ATI chapter 4, questions and answers graded A+

ATI chapter 4, questions and answers graded A+ Practicing nursing within the confines of the law, nurses are able to Shield oneself from liability. Advocate for clients' rights. Provide care that is within the nurse's scope of practice. Discern the responsibilities of nursing in relationship to the responsibilities of other members of the health care team. Provide safe, competent care that is consistent with standards of care. Some of the Federal laws impacting nursing practice include The Health Insurance Portability and Accountability Act (HIPAA) The Americans with Disabilities Act (ADA) The Mental Health Parity Act (MHPA) The Patient Self-Determination Act (PSDA) Criminal and Civil Laws Criminal law is a subsection of public law and relates to the relationship of an individual with the government. A nurse who falsifies a record to cover up a serious mistake may be found guilty of breaking a criminal law Civil laws protect the individual rights of people. One type of civil law that relates to the provision of nursing care is tort law State Laws The core of nursing practice is regulated by state law. Each state has enacted statutes that define the parameters of nursing practice and gives the authority to regulate the practice of nursing to its state board of nursing. In turn, the boards of nursing have the authority to adopt rules and regulations that further regulate nursing practice. Although the practice of nursing is similar among states, it is critical that nurses know the laws and rules governing nursing in the state in which they practice. Boards of nursing have the authority to both issue and revoke a nursing license. Boards also set standards for nursing programs and further delineate the scope of practice for registered nurses, licensed practical nurses, and advanced practice nurses Licensure In general, nurses must hold a current license in every state where they practice. The states (about half of them) that have adopted the nurse licensure compact are exceptions. This model allows licensed nurses who reside in a compact state to practice in other compact states under a multi-state license. Within the compact, nurses must practice in accordance with the statues and rules of the state in which they provide care. Professional negligence Professional negligence is the failure of a person with professional training to act in a reasonable and prudent manner. The terms "reasonable and prudent" are generally used to describe a person who has the average judgment, intelligence, foresight, and skill that would be expected of a person with similar training and experience Negligence issues that prompt most malpractice suits include failure to: Follow either professional or facility-established standards of care. Use equipment in a responsible and knowledgeable manner. Communicate effectively and thoroughly with the client. Document care that was provided Nurses can avoid being liable for negligence by Following standards of care. Giving competent care. Communicating with other health team members. Developing a caring rapport with clients. Fully documenting assessments, interventions, and evaluations. Nurses are accountable for protecting the rights of clients. Specific situations that provide nurses with the opportunity to protect clients' rights are informed consent, refusal or treatment, advance directives, confidentiality, and information security Clients' rights are the legal guarantees that clients have with regard to their health care. 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 patients' rights in health care settings and is contained in "The Patient Care Partnership." For more information regarding this document, visit the organization's Web site (). Further protection of rights are ensured for residents in nursing facilities that participate in Medicare programs from "Resident Rights" statutes that govern their operation Rising role in Client rights Nurses must ensure that clients understand their rights, and nurses must also protect the rights of clients for whom they are providing care. Regardless of the age of the client, the client's nursing needs or the setting in which care is provided, the basic tenets are the same. The client has the right to: Be informed about the aspects of care in order to be active in the decision-making process. Accept, refuse, or request modification to the plan of care. Receive care that is delivered by competent individuals who treat the client with respect Informed consent is a legal process by which a client has given written permission for a procedure or treatment to be performed. Consent is considered to be informed when the client has been provided and understands The reason the treatment or procedure is needed How the treatment or procedure will benefit the client The risks involved if the client chooses to receive the treatment or procedure Other options to treat the problem, including the option of 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 to ensure that informed consent has been appropriately obtained Individuals who are authorized to grant consent for another person include: Parent of a minor Legal guardian Court-specified representative An individual who has durable power of attorney authority for health care Emancipated minors (minors who are independent from their parents, such as a married minor) provide informed consent for themselves. The nurse must verify that consent is "informed" and may witness the client sign the consent form refusal of treatment The Patient Self-Determination Act (PSDA) stipulates that on admission to a health care facility, all clients must be informed of their right to accept or refuse care. Competent adults have the right to refuse treatment, including the right to leave a health care facility without a discharge order from the provider. If the client refuses a treatment or procedure, the client is asked to sign a document indicating that he understands the risk involved with refusing the treatment or procedure and that he has chosen to refuse it. When a client decides to leave the facility without a discharge order, the nurse notifies the provider and discusses with the client the risks faced by leaving the facility prior to discharge. The nurse carefully documents the information that was provided to the client and that notification of the provider occurred. The client is asked to sign an "Against Medical Advice" form. If the client refuses to sign the form, this is also documented by the nurse. Standards of Care (Practice) Nurses base practice on established standards of care or legal guidelines for care. These standards of care can be found in: The nurse practice act of each state. Its legal guidelines for practice are established and enforced through a state board of nursing or other government agency. Nurse practice acts vary from state to state, making it obligatory for the nurse to be informed about her state's nurse practice act as it defines the legal parameters of practice. Published standards of nursing practice developed by professional organizations and specialty groups, including the American Nurses Association (ANA), the American Association of Critical Care Nurses (AACN), and the American Association of Occupational Health Nurses (AAOHN).Health care facility policies and procedures maintained in the facility's policy and procedure manual. Policies and procedures establish the standard of practice expected to be maintained by employees of that institution. These manuals provide detailed information about how the nurse should respond to or provide care in specific situations and while performing client care procedures. Nurses should be familiar with their facility's policies and procedures and provide client care in accordance with these policies. For example: Assess and document client findings postoperatively according to institutional policy. Change IV tubing and flush saline locks according to institutional policy. Standards of care define and direct the level of care that should be given by practicing nurses, and they are used in malpractice lawsuits to determine if that level was maintained. Nurses should refuse to practice beyond the legal scope of practice and/or outside of their areas of competence regardless of reason (staffing shortage, lack of appropriate personnel). Nurses should use the formal chain of command to verbalize concerns related to assignment in light of current legal scope of practice, job description, and area of competence paired Coworkers Impaired health care providers pose a significant risk to client safety. A nurse who suspects a coworker of using alcohol or abusing drugs while working has a duty to report the coworker to appropriate management personnel as specified by institutional policy. Institutional policies should provide guidelines for handling employees with a chemical abuse issue, and many provide peer assistance programs that facilitate the health care provider's entry into a treatment program. Each state has laws and regulations that govern the disposition of nurses who have been reported secondary to chemical abuse. Health care providers who are found guilty of misappropriation of controlled substances can also be charged with a criminal offense consistent with the infraction.