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Chapter 3: Nursing Professional Responsibilities and Law

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49 Questions

What should you do if you encounter a violation of facility social media policies?

Report it to the nurse manager

Which federal law has a significant impact on nursing practice?

All of the above

Who has the authority to adopt rules and regulations that govern nursing practice?

Boards of nursing

What is the core of nursing practice regulated by?

State laws

Which of the following is NOT a source of law that affects nursing practice?

Patient preferences

Why is it important for nurses to know the laws governing nursing practice in their state?

Because the laws and rules governing nursing practice vary from state to state

What is the primary authority responsible for regulating the practice of nursing?

Boards of nursing

Which of the following federal laws affects nursing practice?

All of the above

What is the primary purpose of institutional manuals in a healthcare setting?

To outline detailed procedures for client care

What is the legal consequence for a nurse who follows institutional policy, but still results in an injury to the client?

The nurse will not be held legally responsible

Why is it important for nurses to be familiar with their institution's policies and procedures?

To reduce the risk of legal liability

What is an example of providing client care in accordance with institutional policy?

Assessing and documenting findings postoperatively

What is the primary benefit of following institutional policy and procedures?

Legal protection in case of injury

What is the consequence of not following institutional policy and procedures?

Legal liability for the nurse

What is the purpose of institutional policies and procedures related to infection prevention?

To reduce the risk of infection transmission

Why is it essential to follow institutional policies and procedures related to medication use?

To reduce the risk of medication errors

What is a primary concern when a client decides to leave the facility without a prescription for discharge?

Discussing the potential risks associated with leaving the facility prior to discharge

What is the purpose of the Against Medical Advice form?

To ensure the client understands the potential risks associated with leaving the facility without treatment

What is a client's right in a healthcare institution?

To retain their rights as individuals and citizens of the United States

What is the role of the nurse in the situation where a client decides to leave the facility without a prescription for discharge?

To notify the provider and discuss the potential risks associated with leaving the facility prior to discharge

What is the purpose of the Patient Care Partnership?

To identify client rights in healthcare settings

What should the nurse document in the situation where a client decides to leave the facility without a prescription for discharge?

The information that was provided to the client and notification of the provider

What is a consequence of a client leaving the facility without treatment?

Permanent physical or mental impairment or disability

What is the responsibility of the nurse in ensuring client rights?

To respect the client's autonomy and decision-making capacity

What is the primary purpose of a durable power of attorney for health care?

To guarantee that the client's decisions about health care are honored

What is the nurse's role in ensuring that the client's decisions about health care are respected?

To advocate for the client's autonomy and self-determination

What is the primary purpose of the HIPAA Privacy Rule?

To protect the client's medical records from unauthorized access

What is the nurse's responsibility in ensuring that the client's rights are respected?

To advocate for the client's autonomy and self-determination

What is the primary benefit of obtaining informed consent from the client?

To ensure that the client understands the risks and benefits of treatment

What is the nurse's role in ensuring that the client's decisions about health care are honored?

To advocate for the client's autonomy and self-determination

What is the primary purpose of a living will?

To outline the client's preferences for end-of-life care

What is the nurse's responsibility in ensuring that the client's privacy is respected?

To ensure that the client's medical records are kept confidential

What is the primary benefit of using a durable power of attorney for health care?

To guarantee that the client's decisions about health care are honored

What is the nurse's role in ensuring that the client's autonomy is respected?

To advocate for the client's autonomy and self-determination

What is the nurse's responsibility when administering a medication that may harm the client?

To question the prescription and clarify any concerns with the physician

What is implied consent in a healthcare setting?

Compliance with the nurse's instructions without explicit consent

What is a essential component of advocacy in nursing?

Risk-taking

What is the primary purpose of obtaining informed consent?

To ensure the client understands the risks and benefits of a procedure

What is the nurse's role in ensuring client autonomy?

To respect the client's right to refuse treatment

What is the purpose of state laws regulating informed consent?

To regulate age limitations and emergencies

What is the nurse's responsibility when obtaining informed consent?

To verify that consent is informed and witnessed

What is an essential component of patient education?

Explaining the risks and benefits of a procedure

What is the nurse's role in promoting patient autonomy?

To provide education and support to the client

What is the purpose of the nurse verifying informed consent?

To ensure the client understands the risks and benefits of a procedure

What is the primary purpose of a durable power of attorney for healthcare in ensuring that a client's decisions about healthcare are honored?

To ensure that the client's autonomy is respected in making healthcare decisions

What is the nurse's role in ensuring that a client's decisions about healthcare are respected?

To advocate for the client's autonomy in making healthcare decisions

What is the primary purpose of the HIPAA Privacy Rule in healthcare settings?

To protect the confidentiality of client information

What is the nurse's responsibility in ensuring that a client's autonomy is respected in making healthcare decisions?

To advocate for the client's autonomy in making healthcare decisions

What is the primary benefit of obtaining informed consent from the client in healthcare settings?

To respect the client's autonomy in making healthcare decisions

Study Notes

Professional Responsibilities

  • Report any violations of facility social media policies to the nurse manager.

Sources of Law

  • State laws define the parameters of nursing practice and give authority to regulate the practice of nursing to its state board of nursing.
  • Federal regulations, such as HIPAA, Americans with Disabilities Act (ADA), Mental Health Parity Act (MHPA), Patient Self-Determination Act (PSDA), Uniform Anatomical Gift Act (UAGA), and National Organ Transplant Act (NOTA), have a great impact on nursing practice.

Institutional Policies

  • Institutions have policy manuals that provide detailed information on how to respond to or provide care in specific situations and while performing client care procedures.
  • Nurses who practice according to institutional policy are legally protected if that standard of care still results in an injury.
  • It is essential for nurses to be familiar with their institution's policies and procedures and provide client care in accordance with them.

Client Rights

  • Client rights are legal guarantees that clients have with regard to their healthcare.
  • Clients using the services of a health care institution retain their rights as individuals and citizens of the United States.
  • The American Hospital Association (AHA) identifies client rights in health care settings in the Patient Care Partnership.
  • When a client decides to leave the facility without a prescription for discharge, the nurse notifies the provider and discusses the potential risks associated with leaving the facility prior to discharge.
  • The nurse documents the information provided to the client and notification of the provider.
  • Clients should be informed of possible complications that could occur without treatment, possibility of permanent physical or mental impairment or disability, and possibility of other complications that could lead to death.
  • Clients are asked to sign an Against Medical Advice form; if they refuse, this is also documented by the nurse.

Professional Responsibilities

  • Any violations of facility social media policies should be reported to the nurse manager.

Sources of Law

  • Federal regulations have a significant impact on nursing practice.
  • Examples of federal laws affecting nursing practice include:
    • HIPAA (Health Insurance Portability and Accountability Act)
    • Americans with Disabilities Act (ADA)
    • Mental Health Parity Act (MHPA)
    • Patient Self-Determination Act (PSDA)
    • Uniform Anatomical Gift Act (UAGA)
    • National Organ Transplant Act (NOTA)
  • State laws regulate nursing practice, with each state having its own statutes defining the parameters of nursing practice.

Confidentiality

  • HIPAA regulates the confidentiality of health care information and gives clients the right to control the release of their health information.
  • Rights provided by HIPAA legislation include:
    • Clients' right to obtain a copy of their medical record and submit requests to amend erroneous or incomplete information.
    • Requirement for health care and insurance providers to provide written information about how medical information is used and shared.
  • Nurses should ask for a code from individuals inquiring about a client's status and only disclose information when the code is provided.
  • Communication about a client should only take place in a private setting where it cannot be overheard by unauthorized individuals.

Nursing Role in Confidentiality

  • Nurses must be aware of clients' rights regarding privacy and confidentiality.
  • Facility policies and procedures are established to ensure compliance with HIPAA regulations.
  • Nurses must know and adhere to the policies and procedures to protect client confidentiality.
  • HIPAA regulations provide for penalties in the event of noncompliance with the regulations.

Prescriptions and Client Decisions

  • Unless a DNR (Do Not Resuscitate) or AND (Allow Natural Death) prescription is written, the nurse should initiate CPR when a client has no pulse or respirations.
  • Written prescriptions for DNR or AND must be placed in the client's medical record.
  • Additional prescriptions by the provider are based on the client's individual needs and decisions and provide for comfort measures.
  • The client's decision is respected regarding the use of antibiotics, initiation of diagnostic tests, and provision of nutrition by artificial means.

Nursing Role in Advocacy

  • Nurses must ensure clients are informed of their rights and have adequate information to make healthcare decisions.
  • Nurses must assist clients with making healthcare decisions, without directing or controlling their decisions.
  • Nurses are accountable for protecting clients' rights, including informed consent, refusal of treatment, advance directives, confidentiality, and information security.
  • Informed consent is a legal process by which a client gives written permission for a procedure or treatment to be performed.
  • Consent is considered informed when the client has been provided with and understands the necessary information.
  • The necessary information includes the client's rights under statutes that govern the operation of healthcare facilities.

Nursing Responsibilities

  • Nurses must ensure clients understand their rights, regardless of age, nursing needs, or care setting.
  • Each client has the right to be informed about all aspects of care and take an active role in the decision-making process.
  • Nurses must act as advocates, even when they disagree with clients' decisions.

Advocacy Skills

  • Vision is essential for advocacy, as nurses must be able to see the client's perspective.
  • Articulate communication is necessary for effective advocacy.
  • Assertiveness is required to ensure clients' rights are respected.
  • Self-confidence is essential for nurses to take risks and question prescriptions or care plans that may harm clients.
  • Caring and respect are fundamental values for nurses, as they support and advocate for clients.
  • Consent is required for all care given in a healthcare facility.
  • Implied consent is adequate for most aspects of nursing care.
  • Written consent is required for invasive procedures or surgery.
  • State laws regulate who is able to give informed consent, and laws vary regarding age limitations and emergencies.

Professional Responsibilities

  • Any violations of facility social media policies should be reported to the nurse manager.

Sources of Law

  • Federal regulations have a significant impact on nursing practice.
  • Examples of federal laws affecting nursing practice include:
    • HIPAA (Health Insurance Portability and Accountability Act)
    • Americans with Disabilities Act (ADA)
    • Mental Health Parity Act (MHPA)
    • Patient Self-Determination Act (PSDA)
    • Uniform Anatomical Gift Act (UAGA)
    • National Organ Transplant Act (NOTA)
  • State laws regulate nursing practice, with each state having its own statutes defining the parameters of nursing practice.

Confidentiality

  • HIPAA regulates the confidentiality of health care information and gives clients the right to control the release of their health information.
  • Rights provided by HIPAA legislation include:
    • Clients' right to obtain a copy of their medical record and submit requests to amend erroneous or incomplete information.
    • Requirement for health care and insurance providers to provide written information about how medical information is used and shared.
  • Nurses should ask for a code from individuals inquiring about a client's status and only disclose information when the code is provided.
  • Communication about a client should only take place in a private setting where it cannot be overheard by unauthorized individuals.

Nursing Role in Confidentiality

  • Nurses must be aware of clients' rights regarding privacy and confidentiality.
  • Facility policies and procedures are established to ensure compliance with HIPAA regulations.
  • Nurses must know and adhere to the policies and procedures to protect client confidentiality.
  • HIPAA regulations provide for penalties in the event of noncompliance with the regulations.

Prescriptions and Client Decisions

  • Unless a DNR (Do Not Resuscitate) or AND (Allow Natural Death) prescription is written, the nurse should initiate CPR when a client has no pulse or respirations.
  • Written prescriptions for DNR or AND must be placed in the client's medical record.
  • Additional prescriptions by the provider are based on the client's individual needs and decisions and provide for comfort measures.
  • The client's decision is respected regarding the use of antibiotics, initiation of diagnostic tests, and provision of nutrition by artificial means.

This quiz covers the professional responsibilities of nurses, including reporting social media policy violations, and the sources of law that govern nursing practice, such as state laws and federal regulations.

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