NUR 1290 FINAL

Purpose of the ANA Code of Ethics 

• general standard for the professional behavior of nurses

• guide or resource to help when faced with ethical dilemnas 

Criminal Law

Addresses general welfare of public 

Violation is a crime → Prosecuted by government, Classified a either misdemeanor 

Criminal Law Example

Gross negligence, Reckless endangerment, Criminal negligence, felonies

Civil Law

• Regulates conduct between private individuals or businesses 

• Enforced through the courts as damages or monetary compensation 

• Legal action (lawsuit) for breach (breaking) civil law, judgment of court decision 

Civil Law Example

Torts, Negligence, Malpractice 

Euthanasia 

Intentionally ending a person’s life to relieve suffering through lethal injection (active) or withholding life-saving treatment (passive), done by doctor/healthcare provider 

Autonomy

Nurses need to respect clients’ rights to make choices about their own health care 

Nonmaleficence

nurses should not harm or injure a patient. → check medication doses to avoid giving wrong meds 

Beneficence

Nurses should do good and help patients → should comfort patients and provide best care possible 

Justice

treating all patients fairly/equally and giving them the healthcare they deserve 

Fidelity

being loyal/faithful to promises and responsibilities as a nurse 

Confidentiality

Keeping patients personal/medical info private, only sharing with those who need to know  

Veracity

Being honesty and always telling the truth to patients 

Accountability

Taking responsibility for actions and decisions as a nurse 

Principles of ethical concepts 

autonomy, beneficence, nonmaleficence, and justice  

HIPAA guidelines

Privacy, Security, Breach Notification, Business Associate Agreement

Privacy

Protects "individually identifiable health information" (PHI) held or transmitted by a covered entity or its business associate in any form.

Provides patients the right to examine, copy, and request corrections to their health records. 

Security

requires appropriate administrative, physical, and technical safeguards for electronic PHI → ensure its confidentiality, integrity, and availability. 

Breach Notification Rule

Mandates that covered entities notify affected individuals, the HHS Secretary, and sometimes the media, if a breach of unsecured PHI occurs. 

Business Associate Agreement

Contracts required when sharing PHI with vendors or partners, establishing their responsibility to protect the data 

When to break HIPAA

Reporting abuse, protecting public health

Actions by a nurse that constitute a crime 

willful misconduct, extreme recklessness, or violation of state/federal laws (including drug diversion, patient abuse, sexual assault, theft, and fraudulent charting)

Gross negligence 

Showing extreme carelessness or disregard for patient safety 

Reckless endangerment 

Knowingly putting others at serious risk of harm 

Criminal negligence 

Crime, reckless disregard for safety leading to injury/death → results in legal prosecution 

Negligence 

Conduct that does not show due care 

Malpractice  

Negligence of a specially trained or educated person in the performance of job

How to prevent malpractice?

• Maintaining excellent standards of care 

• Self-awareness 

• adapting proposed assignments 

• following/changing protocols, policies, procedures 

• Effective documentation 

Purpose/content of operation consents-especially with children 

legally and ethically ensure that a patient—or their legal representative—fully understands a planned surgical procedure before agreeing to it. 

• Pediatric assent = Minor consent  

Torts

civil wrongs committed by one person against another person or a person’s property. 

Torts example

Physical harm, Psychological harm, Harm to livelihood, Harm to reputation, Unintentional tort 

Nurse’s responsibility regarding child abuse laws 

Must report child abuse

What action should the nurse take if questioning a doctor’s order 

clarify with provider, initiate chain of command, document incident 

Purpose of documentation

official, permanent, and legal record of a patient's care. It bridges the gap between clinical actions, patient outcomes, and regulatory compliance. 

Quality Improvement indicators   

Hospital Healthcare, Outcomes Institutional Outcomes Measurement, Long-Term Care Quality Measures, Home Care Quality Indicators 

National Health Indicators 

Purpose of nurse practice acts 

regulate practice of nursing, establishes consequences if nursing law isn’t followed, governs safe, competent nursing practice, defines the scope of practice 

OSHA

Occupational Safety and Health Act -> To guarantee that employers provide safe, healthy workplaces free from known hazards. 

DHHS

Department of Health Human and Services -> To enhance the health and well-being of Americans by providing effective health and human services.

CDC

Centers for Disease Control and Prevention -> To protect America from health, safety, and security threats, both foreign and in the U.S. 

Medicare 

• Covers elderly (65 and older) and non-elderly with disabilities. 

• Administered by the federal government (single-payer) 

• Financed through: Federal income taxes, Payroll taxes Out of pocket payments by enrollees  

Medicaid

Covers certain low income individuals.

• Administered by state government. 

• Financed jointly by the state and federal governments 

Vulnerability to Legal actions  

Nursing professionals face significant vulnerability to legal actions, primarily through unintentional torts (negligence/malpractice) such as medication errors, failure to monitor, or improper documentation. 

NCLEX format 

Focused on clinical judgment/thinking and decision making. Will include case studies and clinical scenarios 

Primary Care

• Clinics 

• Community health centers 

• Public health service organizations 

• Often the entry point for managed care. 

Secondary Care

• Hospital 

• Outpatient surgical center 

• Specialist’s office 

Tertiary Care

• Hospital 

• Acute care facility 

• Rehabilitation center 

• Extended care facility 

Purpose of Institute of Medicine reporting  

avoid mistakes or people getting hurt in the future  

Five A’s

• ASK - question patient issues 

• ACQUIRE - best evidence from sources 

• APPRAISE - resources, check for validity 

• APPLY - evidence to clinical practice 

• ASSESS - outcome

Importance of evidence based practice 

Uses current research to solve problems while integrating the use of the nurses clinical expertise and patients preference/values 

Culture of Safety  

commitment to core values and principles by organizational leadership and healthcare workers → the same ways to identify people and practice safety IS THE SAME WAY to avoid mistakes.

Health care proxy- nursing responsibility  

Immediately identifying, validating, and facilitating the role of a patient’s health care proxy 

Quantitative

DATA DRIVEN, NUMBERS AND PERCENTAGES, CONCERTE/OBJECTIVE 

Qualitative

DESIGN THINKING, QUOTES/EXPRESSIONS, ABSTRACT/SUBJECTIVES 

Factors of The Joint Commission's Sentinel Event Database  

• SENTINEL EVENT, IMPROVE HEALTHCARE

Strategies to control health care costs 

• Limiting hospital costs 

• Preferred provider organizations (PPOs) 

• Case management 

• Vertically integrated healthcare systems 

• Using acuity measures to determine costs 

• Increasing availability of mid-level provider 

• Changing fee structures 

• Controlling fraud and abuse 

• Other cost containment measures 

Steps in enacting a health policy  

problem identification, policy analysis, strategy development, and formal enactment (adoption) 

How does informatics equal safety for patients 

digitizing, organizing, and analyzing patient data to reduce human errors, enhance clinical decision-making, and streamline care delivery 

Molloy’s Humanistic Framework 

Valuing, Environment, Health, Humanity 

VALUING

To hold in high esteem the inherent worth and dignity of all individuals. 

ENVIRONMENT

The sum total of all internal and external dimensions that Influence human beings. 

HEALTH

A dynamic state of bio-psycho-socio-spiritual cultural wellbeing. 

HUMANITY

A unique human being, functioning as an integrated whole, reflecting bio-psycho-socio-spiritual-cultural dimensions. 

NYS nurse practice act 

Diagnosing, Treating, Human Responses (Identifying signs, symptoms, processes that contribute to an individuals health concern/problem, using therapeutic measure and prescribed medical orders) 

Nurses can:  

1.) Diagnose/treat : patients response → diagnosed health problem 

2.) Perform health assessments to find new symptoms 

3.) Teach/counsel patients about maintaining health/preventing illness 

4.) Execute medical regiments prescribed by licensed provider, NP, PA, etc 

5.) Contribute to be a member → interdisciplinary healthcare team 

steps of transferring practice in another state  

requires submitting an application, paying fees, and passing a background check in the new state 

CAPS

originally large to cover most of head to keep hair neat -> signified respectability, cleanliness and servitude. became symbolic of recognition of achievement (ceremony)  

PINNING

it is to be worn by those who have graduated from nursing school programs, helps to identify nurses according to their level in nursing school/the school from which they graduated. 

UNIFORM

symbolic of servant, sign of respectability 

Organization focused on quality nursing education 

National League for Nursing (NLN) 

Primary purpose of research 

systematic investigation designed to test a research question or hypothesis and draw conclusions from collected data 

NSNA

mentors the professional development of future registered nurses and facilitates their entrance into the profession by providing 

educational resources, leadership opportunities, and career guidance. 

Licensure requirements  

Application, Education (diploma/degree in professional nursing), Experience, Examination (NCLEX), Age (at least 18), Citizenship, Good character, Fees 

Delegation- roles  

Nurse’s roles can only go to a nurse  

Essential features of a culture of caring

Supporting and caring for people  

Global Health Concerns 

Coronary heart disease, Stroke and other cerebrovascular diseases, Lower respiratory infections, Chronic obstructive pulmonary disease, Diarrheal diseases, HIV/AIDS, Tuberculosis, Trachea, bronchus, lung cancers, Road traffic accidents, Prematurity and low birth weight 

Levels of government 

Federal, Local, State

Local

Cities, counties, local government → meets needs of residents (ex: safe drinking water).

Concerned about public health department budgets 

State

Needs of the state through regulatory activities (ex: safe preparation of foods at restaurants, Medicaid) Concerns: staffing shortages 

Federal

Nation level, focuses on financing healthcare for all citizens 

How does accreditation affect the school? 

organization recognized program/study meeting predetermined qualifications/standards -> school gets financial aid  

Molloy Accreditation

CCNE AND ACEN 

Florence Nightingale

Founder of modern nursing

James Derham

first male nurse in north America

Mary Seacole

worked with military in Caribbean

Clara Barton

Brought supplies and nursed the wounded on the front (battlefield), formed American Red Cross in 1881 

Mary Ezra Mahoney

First African American graduate of nursing program (1898)