Chapter 4: Nursing Practice and State Laws
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Questions and Answers

What must clients do to consent to all care they receive in a health care facility?

  • Implied consent by adhering to nurse's instructions (correct)
  • Sign a waiver
  • Verbally acknowledge the care
  • Provide a detailed written consent

    • Nurses are responsible for knowing the laws regarding informed consent in the states they practice.

    True

    When the client is unable to provide consent, another authorized person must give ________.

    consent

    What is the legal process by which a client gives written permission for a procedure or treatment?

    <p>Informed Consent</p> Signup and view all the answers

    Negligence is the failure of a person with professional training to act in a reasonable and imprudent manner.

    <p>True</p> Signup and view all the answers

    What kind of law protects individual rights and can relate to the provision of nursing care?

    <p>tort law</p> Signup and view all the answers

    ______ is a legal privilege where a client gives written permission for a procedure or treatment.

    <p>Informed consent</p> Signup and view all the answers

    Match the tort with its description:

    <p>Assault = Intentionally making a person fearful and apprehensive Battery = Physical contact with a person that involves injury or offensive contact False Imprisonment = Restraining a person against their will</p> Signup and view all the answers

    Which of the following torts is the assistive personnel (AP) committing by reprimanding a client for not using the urinal properly and threatening to use diapers next time?

    <p>Assault</p> Signup and view all the answers

    Which type of tort is the nurse about to commit by preparing to administer a PRN sedative medication to a competent adult client without the client's request?

    <p>False imprisonment</p> Signup and view all the answers

    Which statement made by a client indicates an understanding of advance directives?

    <p>I plan to write that I don't want them to keep me on a breathing machine.</p> Signup and view all the answers

    Regarding informed consent for an elective surgical procedure, which actions should the nurse take? (Select all that apply)

    <p>Witness the client's signature on the consent form.</p> Signup and view all the answers

    What should a nurse do if they notice another nurse appearing drowsy and unable to focus on the job, including being found asleep during work hours?

    <p>Report the observations to the nurse manager on the unit.</p> Signup and view all the answers

    What is the primary reason for reporting communicable diseases to the local or state health department?

    <p>All of the above</p> Signup and view all the answers

    What is the legal consequence for nurses who have substance use disorders and fail to report their condition?

    <p>Criminal charges and loss of license</p> Signup and view all the answers

    What is the underlying principle of negligence in nursing?

    <p>Failure to act with reasonable care</p> Signup and view all the answers

    What is the primary concern for nurses regarding confidentiality and privacy?

    <p>Protecting patient information from unauthorized access</p> Signup and view all the answers

    What type of tort is committed when a nurse fails to provide adequate care to a patient, resulting in harm?

    <p>Negligent tort</p> Signup and view all the answers

    What is the legal consequence for nurses who violate HIPAA regulations?

    <p>Criminal penalties and fines</p> Signup and view all the answers

    What is the primary responsibility of nurses regarding reporting of abuse or suspected abuse?

    <p>To follow facility policy</p> Signup and view all the answers

    What is the legal concept that protects individual rights and can relate to the provision of nursing care?

    <p>Constitutional law</p> Signup and view all the answers

    What is the primary purpose of HIPAA in the healthcare industry?

    <p>To protect the confidentiality and privacy of patient's health information</p> Signup and view all the answers

    What is an example of unintentional tort in nursing practice?

    <p>A nurse fails to implement safety measures for a patient at risk for falls</p> Signup and view all the answers

    What is the consequence of a nurse violating HIPAA regulations?

    <p>All of the above</p> Signup and view all the answers

    What is the primary reason for Good Samaritan laws?

    <p>To protect healthcare workers from liability in emergency situations</p> Signup and view all the answers

    What is an example of a federal regulation that affects nursing practice?

    <p>All of the above</p> Signup and view all the answers

    What is the primary purpose of the Nurse Licensure Compact?

    <p>To regulate the licensure of nurses across states</p> Signup and view all the answers

    What is the consequence of a nurse committing negligence in practice?

    <p>All of the above</p> Signup and view all the answers

    What is the primary purpose of the Americans with Disabilities Act (ADA) in healthcare?

    <p>To ensure equal access to healthcare for individuals with disabilities</p> Signup and view all the answers

    A nurse accidentally administers a large dose of medication due to a calculation error, resulting in a client's death. What type of law is the nurse likely to be charged with?

    <p>Criminal law</p> Signup and view all the answers

    Breach of confidentiality by revealing a client's medical diagnosis to a member of the press is an example of which type of tort?

    <p>Breach of confidentiality</p> Signup and view all the answers

    What type of law is related to the provision of nursing care and involves wrongful acts that result in harm to clients?

    <p>Tort law</p> Signup and view all the answers

    A nurse restrains a competent client to prevent them from leaving the healthcare facility. What type of tort is the nurse committing?

    <p>False imprisonment</p> Signup and view all the answers

    What is the term for a nurse's failure to act in a reasonable and prudent manner, resulting in harm to a client?

    <p>Negligence</p> Signup and view all the answers

    A nurse tells a coworker that they believe a client has been unfaithful to their partner. What type of tort is the nurse committing?

    <p>Defamation of character</p> Signup and view all the answers

    What type of law is related to the relationship between an individual and the government?

    <p>Criminal law</p> Signup and view all the answers

    A nurse threatens to place an NG tube in a client who is refusing to eat. What type of tort is the nurse committing?

    <p>Assault</p> Signup and view all the answers

    Study Notes

    Safe, Effective Care Environment

    • Each state has enacted statutes that define the parameters of nursing practice and give the authority to regulate the practice of nursing to its state board of nursing.
    • Boards of nursing have the authority to issue and revoke a nursing license, set standards for nursing programs, and further delineate the scope of practice for RNs, practical nurses (PNs), and advanced practice nurses.

    Licensure

    • Nurses must have a current license in every state in which they practice.
    • The nurse licensure compact allows licensed nurses who reside in a compact state to practice in other compact states under a multistate license.

    Sources of Law

    • Federal laws affecting nursing practice include:
      • Health Insurance Portability and Accountability Act (HIPAA)
      • Americans with Disabilities Act (ADA)
      • Mental Health Parity Act (MHPA)
      • Patient Self-Determination Act (PSDA)
    • Tort laws include:
      • Unintentional torts (e.g., negligence)
      • Quasi-intentional torts (e.g., breach of confidentiality)
      • Intentional torts (e.g., assault, battery, false imprisonment)

    Professional Negligence

    • Professional negligence is the failure of a person with professional training to act in a reasonable and prudent manner.
    • Examples of negligence include:
      • Failure to follow professional and facility-established standards of care
      • Failure to use equipment in a responsible and knowledgeable manner
      • Failure to communicate effectively and thoroughly with clients
      • Failure to document care provided
      • Failure to notify the provider of a change in the client's condition

    Clients' Rights

    • Nurses are accountable for protecting the rights of clients, including:
      • Informed consent
      • Refusal of treatment
      • Advance directives
      • Confidentiality
      • Information security
    • Clients have the right to understand the aspects of care to be active in the decision-making process.
    • Clients have the right to accept, refuse, or request modification of the plan of care.
    • Informed consent is a legal process by which a client or their legally appointed designee gives written permission for a procedure or treatment.
    • The client must be informed of:
      • The reason they need the treatment or procedure
      • The benefits of the treatment or procedure
      • The risks involved if they choose to receive the treatment or procedure
      • Other options to treat the problem, including not treating the problem
    • The nurse's role in the informed consent process is to witness the client's signature on the informed consent form and ensure that the provider has obtained the informed consent responsibly.

    Refusal of Treatment

    • Clients have the right to refuse treatment, including the right to leave a health care facility without a discharge prescription from the provider.
    • If the client refuses a treatment or procedure, the nurse must document the incident and discuss the risks involved with refusing the treatment or procedure with the client.

    Advance Directives

    • Advance directives are used to communicate a client's wishes regarding end-of-life care should they become unable to do so.

    • Types of advance directives include:

      • Living will
      • Durable power of attorney for health care

    • The Patient Self-Determination Act (PSDA) requires asking all clients on admission to a health care facility whether they have advance directives.### Healthcare Facilities' Policies and Procedures

    • Establish the standard of practice for employees in that facility

    • Provide detailed information on how to respond to or provide care in specific situations and while performing client care procedures

    • Implicate nurses in malpractice lawsuits if they do not follow these standards

    Nursing Role in Advance Directives

    • Provide written information about advance directives
    • Document the client's advance directives status
    • Ensure that the advance directives reflect the client's current decisions
    • Inform all members of the healthcare team of the client's advance directives

    Mandatory Reporting

    • Healthcare providers have a legal obligation to report their findings in accordance with state law in certain situations
    • Nurses must report any suspicion of abuse (child or elder abuse, adult violence) following facility policy
    • Nurses must report communicable disease diagnoses to the local or state health department
    • Reporting allows officials to ensure appropriate medical treatment, monitor for common-source outbreaks, plan and evaluate control and prevention plans, and identify outbreaks and epidemics

    Impaired Coworkers

    • Impaired healthcare providers pose a significant risk to client safety
    • Nurses who suspect a coworker of any behavior that jeopardizes client care or could indicate a substance use disorder have a duty to report the coworker to the appropriate manager
    • Facilities' policies provide access to assistance programs that facilitate entry into a treatment program

    Nursing Interventions to Avoid Liability for Negligence

    • Refuse to practice beyond the legal scope of practice or outside of their areas of competence
    • Use the formal chain of command to verbalize concerns related to assignment
    • Document all client information and communications accurately and fully
    • Inform all members of the healthcare team of the client's advance directives
    • Verify that the client has given informed consent before performing any procedure or treatment

    Good Samaritan Law

    • Protects healthcare workers from liability when intervening at the scene of an emergency
    • Exists in all states

    Licensure

    • Nurses must have a current license in every state they practice
    • Some states have adopted the Nurse Licensure Compact, allowing licensed nurses to practice in other compact states
    • Nurses must practice in accordance with the statutes and rules of the state in which they provide care

    Sources of Law

    • Federal laws affecting nursing practice:
      • Health Insurance Portability and Accountability Act (HIPAA)
      • Americans with Disabilities Act (ADA)
      • Mental Health Parity Act (MHPA)
      • Patient Self-Determination Act (PSDA)
    • Criminal and civil laws:
      • Criminal law: relates to the relationship between an individual and the government
      • Civil law: protects individual rights

    Tort Law

    • Unintentional torts: negligence (e.g., failing to implement safety measures for a client at risk for falls)
    • Quasi-intentional torts: breach of confidentiality (e.g., releasing a client's medical diagnosis to a member of the press)
    • Intentional torts:
      • Assault (e.g., threatening to place an NG tube in a client)
      • Battery (e.g., physically contacting a client without consent)
      • False Imprisonment (e.g., restraining a competent client to prevent their leaving)

    Reporting Responsibilities

    • Abuse: nurses must report any suspicion of abuse (child or elder abuse, adult violence) following facility policy
    • Communicable diseases: nurses must report diagnoses to the local or state health department to:
      • Ensure appropriate medical treatment
      • Monitor for common-source outbreaks
      • Plan and evaluate control and prevention plans
      • Identify outbreaks and epidemics

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    Related Documents

    Legal Responsibilities PDF

    Description

    This quiz covers the legal aspects of nursing practice, including state laws and regulations that govern nursing practice.

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