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Consumer awareness, technological advances, multicultural population, and cost containment.
Failure to recognize changes in patient condition.Failure to
communicate: Changes in status and Critical informationMedication
errors, IV therapy errors, infiltrations/phlebitis.Burns.Falls.Errors in
sponge, instrument, or needle counts (surgery).Failure to follow
orders/protocols.Failure to document ex. "if you didn't chart it you
didn't do it!".Failure to report an impaired co-worker.
Witnessing client's signature: client voluntarily gave consent,
comprehends what is to be done, signature authentic, and client appears
to be competent.You are NOT responsible to explain the procedure.Must
notify physician or supervisor if concerned. As a student you may NOT
obtain consent or sign as a witness to a consent. Informal verbal
consent is part of nursing care also, explaining what you are going to
do and why.
Felonies: more serious, jail for years.Misdemeanors
A peer review committee to keep patients honest.
Patient must receive information about their rights. Informed Consent.
Advanced Directives (State specific): Living Will: DNR or Organ
Donation, and Durable Power of Attorney. As a nurse you need to know if
the patient has advanced directives, we encourage patients to have
these.
Being temporarily assigned to another unit.Inform supervisor of lack
of experience with that type of patient.Request an orientation to the
unitKnow the institution's policy regarding floating before accepting
job.
Ethical questions that arise out of nursing practice, usually involve
issues of caring. Ethics are rooted in the legal system but issues can
be legal but not ethical.
Contracts: breaches in legal agreements.Tort law: due to torturous conduct.
True
Assault and battery: assault is a threat, battery is an act.False
imprisonment: against their will, restraints to leave.Fraud: misleading
someone.Invasion of privacy: HIPAA, walking away with computer screen
on.
Be aware and sensitive to issues. Assume responsibility for your own
moral actions. Function as a team member when ethical issues arise.
Support the patient and family, avoid being judgmental. Participate in
ethics committees.
A claim is made that care did not meet the standards of care and
violated the nurse practice act.All 4 of the following must be proven:
Duty to the patient, nurse patient relationship. Breach of that duty:
failed to meet the standard of care. Nurse practice act, job
description, hospital P&P, professional organization standards,
authoritative textbook. Causation: acts or failure to act caused the
injury and it was foreseeable. Damages: must be actual injury or damage.
Autonomy: patient's right to choose. Nonmaleficence: duty to do no
harm or prevent harm.Beneficence: duty to do or promote good.Fidelity:
obligation to keep promises. Veracity: duty to tell the truth. Justice:
obligation to be fair, equal treatment to all patients.
"No code" order. Written, not verbal. Do not follow "slow code"
orders. All clients are resuscitated unless DNR order written. Adult
client may consent to DNR order. May be rescinded. Usually wear a purple
band.
Application of ethical principles to health care, often involve issues of "curing".
True
Private, personal, or group standards of what is right and wrong.
Reflects personal and religious beliefs. Learned in childhood; develop
and change as we go through life. Morals form a basis for ethical
decisions in individuals.
Negligence and malpractice, make sure orders are written and transcribed correctly.
Values, Attitudes, and Beliefs. May be based on fact or faith. When in
doubt with the questions that arise, refer the patient to their own
physician.
What should I do in a given situation? What is right and wrong in a
given situation that involves issues of values and morals. Morals tend
to be well defined for individuals. Ethical dilemmas occur when equally
justifiable alternatives arise to handle a given situation.
True.*Sedated patient cannot sign or make decisions.
Based on nurse practice acts.Professional organizations also identify
standards of care.JCAHO (Joint Commission on Accreditation of Healthcare
Organizations)ANA (American Nurses Association)Individual institutions
have policy and procedure manuals specific to that institution.
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