If the patient subsequently develops complications as a result of your actions, you are immune from liability as long as you acted without gross negligence (Good Samaritan Act, 1997). What does the Food and Drug Administration do? The health care provider who certifies death is not involved in the removal or transplantation of organs (see Chapter 36). 19) Outline the legal responsibilities for nurses when giving drugs. A nurse may be requested to give evidence in a deposition; this appearance needs to be taken seriously (Scott, 2009). An intention tort is an injury that is sustained by an intentional act rather than an act of negligence-or accident. Message boards used in patients’ hospital rooms to post daily nursing care information can no longer contain information revealing the patient’s medical condition. A tort is a civil wrong made against a person or property. It limits who is able to access a patient’s record. This constitutes intentional tort since John “intended” to kick Adam knowing the “act” could cause harm. However, several cases have held that the health care provider has to disclose the fact that he or she has HIV. For example, if a patient receives a burn from a warm compress application, negligence is determined by reviewing if the nurse followed the correct procedure for applying the compress. Do not disclose the patient’s confidential medical information without his or her consent. Likewise, check the state laws to see if a state honors an advance directive that originates in another state. However, if health insurance plans provide mental health benefits, the Mental Health Parity Act of 1996 forbids health plans from placing lifetime or annual limits on mental health coverage that are less generous than those placed on medical or surgical benefits. * Publicly placing one in a false light Almost every state uses this 1965 Illinois Supreme Court case as legal precedence. Some states such as Ohio offer DNR Comfort Care and DNR Comfort Care Arrest protocols. Side effects may be harmless or injurious. Tort Law in Nursing Download PDF file from https://www.omnursingacademy.weebly.com #Aiimsstaffnurseprepration #NursingExamPrepration #Tort With this legal document the patient is able to declare which medical procedures he or she wants or does not want when terminally ill or in a persistent vegetative state. Pharmacodynamics: the study of how long a drug acts on a living organism, including pharmacologic response and the duration and magnitude of response observed, relative to the concentration of the drug at the active site in the organism. The New York law, the first adopted legislation regarding DNR, is one of the most comprehensive in the United States (New York DNR Statute, 1988). With loyalty will I endeavor to aid the physician in his work, and devote myself to the welfare of those committed to my care. Americans with Disabilities Act (ADA) (1990), National Council of State Boards of Nursing [NCSBN], 2005, The Americans with Disabilities Act (ADA) (1990), The Patient Self-Determination Act (PSDA) (1991), Health Insurance Portability and Accountability Act of 1996, Centers for Medicare and Medicaid Services (2007), Uniform Determination of Death Act (1980), Failure to assess and/or monitor, including making a nursing diagnosis, Failure to use proper equipment to monitor the patient, Failure to notify the health care provider of problems, Failure to follow the six rights of medication administration, Failure to ensure patient safety, especially patients who have a history of falling, are heavily sedated, have disequilibrium problems, are frail, are mentally impaired, get up in the night, and are uncooperative, Failure to follow policies and procedures, Failure to properly delegate and supervise. This article explores the potential application of intentional torts claims in a medical context in light of recent case law. Trough level: minimum blood serum concentration of medication reached just before the next schedule dose. Another example involves the use of nursing assistive personnel (NAP) (e.g., nurse assistants). In addition to federal statutes, the ethical doctrine of autonomy ensures the patient the right to refuse medical treatment. * Malice -person knows information is false and still publishes it. * Have nurse or Dr. assess a medication history, including allergies Likewise, it is an assault for a patient to threaten a nurse (Guido, 2010). The tort of false imprisonment occurs with unjustified restraint of a person without legal warrant. IV) The person giving consent has the right to have all questions answered satisfactorily and confirm his or her understanding of the treatment given. The priority for giving consent is (1) the patient in writing before death; (2) durable power of attorney; (3) surviving spouse; (4) surviving child, parent, or sibling in the order named. f) The record is used to document the client’s name, date, time of medication administration, name of medication, dose, and signature of nurse dispensing the medication. Assault, battery, false imprisonment….these are all examples of intentional torts. 12) What are the perceptions of death according to the stages of development? • Define legal aspects of nurse-patient, nurse–health care provider, nurse-nurse, and nurse-employer relationships. A patient must authorize the release of information and designate to whom the health care information may be released. The administration of medications to clients requires knowledge and a set of skills that is unique to the nurse. If a client is affected, the physician documents the examination and findings in the client’s medical record. Legally competent adult patients consent to a DNR order verbally or in writing after receiving the appropriate information by the health care provider. The defendant. Most states have adopted the Uniform Determination of Death Act (1980). Certain criteria are necessary to establish nursing malpractice: (1) the nurse (defendant) owed a duty to the patient (plaintiff), (2) the nurse did not carry out that duty, (3) the patient was injured, and (4) the nurse’s failure to carry out the duty caused the injury. Even though the nurses attempted to contact the physician, this case holds that, when the physician fails to respond, the nurse must go over the health care provider’s head to make sure that he or she is appropriately treated. * Initiative vs. Documentation of precautions against suicide is essential. It protects individuals from losing their health insurance when changing jobs by providing portability. 22) What does the nurse do for drug omissions, erroneous drug order? An intentional tort is when an individual or entity purposely engages in conduct that causes injury or damage to another. * Autonomy vs. Shame and Doubt (1 to 3yrs) The report is completed even though an injury does not occur or is not apparent. Under the act the patient’s record needs to document whether or not the patient has signed an advance directive. * Assault -verbal or offensive contact i.e. The couple filed a lawsuit. The emergency department physician applied a cast with insufficient padding. * Latency (6 to 12 yrs) -time of minimal sexual interest or activity. HIPAA violations have civil and criminal sanctions. There are two classifications of crimes. Protocols in these instances list specific actions that health care providers will take when providing cardiopulmonary resuscitation (CPR). Living wills are often difficult to interpret and not clinically specific in unforeseen circumstances. For example, if the patient gives consent for an appendectomy and the surgeon performs a tonsillectomy, battery has occurred. Intentional Torts. Quasi-intentional tort has to do with something you SAY that causes harm to someone or their reputation. Examples of common law include informed consent, the patient’s right to refuse treatment, negligence, and malpractice. A boyfriend or girlfriend may decide to break off a relationship with you, leading to hurt feelings and genuine grief or pain. Explain the legal concept of standard of care. h) If only one part of a pre-measured dose of a controlled substance is given, a second nurse witnesses’ disposal of the unused portion and documents such on the record. Although the courts will not force adults to undergo treatment refused for religious reasons, they will grant an order allowing hospitals and health care providers to treat children of Christian Scientists or Jehovah’s Witnesses who have denied consent for treatment of their minor children. The act also protects the donor’s estate from liability for injury or damage that results from the use of the gift. For example, if a nurse assesses a client for pain and then offers a plan to manage the pain, the standard of fidelity encourages monitoring the client’s response to the plan. These laws limit liability and offer legal immunity if a nurse helps at the scene of an accident. A health care proxy or durable power of attorney for health care (DPAHC) is a legal document that designates a person or persons of one’s choosing to make health care decisions when the patient is no longer able to make decisions on his or her own behalf. • Describe the nurse’s role regarding a “do not resuscitate” (DNR) order. Which examples mentioned by the nursing student need correction? To administer medication safely to clients certain cognitive skills are essential. Both nurses sign the narcotic record to indicate that the count is correct. This means that the ADA protects a person who is HIV positive but does not have acquired immunodeficiency syndrome (AIDS). In addition, once you have committed to providing emergency care to a patient, you must stay with that patient until you can safely transfer his or her care to someone who can provide needed care such as emergency medical technicians (EMTs) or emergency department staff. The third classification of tort is the unintentional tort, which includes negligence or malpractice. Licensure protects the consuming public and insures that the nurse has completed a state approved nursing school, has successfully passed their licensure examination and has also continuously met the requirement(s) for relicensure each biennium without any suspensions or revocations of their license. The procedure, however, may require long periods of pain and suffering. For example, the purpose of the preoperative consent that clients must read and sign before surgery is the assurance that the health care team respects the client’s independence by obtaining permission to proceed. In many cases a physician is notified and determines actions to be taken to determine if any injury has been suffered. * Be informed of med’s name, purpose, action, and potential undesired effects II) Prizing one’s beliefs and behaviors. Admission of a patient to a mental health unit occurs involuntarily or on a voluntary basis. An individual who is at least 18 years of age has the right to make an organ donation (defined as a “donation of all or part of a human body to take effect upon or after death”). I will do all in my power to maintain and elevate the standard of my profession and will hold in confidence all personal matters committed to my keeping and family affairs coming to my knowledge in the practice of my calling. CHAPTER 46. Similarly, do not assume that a patient’s spouse or family members know all of the patient’s history, particularly with respect to private issues such as mental illness, medications, pregnancy, abortion, birth control, or sexually transmitted infections. Those laws limit liability and offer legal immunity for nurses who help at the scene of an accident. These standards outline the scope, function, and role of the nurse in practice. Part 2 . Nurses act as Good Samaritans by providing emergency assistance at an accident scene (Good Samaritan Act, 1997). DNR means “do not resuscitate” or “no code.” Documentation that the health care provider has consulted with the patient and/or family is required before attaching a DNR order to the patient’s medical record (Guido, 2010).The health care provider needs to review DNR orders routinely in case the patient’s condition demands a change. Patients who require organ transplantation are on a waiting list for an organ in their geographical area that gives priority to patients who demonstrate the greatest need. Malpractice sometimes involves failing to check a patient’s identification correctly before administering blood and then giving the blood to the wrong patient. Peak level: time it take for a medication to reach its highest serum concentration. Demonstrating accountability, and acting responsibly in professional practice, means that the nurse acknowledges when errors in professional practice occurs. The most familiar health care tort is termed “professional negligence.” In fact there is only one tort, negligence. Is coming to terms with the situation, rather than submitting to resignation or hopelessness. Any health care professional who does not report suspected child abuse or neglect may be liable for civil or criminal legal action. * Must have a License In most states Required Request laws mandate that, at the time of admission to a hospital, a qualified health care provider has to ask each patient over age 18 whether he or she is an organ or tissue donor. The Nurse Practice Act is a set of standards which a nurse has to follow in order to maintain a professional performance. Learning Outcome Wrongful handling of a deceased person’s remains causes emotional harm to the surviving family. The ADA regulations protect the privacy of infected people by giving individuals the opportunity to decide whether to disclose their disability. Malpractice and Negligence Alice C. Murr and Mary Frances Moorhouse Nursing is a dynamic profession that continually evolves in response to changing needs, demands, and resources of society. You should only provide care that is consistent with your level of expertise. It defines the scope of a nurse’s professional functions and responsibilities. Community and public health nurses have the legal responsibility to enforce laws enacted to protect public health (see Chapter 3). Society expects safe health care delivery, especially from nurses who are typically perceived as the most trusted profession. These rules create patient rights to consent to the use and disclosure of their protected health information, to inspect and copy one’s medical record, and to amend mistaken or incomplete information. Even though the patient is legally “brain dead,” the patient’s organs are sometimes healthy for donation to other patients. Most states have adopted the, An individual’s right to privacy sometimes conflicts with the public’s right to know. If the answer is affirmative, the health care provider obtains a copy of the document. Select all that apply. QUASI-INTENTIONAL TORTS EXAMPLE Breach of confidentiality A nurse releases the medical diagnosis of a client to a member of the press. Usual questions concern witnesses, insurance experts, and which health care providers the plaintiff has seen before and after the incident. Slander occurs when one speaks falsely about another. The positions of these two national organizations are not contradictory and require nurses to approach a patient’s end of life with openness to listening to the patient’s expressions of fear and to attempt to control the patient’s pain. The tort of invasion of privacy protects the patient’s right to be free from unwanted intrusion into his or her private affairs. It allows employees to change jobs without losing coverage as a result of preexisting coverage exclusion as long as they have had 12 months of continuous group health insurance coverage (Carter, 2010). Tort Look on pages 158-159 for the comparison. I will abstain from whatever is deleterious and mischievous Torts: Torts are civil laws that address the legal rights of patients and the responsibilities of the nurse in the nurse patient relationship. Avoid abandonment of clients, even when client goals differ from health care provider goals. 4) The right route. Licensure permits people to offer special skills to the public, and it also provides legal guidelines for protection of the public. What would be a crime committed by a nurse? Malpractice: is negligence committed by a professional such as a nurse or physician. tort. A judge may determine that the patient is a danger to self or others; then the judge will grant the involuntary detention, and the patient can be detained for 21 more days for psychiatric treatment. • List sources for standards of care for nurses. This stage provides the opportunity to work trough the loss and to begin solving problems. When a patient’s death has occurred under suspicious circumstances or if the patient died within 24 hours of admission to a health care facility, the decision to conduct a postmortem examination is made by the medical examiner (Autopsy Consent, 1998). * Intimacy vs. III) Acting on one’s beliefs. In Quasi intentional torts the accusation is lacking but there is still a volitional act and direct allegations. John does not know that Adam suffers a disability, but he does know that kicking someone will cause discomfort. Phone calls and embarrassing questions guide the nurse in identifying strengths and those who need additional support crime committed a... 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