Nursing Chapter 2: Legal and Ethical Aspects

Legal and Ethical Aspects of Nursing

• The Nurse Practice Act (NPA) defines the scope of nursing practice and sets forth educational requirements.
• Patient advocacy involves safeguarding the well-being of patients, maintaining their rights, and ensuring privacy.
• Allowing a patient to walk alone after an order to assist can lead to negligence and potential legal liability.
• Patients have the right to refuse medication, established under the Patient Self-Determination Act.
• Building a positive nurse-patient relationship is a strong defense against lawsuits.
• The ethical principle emphasizing treating all patients as individuals is respect for people.
• A code of ethics for nurses promotes trustworthiness and accountability.
• Patient confidentiality is critical, especially when discussing healthcare decisions with family members.
• Nurses should evaluate personal beliefs and customs that may affect care, especially in sensitive situations.
• An advance directive empowers patients to determine their treatment preferences.
• Justice in nursing means providing equal care to all patients, regardless of their background.
• Administering treatment without consent can lead to civil battery charges.
• Breaching patient privacy by sharing information or images can have legal consequences.
• Nurses must adhere to the Health Insurance Portability and Accountability Act (HIPAA) to protect patient information.
• Legal guidelines regarding what nurses can do are outlined in their state’s nurse practice act.
• Malpractice can occur when there’s a breach of the nurse-patient relationship resulting in harm.
• Informed consent must be obtained before medical procedures are performed.
• Standards of care are essential for ensuring appropriate nursing interventions.
• The Nurse Practice Act provides legal guidelines governing what nurses are permitted to do in their practice.
• Ethical principles in nursing include justice, beneficence, and nonmaleficence.
• Federal regulations protecting patient information include the Health Insurance Portability and Accountability Act (HIPAA).
• State laws govern the legality of advance directives concerning patients' treatment wishes.
• Vulnerability factors for older adults at risk of abuse include decreased strength, isolation, and declining mental ability.
• The initiation of a legal action begins with filing a complaint in court.
• A nurse-patient relationship forms a legally binding contract for care responsibilities.
• Ethical responsibilities include maintaining patient confidentiality regarding health information.
• Suspected elder abuse must be reported immediately to the charge nurse for further investigation.
• Providing compassionate, competent care is the best strategy for avoiding legal issues.
• Compliance with a do-not-resuscitate (DNR) order is a legal obligation, regardless of personal beliefs.
• Nurses have the right to request reassignment if their moral convictions conflict with assigned tasks.
• Understanding standards of care is critical for determining permissible nursing actions.### Nurse Roles and Responsibilities
• Nurses serve as advocates for patients, ensuring their interests are protected alongside providing care.
• For procedures not previously performed, nurses should discuss concerns with the charge nurse for guidance rather than refusing outright.

Patient Care and Ethical Principles

• During values clarification, nurses must withhold personal opinions to encourage patient expression.
• The fundamental ethical principle in decision-making is respect for people, emphasizing dignity and individual rights.

Reporting and Accountability

• Nurses must report unethical behavior of colleagues to uphold professional standards and patient safety.
• Institutional malpractice insurance typically only covers actions performed during official duty hours.

Legal and Ethical Issues in Nursing

• Violations of HIPAA can occur through improper handling of patient information, such as leaving documents unattended at the photocopier.
• Malpractice can occur if a nurse administers medications to patients with known allergies or health complications.

Consent and Patient Rights

• Performing procedures without informed consent may lead to civil battery claims against healthcare providers.
• Patient care negligence, like failing to monitor vital signs after medication, demonstrates malpractice due to breach of duty.

Nurse Practice Acts and Standards

• Nurse practice acts define legal scopes of nursing and are essential for nurses to understand within their jurisdiction.
• Care standards delineate required, permitted, or prohibited actions necessary for quality patient care.

Legal Concepts in Nursing

• Negligence refers to carelessness and can involve medication errors or inadequate monitoring.
• Key malpractice elements include established duty, breach of that duty, and resultant harm to the patient.

Ethical Principles and Metrics

• Core ethical principles in nursing encompass autonomy, beneficence, nonmaleficence, justice, and respect for persons.
• The Patient Self-Determination Act (PSDA) ensures patients can make informed choices about their medical care and treatment options.

Patient Rights and Legal Obligations

• Patients are entitled to dignity, privacy, safety**, and complete information about their health conditions.
• Nurses must ensure competent and compassionate care to avoid potential lawsuits and foster trust in the nurse-patient relationship.

Documentation and Litigation

• Medical records serve crucial purposes in litigation, including proof of adherence to standards and evidence of any omissions.
• Violations such as discussing a patient’s condition with unauthorized parties can lead to HIPAA violations and legal repercussions.

Professional Ethics and Standards

• The Code of Ethics for Nurses provides guidelines to ensure the moral integrity of nursing practices.
• Effective communication and thorough documentation reduce the risk of malpractice claims against nurses.

Understanding Legal Responsibilities

• Various forms of defamation exist: libel (written) and slander (spoken), both can impact a nurse’s professional standing.
• In the context of torts, nurses must be vigilant about actions that could be construed as wrongful against patients.

Strategies for Legal Protection

• To minimize malpractice risks, nurses should focus on trust-building, open communication, and thorough patient assessment.