Nursing laws Complete Verified Solution, Graded A+

Nursing laws Complete Verified Solution, Graded A+ Statutory Law • Laws written and enacted by legislative bodies • Violations are criminal offenses and are punishable by fines or imprisonment Federal statutes related to nursing and health care Have a major impact on nursing care—mandate a minimum standard of care in all settings that receive federal funds (Medicare, Medicaid) FEDERAL: Emergency Medical Treatment and Active Labor Law (EMTALA) • Enacted to prohibit the refusal of care for indigent and uninsured patients seeking medical assistance in emergency departments • Prohibits the transfer of unstable patients, including women in active labor, from one facility to another • Applicable to nonemergency facilities such as urgent care clinics FEDERAL: Americans With Disabilities Act of 1990 (ADA) prohibits discrimination against persons with disabilities by removing barriers that might prevent the same opportunities available to persons without disabilities FEDERAL: Patient Self-Determination Act of 1990 requires that federally funded hospitals (Medicare, Medicaid) inform adult patients in writing about their right to make treatment choices and that they ask patients if they have a living will or durable power of attorney for health care FEDERAL: Health Insurance Portability and Accountability Act of 1996 (Public Law No. 104-191) (HIPAA) intent of this law is to ensure confidentiality of the patient's medical records; the statute sets guidelines for maintaining the privacy of health data FEDERAL: The Patient Safety and Quality Improvement Act allows certain disclosures of patient safety data (reporting certain illnesses - HIV, VD, etc - to health department) STATE: Nurse Practice Act and board of nursing rules and regulations Define the scope and limitations of professional nursing practice • Vary from state to state, but common elements include the following: Definition of the term registered nurse Description of professional nursing functions Standards of competent performance Behaviors that represent misconduct or prohibited practices Grounds for disciplinary action Fines and penalties for violations • Each nurse should own a copy and should understand the content STATE: Nurse/patient ratio and mandatory overtime statutes + California was the first state to enact a law in January 2004 that mandates the establishment of minimum nurse/patient ratios in acute care facilities (e.g., critical care units, step-down and medical-surgical units, maternity departments). + Research indicates that improved nurse/patient ratios are associated with lower "failure-to-rescue" rates and lower inpatient mortality rates. STATE: Child Abuse Prevention and Treatment Act and reporting statutes • Laws mandating the reporting of specific health problems and suspected or confirmed abuse • Health professionals must report the following under penalty of fine or imprisonment for failing to do so: Infant and child abuse Dependent elder abuse Specified communicable diseases • Most laws grant immunity from suit within the context of the mandatory reporting statute. Institutional licensing laws: + All facilities that provide health care services must comply with licensing laws. + Generally contained within the law are the following: • Minimum standards for maintenance of the physical plant • Basic operational aspects for major departments—nursing, dietary, clinical labs, and pharmacy • Essential aspects of patient rights and informed consent process • Copies of licensing laws can be obtained from the state health department. American Nurses Association (ANA) Standards of Professional Performance Should be used along with Standards of Quality Practice to guide nurses Common Law Created through cases heard and decided in federal and state appellate courts—also known as decisional or judge-made law (Common law and case law provide courts with guidelines for deciding future cases) Nursing case law • Body of written opinions about nursing practice, also known as nursing case law • Importance cannot be overstated in establishing the current standard of practice • One important case established "affirmative duty"—the duty that nurses will exercise independent judgment to prevent harm to patients. • Nurses should review case law and journals dedicated to legal issues in nursing practice. • Common law and case law provide courts with guidelines for deciding future cases. Civil Laws Negligence and malpractice CIVIL: neglicence failure to act in a reasonable and prudent manner. CIVIL: malpractice a special type of negligence, that is, the failure of a professional, a person with specialized education and training, to act in a reasonable and prudent manner. Elements essential for proving negligence or malpractice • Nurse owed the patient or client a special duty of care based on the establishment of a nurse-patient relationship. • Nurse breached his or her duty to the patient or client. • The patient suffered actual harm or damage. • Proximate cause or a causal connection has been established between the standard of care provided by the nurse and the patient's injury. Most frequent allegations of nursing negligence • Failure to ensure patient safety • Improper treatment or negligent performance of treatment • Failure to monitor the patient and report significant findings • Medication errors • Failure to follow the agency's policies and procedures CIVIL: Negligence and the doctrine of res ipsa loquitur • Doctrine that applies when the negligent act clearly lies within the range of a jury's common knowledge and experience to determine the standard of care—"the thing that speaks for itself" • Expert nurse witness is not required to help establish the standard of care. • For example, recent studies confirm that approximately 1000 to 2500 foreign bodies (instruments, needles, sponges) are inadvertently left in the patient after surgery. CIVIL: Gross negligence • Reckless act that reflects a conscious disregard for the patient's welfare • Court may award special damages meant to punish the nurse for the outrageous conduct; these damages are referred to as punitive damages. CIVIL: Criminal negligence Negligent act also constitutes a crime—The act is deemed so reckless that the action results in serious injury or death to the patient. Defenses against claims of negligence • In no case may a nurse use the defense "following physician's orders." • Emergency situations—Nursing care rendered in a lifethreatening emergency may breach the standard of care required under normal circumstances • Governmental immunity—Individual health care workers employed in federal or state facilities are shielded from personal responsibility for damages in malpractice cases. • Good Samaritan immunity—limits a nurse's liability or shields the nurse from malpractice for rendering emergency assistance outside the employment setting Statutes of Limitation in Malpractice Cases • Establish time limits within which a person may initiate a lawsuit • Time limits vary depending on state laws and a variety of case circumstances. Liability Asserts that every person is responsible for the wrong or injury done to another as the result of carelessness Personal liability • Requires the nurse to assume responsibility for patient harm or injury that is a result of his or her negligent acts • Nurse cannot be relieved of liability by another professional such as a physician or