Legal and Ethical Healthcare Practices PDF

Why are healthcare laws important? Nurses must be aware of the aspects of healthcare law and its applications. More importantly nurses must understand the effects and consequences of these laws and the nursing practice. Laws are a specific set of rules created by society or government that regulat...

Why are healthcare laws important? Nurses must be aware of the aspects of healthcare law and its applications. More importantly nurses must understand the effects and consequences of these laws and the nursing practice. Laws are a specific set of rules created by society or government that regulate specific behaviors, that either prohibit action or require action. Tort Law Tort law is a wrongful action or omission committed by an individual against a person who suffers harm from that act or omission. Most common basis for individual liability of nurses and physicians is Medical negligence Medical malpractice Goals of Tort law To provide relief to the harmed party To impose liability on those responsible for the harm To deter others from such harmful acts Duty of care Legal obligation to provide a reasonable standard of care. a general responsibility to act with reasonable care and prevent harm to patients, based on the accepted standards of nursing practice. Breach of Duty This happens when a nurse's actions or inactions fall below the expected standard of care, potentially leading to a negative outcome for the patient. Causation The link between the breech and the injury. Ethical Dilemmas – in order to do something right you may risk doing something wrong. Patient care: determining whether aggressive treatment for end of life will cause more harm than benefit. Autonomy – the freedom to make decisions supported by knowledge and self-confidence. A patient who makes independent health care decisions is demonstrating autonomy. Accountability – willingness to accept responsibility for one’s actions. Advocacy – promoting the interest of others. Advocacy requires the nurse to focus on the patients’ needs and benefits. Justice – mandates that all people are treated equally regardless of income, power, position. No individual should have an advantage over others. Good Samaritan law The law protects people who use reasonable care when helping someone in need. Narcan. AED (from ordinary neg) Medical Negligence and Medical Malpractice Negligence committed by a person functioning in a professional role. 4 elements that must be proven for patient to receive compensation: The nurse or doctor : 1. owed a duty/standard of care to the patient 2. breached the duty/standard in providing the care 3. caused injury to the patient 4. caused an injury that resulted in damage to the patient Employer/Employee liability Employer can be liable for the acts of its employee if the employee was acting as an agent of the employee and the action resulted in injury. Licensing and Scope of Practice Scope of Practice is the range of permissible activity as defined by law; what nurses can and cannot do. Varies from state to state. BON Board of Nursing exercises its power to discipline a nurse in violation of the scope of practice. Penalties Mandatory education Probation Suspension Revocation of license Patient Decision Making: Concept of Consent Informed Consent Healthcare providers are obligated to explain procedures and treatments including the risks and benefits and alternatives to the procedure in a language the patient understands. The patient or the patient’s representative as well as the doctor signs the informed consent. A nurse can witness a patient's signature on an informed consent form in Connecticut, but the physician is responsible for obtaining the consent. Nurse must alert the physician of the patient’s refusal and document. Competence is a legal term that means a person has sufficient capacity and ability to make reasonable decisions. If a person is determined to be incompetent the court will appoint a guardian to make healthcare decisions. Confidentiality Laws HIPAA – protects patient information and distribution of that information verbally as well as electronically. Advanced Directives Living will – specifies the treatment a person wants to receive when the patient is unconscious or unable to make decisions for themselves. May address: end of life care treatment to be withheld CPR organ donation Power of Attorney Legal document that allows designated persons to make legal and financial decisions on behalf of an individual. Health care proxy – designated person who can make healthcare decisions for individual who cannot communicate wishes or comprehend information. Do-Not-Resuscitate Orders DNR also NO CODE, DNI Order by patient or designated family member who chooses to refuse or limit treatment in the case of cardiac or respiratory arrest. DNR - Do not resuscitate NO CODE - do not code. DNI do not intubate – CPR resuscitation measures only. No intubation Laws Affecting End-of-Life Death with Dignity Act 1997 – Nine states have legalized physician-assisted suicide. Allows physicians to write a lethal dose of medication that a mentally competent patient can use to end their life if the patient has less than 6 months to live. Beneficence – “doing good”. Nurses demonstrate beneficence by acting on behalf of and the needs of others excluding their personal thoughts and feelings. Ethical concept of beneficence – providing compassionate care for all people in all circumstances. Nonmaleficence – “first do no harm” requires the avoidance of harm. Appears on the Hippocratic oath. Code of Ethics for Nurses According to the American Nurses Association (ANA), the nursing code of ethics is a guide for “carrying out nursing responsibilities in a manner consistent with quality in nursing care and the ethical obligations of the profession.” There are 4 main principles of the nursing code of ethics: 1. Autonomy 2. Beneficence 3. Justice 4. Nonmaleficence Responsibility of Student Nurses Student nurses are held to the same professional standards as professional nurses. Acting responsibly, respectfully toward faculty, staff and patients, take accountability for their actions. “Promote the highest level of moral and ethical principles” Respect human rights, values, and choices of cultural and spiritual beliefs of patients and others. Academic setting, lab and classroom: If a peer is acting inappropriately, it is every student’s responsibility to report that student to a faculty member (page 144)