what are medical practice acts quizlet nursing

Frequent bending and standing contributes to fatigue and may increase the risk of slips of falls. 1) describes the organizations history starting in 1896 as the story of individual nurses everywhere united in common cause to advance nursing practice. The profession of nursing has changed significantly in the 160 years since Florence Nightingales day, but her words still ring true today, Unless we are making progress in our nursing every year, every month, every week, take my word for it we are going back (Nightingale, 1914, p. 1). As chief executive of the Texas Nurses Association, Cindy leads the strategic operations of the Texas Nurses Association, a professional membership organization of registered nurses that empowers Texas Nurses to advance the profession. The couple filed a lawsuit. Petitionelements of the claim: The plaintiff outlines what the defendant nurse did wrong and how, as a result of that alleged negligence, the plaintiff was injured. Retrieved from https://capitol.texas.gov/tlodocs/79R/billtext/pdf/SB01525F.pdf, Texas Legislature Online. Kane. Standards reflect the knowledge and skill ordinarily possessed and used by nurses actively practicing in the profession (Guido, 2010) (see Chapter 1). Organ transplantation is extremely expensive. They include issues such as telenursing and telehealth, forensic evidence collection and lists of tasks that a nurse in Texas can or cannot perform. Protections are imperfect, but that does not diminish their importance. Even though nurses do not intend to injure patients, some patients file claims of malpractice if nurses give care that does not meet the appropriate standards. The statute was implemented in 2004. Texas was the first state to have safe patient handling and movement policies enacted in legislation. 16, New York companion bills A11484, A07836, S05116, and S08358. Nurse staffing is resource intensive and is the largest component of hospital operational budgets. You should only provide care that is consistent with your level of expertise. Nightingale, F. (1860). Key Words: nurse, nurse advocacy, health policy, legislation, nurse practice act, whistleblower. A) The states Attorney General B) The Nurse Practice Act C) The ANA standards of practice D) The ANA Code for Nurses, How is the question of whether a nurse acted with reasonable care generally proven? A BON's investigation into violations of a state's nurse practice act (NPA), The process for filing a complaint against a nurse who has exhibited unsafe, negligent or incompetent behavior, What a nurse can expect while their complaint is being investigated, Serves as a guide for consumers who have experienced or witnessed a nurse exhibiting unsafe, negligent or incompetent behavior, Explains what consumers can expect when a complaint is being investigated, Defines various nursing roles and responsibilities. Society expects safe health care delivery, especially from nurses who are typically perceived as the most trusted profession. New York, NY: Little, Brown Book Group. The whole-brain standard requires irreversible cessation of all functions of the entire brain, including the brainstem. She is active in policy development, actively assisting policy committees in analyzing issues and developing policy positions. For living wills or durable powers of attorney for health care to be enforceable, the patient must be legally incompetent or lack the capacity to make decisions regarding health care treatment. provide guidance for nurses and other healthcare professionals in Texas. It also involves administering a medication to a patient even though the medical record contains documentation that the patient has an allergy to that medication. The U.S. Supreme Court stated in the Cruzan v Director of Missouri Department of Health case in 1990 that we assume that the U.S. Constitution would grant a constitutionally protected competent person the right to refuse lifesaving hydration and nutrition. In cases involving the patients right to refuse or withdraw medical treatment, the courts balance the patients interest with the interest of the state in protecting life, preserving medical ethics, preventing suicide, and protecting innocent third parties. Taylor, J. L. (2010). Usually a panel of professionals conducts the hearing. Ignorance of the law or of standards of care is not a defense against malpractice. The most recent example is a nurse who contacted the TNA practice hotline because she was retaliated against for speaking up for patient safety. Policy, Politics & Nursing Practice, 16(3-4), 79-96. doi.org/10.1177/1527154415616254. Retrieved from https://www.asphp.org/wp-content/uploads/2011/05/SPH-US-Enacted-Legislation-02222015.pdf, Brown, J. L. (2010). With the increasing body of evidence documenting the relationship between nurse staffing and patient outcomes, several states have passed legislation requiring organizations to adopt more specific policies and practices. Voluntary self-regulation of complementary and alternative medicine practitioners, Affirmation of the practice of professional nursing, Medical Outcomes Study 36-Item Short-Form Health Survey, Medical Physics and Biomedical Engineering, Medical Planet Learning Management System, Medical Policy Technology Assessment Committee, Medical Practitioners Disciplinary Tribunal. Minimum nurse-to-patient ratios in acute care hospitals in California. Protection failures represent opportunities for future advocacy. (1997). All states required licensure by the 1970s. (2011). The Centers for Disease Control and Prevention (CDC) (www.CDC.gov) and the Occupational Health and Safety Act (OHSA) (www.osha.gov) provide guidelines on a national level for safe and healthy communities and work environments. If an event falls into any of these categories, guide information through the public relations department of the institution to ensure that invasion of privacy does not occur. Cindys nursing career spans advanced practice, chief nurse executive, and academic roles. Work to understand the law as it applies to the client's clinical condition. Texas was the first state to have safe patient handling and movement policies enacted in legislation.The national Handle with Care campaign, launched by ANA in 2003 to engage members of the healthcare industry in back injury prevention, spurred advocacy efforts to change policy (de Castro, 2004). The use of physical restraints is a safety strategy that has been used in hospitals and long-term care settings to protect patients from injury. Nurses have a specific legal obligation to treat the deceased persons remains with dignity (see Chapter 36). A nurse practice act is a series of statutes that have been enacted by each state legislature to regulate the practice of nursing in that state. The American Association of Colleges of Nursing (AACN) supports the International Council of Nurses mandate to ensure an individuals peaceful end of life (Guido, 2010). It is an assault for a nurse to threaten to give a patient an injection or to threaten to restrain a patient for an x-ray procedure when the patient has refused consent. Declaration of Policy. After the newscast they received phone calls and embarrassing questions. (2009). Nursing Science Quarterly, 19(1), 61-64. doi: 10.1177/0894318405283556. Other witnesses: Factual witnesses, both neutral and biased, including family members on the plaintiffs side and other medical personnel (e.g., nurses) on the defendants side, are deposed to obtain information and their version of the case. All states use the National Council Licensure Examinations (NCLEX) for registered nurse and licensed practical nurse examinations. Retrieved from https://www.nursingald.com/uploads/publication/pdf/231/TX7_11.pdf. As you continue to practice as a nurse in Texas, it is your re- sponsibility to be aware of changes to the law and the Board's rules and regulations. This database became a powerhouse of information for researchers interested in studying relationships between nursing staff characteristics and patient outcomes (Dunton, 2007). Describe the nursing implications associated with legal issues that occur in nursing practice. Discuss the nurses role in witnessing the informed consent process. However, we recognize that there are stories from every state that highlight the valuable work of many nurses that illustrate individual and collective nursing organization advocacy. Texas was the first state to have safe patient handling and movement policies enacted in legislation. National Council of State Boards of Nursing, Inc. All Rights Reserved. In a lawsuit for malpractice or nursing negligence, a nursing expert testifies to the jury about the standards of nursing care as applied to the facts of the case (Box 23-1). Another example involves the use of nursing assistive personnel (NAP) (e.g., nurse assistants). True. Some states such as Ohio offer DNR Comfort Care and DNR Comfort Care Arrest protocols. If the answer is negative, the health care provider discusses the option to make or refuse an organ donation and places such documentation in the patients medical record. Scope of practice refers to those activities that a person licensed to practice as a health professional is permitted to perform, which is increasingly determined by statutes enacted by state legislatures and by rules adopted by the appropriate licensing entity. Define legal aspects of nurse-patient, nursehealth care provider, nurse-nurse, and nurse-employer relationships. This example represents a missed opportunity for nurses to change practice through policy. One of the first objectives of the new organization was the passage of legislation in 1909 requiring registration of nurses through a Board of Nurse Examiners, creating the first nurse practice act in Texas (Brown, 2010). Nurse staffing, burnout, and health careassociated infection. Nurse Practice Act. Patients in end-stage renal disease are eligible for Medicare coverage for a kidney transplant, but private insurance pays for other transplants. The couple had previously told no one but their immediate family that they were involved in the in vitro fertilization program and had received assurance that there would be no publicity or public exposure. online nurse practice acts course program. A., & Spetz, J. Nurses in each state should take the time to learn the details on the laws regarding their state. The National Organ Transplant Act of 1984 prohibits the purchase or sale of organs. Community and public health nurses have the legal responsibility to enforce laws enacted to protect public health (see Chapter 3). Examples of State Legislation to Improve Safe Handling, Hawaii House Concurrent Resolution No. The Department of State Health Services fined the hospital the maximum allowable amount of $1,300 (Thomas & Willman, 2012). This law requires hospitals and nursing homes to adopt policies and procedures for the safe handling of patients that control the risk of injury to patients and nurses associated with the lifting, transferring, repositioning, or movement of a patient. (Texas Senate Bill 1525, 2005). of frequently asked questions about nursing regulations. If a patient does not have a DNR order, health care providers need to make every effort to revive the patient. 476. The reason for the development of different definitions is to facilitate recovery of organs for transplantation. Nurses have been advocating for change since the day Florence Nightingale penned an urgent missive to the Secretary of State for War on the need for trained nurses to care for the wounded soldiers in the Crimea. Retrieved from https://capitol.texas.gov/tlodocs/82R/billtext/html/SB00192F.HTM, Texas Legislature Online. Battery also results if the health care provider performs a procedure that goes beyond the scope of the patients consent. Journal of Nursing Administration, 42(10), Supplement: S10S16. Nurse Practice Acts describe and define the legal boundaries of nursing practice within each state. Where creative models of care to reduce costs dominated dialogue around nurse staffing in the 1990s, attention was cued to staffing outcomes following the IOM report. (2002). When the patients death is not subject to a medical examiner review, consent must be obtained. Exceptions to the ability to access medical records apply to psychotherapy notes or when the health care provider has determined that access would result in harm to the patient or another party (Privacy Rights Clearinghouse, 2011). Nurse Practice Acts define the scope of nursing practice, distinguishing between nursing and medical practice and establishing education and licensure requirements for nurses. Nonfeasance. This means that the ADA protects a person who is HIV positive but does not have acquired immunodeficiency syndrome (AIDS). Not all states have an act that only covers nurses. Establishing a foundation for the role of nurses in evidence-based advocacy, she emphasized the progressive nature of nursing, urging: Let whoever is in charge keep this simple question in her head (not, how can I always do this right thing myself, but) how can I provide for this right thing to be always done? (Nightingale, 1860, p. 40-41). Torts are classified as intentional, quasi-intentional, or unintentional. Every state has some version of a Nurse Practice Act that sets the legal parameters for what nurses can and cannot do within their jurisdiction. This database includes measures directly related to nursing care and patient outcomes (Montalvo, 2007) such as: nursing hours per patient days; hospital-acquired infections and pressure ulcers; and skill mix (percent of total nursing hours supplied by different types of direct care providers). Protections can be eroded through subsequent legislation or agency rules, and enforcement mechanisms may be weak or non-existent. Most states have adopted the, An individuals right to privacy sometimes conflicts with the publics right to know. Tragedy into policy: A quantitative study of nurses' attitudes toward patient advocacy activities. 2410, 2019), which allows nurses to invoke safe harbor orally in situations where patient needs prevents nurses from leaving the beside to complete safe harbor forms. Certain criteria are necessary to establish nursing malpractice: (1) the nurse (defendant) owed a duty to the patient (plaintiff), (2) the nurse did not carry out that duty, (3) the patient was injured, and (4) the nurses failure to carry out the duty caused the injury. American Nurses Association. In one case a television crew filmed a married couple who were participating in a hospital program. For example, a policy/procedure outlining the steps to follow when changing a dressing or administering medication provides specific information about how nurses are to perform these tasks. Retrieved from https://www.govinfo.gov/app/details/FR-2003-01-24/03-1293, Wallace, N., Cropp, B., & Coles, J. Likewise, health care workers cannot discriminate against HIV-positive patients (Guido, 2010). Health insurance plans are free to eliminate coverage for certain specialties and impose limits on the amount of coverage that they will pay for certain illnesses. An estimated 12-18% of nurses leave the profession due to chronic back pain (Nelson & Baptiste, 2006). Defamation of character is the publication of false statements that result in damage to a persons reputation. Safe nursing practice requires understanding the legal framework of health care. However, the Centers for Medicare and Medicaid Services (2007) and The Joint Commission (2011a) have set standards for reducing the use of restraints in health care settings and for using them only with extreme caution. The couple had previously told no one but their immediate family that they were involved in the in vitro fertilization program and had received assurance that there would be no publicity or public exposure. Twenty two nurses were investigated by the Nevada State Board of Nursing for alleged violations of the Nevada Nursing Practice Act, notably failure to safeguard patients (Black, 2011). Study with Quizlet and memorize flashcards containing terms like A medical surgical client is in the radiology department. List sources for standards of care for nurses. The State Board of Nursing suspends or revokes a license if a nurses conduct violates provisions in the licensing statute based on administrative law rules that implement and enforce the statute. The purposes of public health laws are protection of public health, advocating for the rights of people, regulating health care and health care financing, and ensuring professional accountability for care provided. (2019). Usual questions concern witnesses, insurance experts, and which health care providers the plaintiff has seen before and after the incident. Historical Information. Describe the legal responsibilities and obligations of nurses regarding the following federal statutes: Americans with Disabilities Act (ADA), Emergency Medical Treatment and Active Labor Act (EMTALA), Health Insurance Portability and Accountability Act of 1996 (HIPAA), and the Patient Self-Determination Act (PSDA). 68 FR 3435 - Medicare and Medicaid programs; Hospital conditions of participation: Quality assessment and performance Improvement. List the elements needed to prove negligence. The Supreme Court ruled in 1998 in Bragdon v Abbott that even asymptomatic HIV constitutes a disability within the meaning of the ADA. Each state providing for living wills has its own requirements for executing them. The nursing profession has a long history of nurses influencing decisionmakers to make positive change in health policy. Starting in 1938, all states also adopted laws that defined the scope of nursing. Since the beginning of the profession, through individual and collective efforts, nurses have changed practice through policy by addressing systemic barriers to optimal patient care and healthy environments through establishment of standards, regulations, and policy. Workplace violence study. In the fall of 2007, the Centers for Medicare and Medicaid Services (CMS) announced that it would no longer reimburse hospitals for nursing-related, preventable complications occurring during a patient hospital stay (The George Washington University, 2007). C. scope of practice. Intentional torts are willful acts that violate anothers rights such as assault, battery, and false imprisonment. Quasi-intentional torts are acts in which intent is lacking but volitional action and direct causation occur such as in invasion of privacy and defamation of character. focuses on the legal relationships between people and the protection of a persons rights. Other states have passed legislation (ANA, 2019) with an alternative policy approach requiring hospitals to engage nurse staffing committees in the determination of appropriate staffing levels. Study with Quizlet and memorize flashcards containing terms like Which type of medicine is used with physicians who specialize in fighting disease, using proven, traditional treatment methods? Several changes in the healthcare industry have influenced the advocacy efforts of individual nurses and nursing organizations.Hospitals were compelled to focus specifically on safety when in 1999 the Institute of Medicine (IOM) released its groundbreaking report, To Err is Human (Kohn, Corrigan, & Donaldson, 2000). Advance directives include living wills, health care proxies, and durable powers of attorney for health care (Blais et al., 2006). Learn about the law and regulations that guide and govern nursing practice, Locate your state nurse practice act and regulations, Access nurse practice act educational resources. These rules and regulations undergo a process of public review before enactment. It establishes the basis for privacy and confidentiality concerns, viewed as two basic rights within the U.S. health care setting. HIPAA violations have civil and criminal sanctions. The prosecutor must prove anything that the nurse does not admit. Many states, through their respective public health departments, require that hospitals report certain infectious or communicable diseases. We then offer exemplars that illustrate policies that regulate the environment of practice, such as nurse staffing, musculoskeletal injury prevention, and failure to advocate, and discuss needed protections, including whistleblower protections. Each state has a Nurse Practice Act which mandates BRN to establish rules to implement: - scope of nursing practice - methods of initial/continuing licensure - nursing regulations within each state's jurisdiction - advanced practice and public health nurse roles NCSBN partnered with each participating state board of nursing to develop the online nurse practice acts course program. Privacy is the right of patients to keep personal information from being disclosed. The cardiopulmonary standard requires irreversible cessation of circulatory and respiratory functions. Malpractice sometimes involves failing to check a patients identification correctly before administering blood and then giving the blood to the wrong patient. Guidelines for the practice of a profession are called. Lawsuits result from patients attempts at suicide within the hospital. The rules and regulations enacted by a State Board of Nursing define the practice of nursing more specifically. This occurs when nurses restrain a patient in a confined area to keep the person from freedom. In Handbook of Texas Online. (2019). (2019, January 30). The Texas Nursing Practice Actincludes several advocacy protections for nurses. Citation: Martin, E., Zolnierek, C., (January 31, 2020) "Beyond the Nurse Practice Act: Making a Difference through Advocacy" OJIN: The Online Journal of Issues in Nursing Vol. Potentially suicidal patients are admitted to mental health units. Policy frames nursing practice in the most fundamental way: through state nurse practice acts (NPA) which date back over one hundred years in many states. Health insurance companies have followed suit with pay-for-performance and shared-savings programs (Wallace, Cropp, & Coles, 2016). The contact can be harmful to the patient and cause an injury, or it can be merely offensive to the patients personal dignity. has the Occupational Regulation Sections of the Michigan Public Health Code that covers 25 different healthcare occupations, including nursing. Retrieved from https://infectioncontrol.tips/2016/06/15/insurance-pay-for-hais/, Willmann, J. Safe, competent nursing practice is grounded in the law as written in the state nurse practice act (NPA) and the state rules/regulations. Both professional nursing organizations, and individual nurses, must continue advocacy at all levels. The tort of invasion of privacy protects the patients right to be free from unwanted intrusion into his or her private affairs. Durable power of attorney for health care (DPAHC), p. 299. https://doi.org/10.21916/mlr.2018.27, Dunton, N., Gajewski, B., Klaus, S., & Pierson, B. Study with Quizlet and memorize flashcards containing terms like 1. It also can be amended during a special legislative session called by the governor, although this has never happened. This includes protections for whistleblowers. Misfeasance. The nurse did not carry out the duty or breached it (failure to use the degree of skill and learning ordinarily used under the same or similar circumstances by members of his or her profession). Wrongful handling of a deceased persons remains causes emotional harm to the surviving family. There is no provision in the United States to regulate nursing at the federal level, which is why it falls to lawmakers in each state. Discussions of nurse staffing followed these trends. Discuss the nurses role in witnessing the informed consent process. Find Your Nurse Practice Act The state's duty to protect those who receive nursing care is the basis for a nursing license. In 2020, the Year of the Nurse and Midwife, let every nurse and professional nursing organization continue the forward progress that advocacy supports. Journal of Nursing Regulation, 3(3), 36-42. https://doi.org/10.1016/S2155-8256(15)30197-6. The American Nurses Association (ANA) (2008) has held that nurses participation in assisted suicide violates the code of ethics for nurses. "Board" means the Oklahoma Board of Nursing; 2. Retrieved from https://www.nursingworld.org/ana/about-ana/history/. Nurses help organizations protect patients rights to confidentiality. Further protections (Texas Occupations Code, 2019) include refusal to engage in reportable conduct; reporting staffing concerns in hospitals; nurses who refuse to engage in conduct reportable to the board of nursing; and nurse reporting of concerns within a facility about patient exposure to substantial risk of harm or failure to conform to minimum professional, regulatory, or accreditation standards. The Americans with Disabilities Act (ADA) (1990) is a broad civil rights statute that protects the rights of people with physical or mental disabilities (Grohar-Murray and Langan, 2011). London: MacMillan and Company. Although both bills failed to pass in 2011 (Willmann, 2011), similar legislation enhancing penalties for assault of emergency department personnel passed in the next legislative session (Willmann, 2013). The most recent iteration of the code (ANA, 2015) addresses the ethical imperative for engagement in policy. A brief overview is offered here to provide perspective related to the specific exemplars we discuss. All nurses are responsible for knowing the provisions of the Nurse Practice Act of the state in which they work and the rules and regulations enacted by the State Board of Nursing and other regulatory administrative bodies. Parties depositions: The plaintiff and defendants (physician, nurse, hospital personnel) are almost always deposed. Nurse participation in health policy was recognized with the inclusion of the nurse-as-advocate role, added in 1976. Setting standards for nursing education was an important component of early nursing regulation (Russell, 2012). Failure to AdvocatePolicies that protect nurses who advocate for patients are a vital element of safe healthcare delivery.Policies that protect nurses who advocate for patients are a vital element of safe healthcare delivery. (2013). Failure to assess and/or monitor, including making a nursing diagnosis, Failure to use proper equipment to monitor the patient, Failure to notify the health care provider of problems, Failure to follow the six rights of medication administration, Failure to convey discharge instructions, Failure to ensure patient safety, especially patients who have a history of falling, are heavily sedated, have disequilibrium problems, are frail, are mentally impaired, get up in the night, and are uncooperative, Failure to follow policies and procedures, Failure to properly delegate and supervise, Only gold members can continue reading. Patient confidentiality is a sacred trust. To encourage reports of suspected cases, states provide legal immunity for the reporter if the report is made in good faith. Nurse researchers play an important role in policy evaluation by studying the impact of policy changes. Every Nurse Practice Act includes the following, according to the NCSBN: The Texas Nurse Practice Act covers all the above issues. Treating physicians or health care providers depositions: Before subsequent treating, physicians or health care providers depositions are taken to establish issues such as those concerning preexisting conditions, causation, the nature and extent of injuries, and permanency. The United Network for Organ Sharing (UNOS) has a contract with the federal government and sets policies and guidelines for the procurement of organs. If health care workers follow the directions of the living will, they should be immune from liability (Bross, 2006). Texas nurse staffing trends before and after mandated nurse staffing committees. Most states have built their laws upon similar language. https://medical-dictionary.thefreedictionary.com/Medical+Practice+Acts. includes a threat or attempt to injure; unlawful touching of another person without consent. As a result of patients being transferred from private to public hospitals without appropriate screening and stabilization (referred to as patient dumping), Congress enacted the Emergency Medical Treatment and Active Labor Act (EMTALA) (1986).

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