Legal Issues

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Legal Issues by Mind Map: Legal Issues

1. Nurse Practice Acts(NPAs)

1.1. New Topic

1.1.1. Purposes of NPAs

1.1.1.1. Define and limit nursing practice

1.1.1.2. Set standards for nursing

1.1.1.3. Protect the public (safety)

1.2. Professional nurses are accountable to the public for their nursing judgment and the consequences of that judgement

1.3. Legal laws created by legislative bodies and also called nursing laws

1.4. Major themes contained in NPA

1.4.1. Definition of nursing process

1.4.2. Supervision and executing medical treatment plan

1.4.3. Health maintenance and prevention

2. Unlicensed Assistive Personnel (UAP)

2.1. Supervision of unlicensed personnel is a growing responsibility of the licensed practitioner

2.2. Delegation of nursing functions to UAP can create legal problems for the licensed practitioner

3. Consent

3.1. Acceptance of care plan

3.2. Treatment of a patient without consent can constitute battery

3.3. Types of consent

3.3.1. Implied

3.3.1.1. In case of unconscious patients *lifesaving treatment

3.3.2. Express

3.3.2.1. Written or oral agreement to treatment

3.3.3. Informed

3.3.3.1. - Patient has full understanding of risks and benefits of the treatment &legal capacity to consent - patient not under any mind altering drugs _ Nurse should explain the procedure

3.3.4. Involuntary

3.3.4.1. _ Patient refuse to consent to needed medical treatment _ Physician or police officer can ensure receiving treatment *psychiatric or intoxication

4. Advance Directives

4.1. defined as : written statement of a patient's treatment choices

4.2. Theses documents go into effect whenever a patient is no longer able to communicate

4.3. Types of advance directives

4.3.1. Living will

4.3.1.1. Withdraw or continue care plan as organ transplantation

4.3.2. Durable power of attorney of health care

4.3.2.1. Agency take decision instead of patient (Health care proxy)

4.3.3. Do Not Resuscitate order (DNR)

4.3.3.1. No CPR

5. Confidentiality

5.1. Is essential to the relationship between emergency nurses and their patients

5.2. As regard data (personal , social , health)

5.3. Patient information maybe disclosed in these conditions

5.3.1. A written release is signed by patient

5.3.2. Ordered into Court by legal authority

5.3.3. For purpose of continuity of care

5.3.4. Filling the in the insurance billing forms

6. Restraints

6.1. Restraining a person against his or her wishes constitutes false imprisonment

6.2. Types of restraints

6.2.1. Physical restraint

6.2.1.1. Manual method or mechanical device or equipment attached to the patients body

6.2.1.2. Complications of physical restraints

6.2.1.2.1. Skin break down

6.2.1.2.2. Delirium, agitation and fear

6.2.1.2.3. Deconditioning

6.2.1.2.4. Death due to asphyxia

6.2.2. Medical ( chemical) restraints

6.2.2.1. By using of medication to control behavior and restrict patient's freedom . _But not standard treatment to patients medical or psychiatric conditions

6.2.2.2. Complications of chemical restraints

6.2.2.2.1. Respiratory depression

6.2.2.2.2. Hemodynamic instability

6.2.2.2.3. Decreased competency or judgement

6.2.2.2.4. Withdrawal symptoms (e.g. agitation)

7. Violence &Workplace safety

7.1. Violence acts may include any act of aggression

7.2. Violence can be physical , verbal or emotional assaults

7.3. Should have plans to eliminate risks

7.4. Characteristics of ED environment

7.4.1. Safety, Qualified security and alarming system

7.4.2. Keep privacy of patients

7.4.3. Up to date with new technology

7.5. Provide explanation to patient's family about his or her condition

8. Reportable Conditions

8.1. There is legal responsibility of the emergency nurse to ensure proper reporting

8.2. Situations that mandate reporting in the emergency department

8.2.1. Any death in ED and deaths within 48 hours of admission

8.2.2. Communicable diseases such as HIV and hepatitis

8.2.3. Abuse

8.2.3.1. Child

8.2.3.2. Disabled adult

8.2.3.3. Elder

8.2.4. Escape of psychiatric patients

8.2.5. Extensive burns

8.2.6. Gunshot and stab wounds

8.2.7. Suicide (including attempts suicide)

8.2.8. Rape / sexual assault

8.2.9. Sexually transmitted infections

9. Forensics

9.1. Evidence collection

9.1.1. Situations require evidence collection

9.1.1.1. Blood & urine specimens related to drug use

9.1.1.2. Child , disabled adult and elder abuse / neglect

9.1.1.3. Death by fire Death related to transportation events

9.1.1.4. Sexual assault

9.1.1.5. Traumatic deaths

9.1.1.6. Unexpected or unexplained deaths

9.1.2. Examples of evidence collected

9.1.2.1. Clothing , projectile and missiles

9.1.2.2. Blood &blood stains

9.1.2.3. Glass fragments , Knives and gunshot residue

9.2. Evidence preservation

9.2.1. Change gloves often while evidence is collected

9.2.2. Do not cut through rips and holes

9.2.3. Check for blood stains , body fluids , gunshot residue or trace elements

9.2.4. Minimize the handling of potential evidence

9.2.5. Place all evidence collected in paper bag Label the evidence bag with patient's name , medical record numbers , date and signature of collector

9.2.6. Place each article in separate bag

9.2.7. Secure all evidence retrieved and place in a designated location

9.3. Chain of custody

9.3.1. Is a documented record of how evidence was collected , labeled and transferred to law enforcement representatives

9.3.2. Emergency nurse should record information regarding forensic evidence collection in the medical record and clearly label each specimen

9.3.3. Nurse could be subject to civil liability for battery , if principles of consent are not used in the collection of evidence

9.3.4. Law enforcement officials may seek court order to obtain evidence from patients

10. Unusual Events

10.1. Must be documented in incidence reports

10.2. _ Incident report should contain no language admitting liability or blaming others _ state only the facts of the incident _ in patient's chart , never refer to the existence of an incident report

10.3. Common Reportable Events

10.3.1. Errors in assessment , planning, implantation or evaluation of patient conditions

10.3.2. Failure to educate patients on their condition and proper treatment

10.3.3. Failure to monitor and communicate patient conditions and changes in condition

10.3.4. Medication errors

10.3.5. Patients likely to injury themselves or others

10.3.6. Use of unsafe or malfunctioning equipment

10.3.7. Falls

11. Documentation

11.1. Nursing documentation is essential part of patient care

11.2. Intended to

11.2.1. Reflect care administered to patient

11.2.2. Provide a chronology of patient progress or response to treatment

11.2.3. Communicate information to other members of health care team

11.2.4. Provide justification for charges and billing

11.3. Characteristics of medical record

11.3.1. Clear and objective

11.3.2. Realistic and factual

11.3.3. Composed of one's own observations

11.3.4. Free of opinions, generalizations and ambiguities

11.3.5. Grammatically written without spelling errors

11.3.6. Devoid of unapproved observations

11.4. Inclusions of medical record

11.4.1. Assessment data

11.4.2. Time when rapid intervention occurred

11.4.3. Problems , intervention and patient response to intervention

11.4.4. Nursing Obervations

11.4.5. Communications with members of health care team Communications with family members

11.4.6. Patient teaching , including discharge instructions

11.4.7. Patient refusal of care

12. Interfacility Transfers

12.1. A hospital with an emergency department must do :

12.1.1. Provide appropriate medical screening (nature and severity)

12.1.2. Provide appropriate stabilizing treatment for emergency medical conditions

12.1.3. Obtain written informed consent before transfer to an other facility

12.1.4. Verify that receiving facility has a valuable space and qualified personnel to treat patient

12.1.5. Ensure that the receiving facility have accepted the patient

12.1.6. Transfer the patient with appropriate personnel , equipment and mode of transportation

12.1.7. Forward all documents and medical records with the patient at the time if transfer