battery?

• the actual physical act of harming or touching someone without their consent

• ex: nurse administers an injection to a pt who has explicitly refused the treatment

what is false imprisonment?

when someone is unlawfully and intentionally confined for unreasonable amount of time

what is invasion of privacy?

when an individual fails to respect another’s privacy right

what is the Nursing Practice Act (NPA)?

• main legal document that regulates nursing practice

• protect the public

• ensure high standards

• set standards

what is the purpose of consent?

respect the patient’s right to make decisions about their own healthcare

when is consent required/indicated?

• before any medical procedure

• when starting a new medication

what are the components of consent?

• disclosure of information

• ensure patient is understanding the information

what is the role of the nurse during consent?

• witness consent

• document date and time signature was obtained

• verify client is competent and voluntarily signing

• advocate: assess client and confirm they receive and understand the info

• answer questions (diet, exercise, breathing) but not specifics about procedure » notify HCP

what is HIPAA?

health insurance portability and accountability act

• privacy: protected health information

• security: protects information in electronic form

• portability: allows patients to move to another place of work

• fraud and accountability: provision to detect and enforce fraud

• penalties for violation in california

what is tier 1 HIPAA penalty?

• minimum fine of $100 per violation up to $50,000

• violation happened without person entity knowing, and couldn’t have avoided it, even if they were being careful

what is tier 2 HIPAA penalty?

• minimum fine of $1,000 per violation up to $50,000

• person should have known about the violation, but couldn’t have avoided it, even with reasonable care

what is tier 3 HIPAA penalty?

• minimum fine of $10,000 per violation up to $50,000

• violation was due to neglect, but they tried to fix it

what is tier 4 HIAPA penalty?

• minimum fine of $50,000 per violation

• violation was due to neglect, and they didn’t try to fix it within 30 days

what are potential liabilities in nursing?

• may give pt an incorrect dosage of medication

• not notify the doctor of possible medical complications

• injure a pt when using equipment to treat or monitor a pt

what steps can you take to avoid a potential liability?

• practice within the scope of state laws and nurse practice act

• collaborate with colleagues to determine the best course of action

• use established practice standards to guide decisions and actions

what would cause a suspension/revoking a license or registration?

• failure to report

• HIPAA violations: failing to keep patient information private and confidential

• unlicensed activity

• failure to follow general standards of nursing

• gross negligence

what are legal safeguards in nursing practice?

• follow laws and regulations

• maintain confidentiality

• verify consent

• report incidents

• avoid social media

what is the purpose of incident reports?

• serves to document the details of an unexpected event

• ensures safety

• education

• health and safety code (CDPH)

  • identify risks, develop an action plan, avoid future incidents

• root cause analysis

what is beneficence?

• the ethical principle of acting in the best interest of the pt and promoting their well being

• ex: doctor prescribes a treatment that they believe will significantly improve a patient’s quality of life

what is nonmaleficience?

• the ethical principle of “do no harm” ensuring that HCPs avoid causing harm to patients

• ex: doctor refrains from prescribing a medication that has severe side effects, opting for a safe alternative

what are patient boundaries?

establish and maintain boundaries with patients to protect them from harm and avoid conflicts of interest

what is informed consent?

patients should have the opportunity to ask questions, clarify doubts, and consent should be voluntary

what is ethical framework?

• utilitarianism: choose action that maximizes overall good for the greatest number of people

• deontology: follow established rules and principles regardless of consequences

• virtue ethics: focus on developing good character traits and acting in accordance with moral values

what is patient autonomy?

• when a patient has the right to make their own decisions based on their own beliefs and values

• ex: pt has right to refuse medications, treatment, surgery, or other medical interventions

what is legislation?

the creation of law through the federal or state legislatures, commonly known as statutory laws

what is administrative law and regulation?

• specific rules that promote and enforce the legislative policy

• regulatory agencies are given authority via legislation to create and enforce these specific rules

• primary federal regulatory agency is the U.S. Department of Health and Human Services

what is litigation?

• the process of taking legal action, often seen in disputes over medical malpractice or patient rights

• ex: pt sues a hospital for malpractice after a surgical error

what is fidelity?

to keep your promises, fulfill expectations, perform your duties, be trustworthy

what is justice?

• the principle of fairness in healthcare, ensuring that patients receive equitable treatment and resources

• ex: hospital implements a policy to provide equal access to care for all patients, regardless of their background

what is veracity?

truthfulness

what is defamation?

• false statements made about a person that can harm their reputation, particularly in a professional context

• ex: healthcare worker spreads false rumors about a colleague’s professional conduct, damaging their reputation

what is fraud?

• deliberate deception to secure unfair or unlawful gain, often in billing or medical records

• ex: HCP bills for services not rendered or exaggerates the necessity of procedures

what is liability?

• legal responsibility for one’s actions or omissions that result in harm to a patient

• ex: a doctor is found liable for misdiagnosis that led to a patient’s deterioration

what is negligence?

• failure to exercise the care that a reasonably prudent person would under similar circumstances, leading to harm

• ex: nurse fails to monitor a patient’s vital signs, resulting in a critical condition

what is malpractice?

• professional negligence by a HCP that results in harm to a patient

• ex: surgeon performs a procedure without proper consent, resulting in complications

what is statutory law?

• laws enacted by a legislative body that govern healthcare practices and regulations

• ex: laws requiring reporting of certain communicable diseases to public health authorities

• ex: law requires reporting a diagnosed case of TB

• nurse practice acts

• good Samaritan acts

• child and adult abuse laws

• advance directives

• sexual harassment laws

• americans with disabilities

what is tort?

• a civil wrong that causes harm or loss, leading to legal liability

• ex: a pt files a tort claim against a hospital for an injury caused by a slip and fall due to improper maintenance

• acts of negligence/malpractice are torts

what are administrative laws?

• legislative body, through statutory law, delegates the responsibility for the administration and enforcement of those laws to administrative agencies

• may be granted additional power to interpret those laws and enact policies or procedures by which those laws will be implemented and enforced

• ex: state boards of nursing

what are constitutional laws?

• due process

• equal protection

what are criminal laws?

• public

• homicide, manslaughter

• theft

• arson

• active euthanasia

• sexual assault

• illegal possession of controlled drugs

what are contract laws?

• private/civil

• deals with agreements between people or parties and making sure those agreements are kept

• nurse and patient

• nurse and employer

• nurse and insurance provider

• patient and agency