Legal and Professional nursing practice exam questions fully solved(verified for accuracy)

Model of Nursing Practice Regulation Triangle: bottom- Professional, top- self-determination or self-regulation Edges: quality, safety, and evidence Bottom: 1. Professional not legal documents but because they are adopted by professional organizations, practitioners are expected to adhere to them - ANA code of ethics - ANA social policy statement - ANA scope and standards of practice - ANA position statements 2. Legal - State laws such as Nurse practice act- all nurses must be familiar - licensure requirements like continuing education - federal law- HIPPA 3. Institutional - employer policies and procedures - institutional practice guidelines (mission, vision, core beliefs) - job descriptions Top: 4. Self-determination or regulation- personal or local level - peer feedback - personal adherence to ethical code - conforming to guidelines about posting on social media Professional Hallmarks 1. Requires extended education of its members 2. Requires basic liberal foundation 3. Has a theoretical body of knowledge (theory and evidence) leading to defined skills, abilities, and norms 4. Provides a specific service (to society) 5. Members of the profession have autonomy (and accountability) in decision making and practice 6. Profession as a whole has a code of ethics for practice 4 essential elements for professional nursing practice Responsibility- "the charge to act", the obligation and dependability to accomplish work Authority- the ability to perform duties in a specific role, based on preparation and experience, exercised in the best interest of the patient Authority- freedom to make independent decisions in the best interest of the patient Accountability- being answerable for actions or inactions of self; ownership of outcomes achieved: the foundation for evaluation [Examples in PPT] Legal regulation: definition of law, statute, and common law Law- rules of conduct or action reckon zed as binding or enforced by a controlling authority such as local, state, or national government -statute- a rule or formal regulation, established by government authority, that appears in writing Regulatory law or administrative law are the rules and regulations established by government agencies to carry out enacted laws ex) NPA - common law- the body of law developed in England primarily from judicial decisions *based on custom and precedent, unwritten in statute or code, and constituting the basis of the English legal system and of the system in all of the US except Louisiana --consists of broad and comprehensive principles rather than principles based on justice, reason, and common sense -- governs most interactions affecting nursing Legal regulation of the nursing profession: Scope of nursing practice is defined by... 1. Nurses Practice Act: A legal statute established by governmental authority that appears in writing - The state board of nursing is state-created agency that enacts and enforces the NPA - NPA includes delegation and supervision 2. Other statutes and rules that apply to health care professionals 3. Common Law Purpose of NPA and state boards [State boards enacts and enforces the NPA through writing rules for implementation, which is enforceable by law] Purpose of NPA: - Set educational and exam requirements - Provides licensing by individuals meeting requirements - Establishes parameters for disciplinary action - Defines the functions of each category of the nurse, both in general and specific terminology (LPN, RN, APRN) 2 main purposes of state boards: - Ensure enforcement of the act serving to regulate those under its provision and prevent those not addressed in the act from practicing nursing - To protect the public Legal Regulation of Nursing Practice: Nursing practice is also impacted by... 1. Court rulings or advisory opinions (common law) 2. Other statutes such as: - Patient self-determination act - Patient privacy and protection laws (HIPPA) - Community standards of care (TJC) - Organizational policies and procedures [Overall, a diverse amount] Criminal law versus Civil law in nursing Criminal Law- relates to the relationship of an individual with the government - felony - misdemeanor - falsification of a patient's record to cover up a serious mistake Civil Law- protects the individual rights of people - tort law (next slide) --negligence --malpractice Tort law A Civil law that wrongs of one person against another recognized by law to lawsuit Types: 1. Intentional 2. Quasi-intentional 3. Unintentional - negligence- conduct lacking in care, deviation from a standard -malpractice (professional negligence, higher claim)- failure to act in a reasonable and prudent manner of someone with same professional education and skills Commonalities between negligence and malpractice: 1. Both involve unintentional actions 2. Both may involve acts of omission and commission Torts vs. crimes Torts (Civil) vs. Crimes (Criminal) Some torts are considered crimes, but torts law primary aim is to provide relief for the damages incurred and deter to other s from committing the same harms - injured person may sue 6 Elements of malpractice 1. Duty owed to the patient - standard of care 2. Breach of the duty owed 3. Foreseeability of harm 4. Causation (direct cause and effect) 5. Injury: must be physical and not psychological or transient 6. Damages: Mist be able to prove damages/financial harm All 6 must be shown before the court in order for them to continue to find malpractice liability against the nurse or institution Liability: definition and levels Liability- an obligation or debt that can be enforced by law 3 levels of potential liability: 1. Person- responsible for own actions 2. Vicarious (supervisory) - doctrine of respondent superior employers accountable for the negligence of employees 3. Corporate-institutional accountability - indemnification- institution may counter sue the nurse for damages paid Causes of malpractice for nurse managers 1. Assignment, delegation, and supervision 2. Duty to orient, education, and evaluate (i.e. competence level) 3. Failure to warn 4. Staffing issues Health informatics definition Health informatics- intersection fo data management and quality To use information and technology to... 1. Communicate (through computer systems) 2. Manage knowledge (compilation of data from patient's charts) 3. Mitigate error (MAR alerts) 4. Support decision making (compilation of stats for quality reports and medical databases) EMR, EHR, and PHR Electronic Medical Record- An electronic record of health-related info on an individual that can be created, gathered, managed, and consulted by authorized clinicians and staff within one health care organization Electronic Health Record- An electronic record of health-related info on an individual that conforms to nationally recognized interoperability standards and that can be created, managed, and consulted by authorized clinician and staff across more than one health care organization - most technologically and functionally advanced form Personal Health Record- An electronic record of health-related info on an individual that conforms nationally recognized interoperability standards that can be drawn from multiple sources while being managed, shared, and controlled by the individual Integrated EHR systems provide: - Alerts about abnormal test results or other findings that need to cone to the attention of a provider - Clinical decision support tools such as linkage to protocols related to patient problems - A centralized mechanism for access from different locations and institutions - Efficient use of storage space for patient data - Instantaneous retrieval of info by several people at the same time - Aggregation of data to assess quality measures Components of "Meaningful Use" Defined by the HITECH act and thus mandated by law to ensure providers are using certified EHR tech in ways that can be measured significantly in quality and quantity 3 components 1. The use of a certified EHR in a meaningful manner such as e-scribing 2. The use of a certified EHR technology for electronic exchange of health info to improve quality of health care 3. The use of certified EHR tech to submit clinical quality and other measures "Meaningful Use" is to use certified EHR tech to... [Define according to CMS] 1. Improve quality, safety, efficiency, and reduce health disparities 2. Engage patients and families 3. Improve care coordination, population, and public health 4. Maintain privacy and security of patient health information Reducing medication errors through tech 1. CPOE system avoids the mistakes r/t being unable to read a physician or APRN order 2. Bar coding help reduce med errors. 3. Reconciliation of med lists using EHR reduces error 4. Automated dispensing cabinets "Work arounds" reduce the effectiveness of bar code scanning 1. Failure of the scanning equipment 2. Labels on meds being unreadable by the scanner 3. Wireless connections being interrupted 4. Tech hindering usual communications among physicians 5. Changes in work flow 6. Age of nurse 7. Number of nurses on a unit Limitations of info technology 1. Research findings suggest that med databases have frequent errors 2. Some EHR systems are designed poorly 3. Institutions try to implement systems quickly and do not always think about the impact on the end user or provide sufficient training in the use of the systems 4. While HIPAA legislation applies to protection of patient info regardless of the form the info is in, the use of electronic media has created additional concerns especially when there has been numerous examples of breeches of data security 5. A problem exists with info systems that do not recognize nursing "language" in order to reflect nursing assessments, interventions, and outcomes