This chapter discusses various sources of law that impact nursing practice, including statutory law established by legislative bodies, common law from legal cases, and civil and criminal law. It covers specific federal and state statutes governing issues like patient privacy, nondiscrimination, informed consent, and licensing. The chapter also examines legal concepts like negligence, malpractice, and defenses against claims of liability. It notes that nurses can face personal liability for errors but may purchase malpractice insurance and employers can be vicariously liable through principles of respondeat superior.
THE NEED FOR EVIDENCE-BASED PRACTICE
STEPS OF EVIDENCE-BASED PRACTICE
PICOT FORMAT IN EBP
RATING SYSTEM FOR THE HIERARCHY OF EVIDENCE: QUANTITATIVE QUESTIONS
ELEMENTS OF EVIDENCE-BASED ARTICLES
INTEGRATE THE EVIDENCE
EVALUATE THE OUTCOMES OF THE PRACTICE DECISION OR CHANGE
COMMUNICATE THE OUTCOMES OF THE EVIDENCE-BASED PRACTICE DECISION
SUSTAIN KNOWLEDGE USE
NURSING RESEARCH
TRANSLATION RESEARCH
5 PHASES OF TRANSLATION RESEARCH
OUTCOMES RESEARCH
SCIENTIFIC METHOD
CHARACTERISTICS OF SCIENTIFIC RESEARCH
NURSING AND THE SCIENTIFIC APPROACH
TYPES OF RESEARCH
TYPES OF RESEARCH APPROACH
RESEARCH PROCESS
RIGHTS OF HUMAN SUBJECT
COMPARISON OF STEPS OF THE NURSING PROCESS WITH THE RESEARCH PROCESS
Performance Improvement
Performance Improvement Programs
EXAMPLES OF PERFORMANCE IMPROVEMENT MODELS
THE RELATIONSHIP BETWEEN EBP, RESEARCH, AND PERFORMANCE IMPROVEMENT
SIMILARITIES AND DIFFERENCES AMONG EVIDENCE-BASED PRACTICE, RESEARCH, AND PERFORMANCE IMPROVEMENT
KEY ELEMENTS
THE NEED FOR EVIDENCE-BASED PRACTICE
STEPS OF EVIDENCE-BASED PRACTICE
PICOT FORMAT IN EBP
RATING SYSTEM FOR THE HIERARCHY OF EVIDENCE: QUANTITATIVE QUESTIONS
ELEMENTS OF EVIDENCE-BASED ARTICLES
INTEGRATE THE EVIDENCE
EVALUATE THE OUTCOMES OF THE PRACTICE DECISION OR CHANGE
COMMUNICATE THE OUTCOMES OF THE EVIDENCE-BASED PRACTICE DECISION
SUSTAIN KNOWLEDGE USE
NURSING RESEARCH
TRANSLATION RESEARCH
5 PHASES OF TRANSLATION RESEARCH
OUTCOMES RESEARCH
SCIENTIFIC METHOD
CHARACTERISTICS OF SCIENTIFIC RESEARCH
NURSING AND THE SCIENTIFIC APPROACH
TYPES OF RESEARCH
TYPES OF RESEARCH APPROACH
RESEARCH PROCESS
RIGHTS OF HUMAN SUBJECT
COMPARISON OF STEPS OF THE NURSING PROCESS WITH THE RESEARCH PROCESS
Performance Improvement
Performance Improvement Programs
EXAMPLES OF PERFORMANCE IMPROVEMENT MODELS
THE RELATIONSHIP BETWEEN EBP, RESEARCH, AND PERFORMANCE IMPROVEMENT
SIMILARITIES AND DIFFERENCES AMONG EVIDENCE-BASED PRACTICE, RESEARCH, AND PERFORMANCE IMPROVEMENT
KEY ELEMENTS
CORPORATE NEGLIGENCE There are duties that the corporation.docxvanesaburnand
CORPORATE NEGLIGENCE
There are duties that the corporation itself owes to the general public and to its patients.
These duties arise from statutes, regulations, principles of law developed by the courts,
and the internal operating rules of the organization. If a corporation has a duty and fails
in the exercise of that duty, it has the same liability to the injured party as an individual
would have.
Corporate negligence is a doctrine under which the hospital is liable if it fails to uphold the
proper standard of care owed the patient, which is to ensure the patient’s safety and well-
being while at the hospital. This theory of liability creates a nondelegable duty which the
hospital owes directly to a patient. Therefore, an injured party does not have to rely on and
establish the negligence of a third party.6
Corporate negligence occurs when a health care corporation fails to perform those
duties it owes directly to a patient or to anyone else to whom a duty may extend. If such
a duty is breached and a patient is injured as a result of that breach, the organization
can be held culpable under the theory of corporate negligence.
Liability extends to nonemployees who act as a hospital’s ostensible agents. For
example, inThompson v. Nason Hospital,7 a Pennsylvania court recognized that
hospitals are more than mere conduits through which health care professionals are
brought into contact with patients. Hospitals owe some nondelegable duties directly to
their patients independent of the negligence of their employees, such as duties to use
reasonable care in the maintenance of safe and adequate facilities and equipment; select
and retain only competent physicians; oversee all persons who practice medicine within
their walls as to patient care; and formulate, adopt, and enforce adequate rules and
policies to ensure quality care for their patients.
CASE: DARLING—
HEALTH CARE’S BENCHMARK CASE
https://jigsaw.vitalsource.com/books/9781449685065/content/id/ch08fn06
https://jigsaw.vitalsource.com/books/9781449685065/content/id/ch08fn07
In 1965, the landmark case Darling v. Charleston Community Memorial Hospital had a
major impact on the liability of health care organizations.8 The court enunciated a
“corporate negligence doctrine” under which hospitals have a duty to provide adequately
trained medical and nursing staff. A hospital is responsible, in conjunction with its
medical staff, for establishing policies and procedures for monitoring the quality of
medicine practiced within the hospital.
Darling involved an 18-year-old college football player who was preparing for a career
as a teacher and coach. The patient, a defensive halfback for his college football team,
was injured during a play. He was rushed to the emergency department of a small,
accredited community hospital where the only physician on emergency duty that day
was Dr. Alexander, a general practitioner. Alexander had no.
5 The Physician–Patient Relationship Learning Objectives After.docxalinainglis
5 The Physician–Patient Relationship
Learning Objectives
After completing this chapter, you will be able to:
· 1. Define the key terms.
· 2. Describe the rights a physician has when practicing medicine and when accepting a patient.
· 3. Discuss the nine principles of medical ethics as designated by the American Medical Association (AMA).
· 4. Summarize “A Patient’s Bill of Rights.”
· 5. Understand standard of care and how it is applied to the practice of medicine.
· 6. Discuss three patient self-determination acts.
· 7. Describe the difference between implied consent and informed consent.
Key Terms
Abandonment
Acquired immune deficiency syndrome (AIDS)
Advance directive
Against medical advice (AMA)
Agent
Consent
Do not resuscitate (DNR)
Durable power of attorney
Human immunodeficiency
virus (HIV)
Implied consent
Informed (or expressed)
consent
Incompetent patient
In loco parentis
Living will
Minor
Noncompliant patient
Parens patriae authority
Privileged communication
Prognosis
Proxy
Uniform Anatomical Gift Act
THE CASE OF DAVID Z. AND AMYOTROPHIC LATERAL SCLEROSIS (ALS)
David, who has suffered with ALS for 20 years, is now hospitalized in a private religious hospital on a respirator. He spoke with his physician before he became incapacitated and asked that he be allowed to die if the suffering became too much for him. The physician agreed that, while he would not give David any drugs to assist a suicide, he would discontinue David’s respirator if asked to do so. David has now indicated through a prearranged code of blinking eye movements that he wants the respirator discontinued. David had signed his living will before he became ill, indicating that he did not want extraordinary means keeping him alive.
The nursing staff has alerted the hospital administrator about the impending discontinuation of the respirator. The administrator tells the physician that this is against the hospital’s policy. She states that once a patient is placed on a respirator, the family must seek a court order to have him or her removed from this type of life support. In addition, it is against hospital policy to have any staff members present during such a procedure. After consulting with the family, the physician orders an ambulance to transport the patient back to his home, where the physician discontinues the life support.
· 1. What were the primary concerns of the hospital?
· 2. What was the physician’s primary concern?
· 3. When should the discussion about the patient’s future plans have taken place with the hospital administrator?
Introduction
Few topics are as important as the physician–patient relationship. This relationship impacts the entire healthcare team. All healthcare professionals who interact with the patient must understand their responsibilities to both the patient and the physician. The patient’s right to confidentiality must always be paramount.
The first physicians were “medicine men,” witch doctors, or sorcerers. The physician–pa.
IntroductionThis paper will provide a review of the compliance r.docxnormanibarber20063
Introduction
This paper will provide a review of the compliance report based on the general conducts of the medical staff at USA Community Hospital. The validity of patients’ claims for denial of services will be investigated and a mechanism to address such claims will be also provided. The primary roles that the staff can play in upholding ethics at their work place will be provided and legal consequences for non-compliance will also be stipulated.
A Plan to Investigate the Validity of Patients’ Claims for Denial of Services
1. Identification of Allegations and Issues to be Investigated- The issues to be investigated include the allegation of denial of services to the HIV/AIDS patients. Other issues to be investigated include patient review registries, and standard procedures surrounding the ethical treatment of patients with HIV / AIDS. These follow complaints that were brought forward by the public that the professional staff at USA Community Hospital were denying HIV/AIDS patients proper treatment.
2. Investigative Strategy- The investigation will involve a request to the patients who suffered the discriminative treatment to come forward for individual interviews to help in finding out more about their allegations. The medical files of these patients will be checked to verify their claims and to identify any sign of negligence on the doctors’ part. Finally the mentioned medical personnel will also be individually interviewed and thoroughly investigated. The interview panel will be chaired by the head healthcare administrators and other members will consist of the quality assurance manager, case manager, and file coordinator.
3. Sources of Evidence- The sources of evidence will consist of any violation of applicable laws, procedures, regulations, or ethical guidelines as pertained to the hospital patient treatment regulations. Other sources of evidence will involve documentation such as notes on the patients file, patients’ lab reports, e-mail exchange between the patients and doctors, and the personal files of the involved professional staff. Witnesses and physical evidence such as video records will be used.
4. Special Considerations- This process will involve use of power as provided in the US constitution. It will also involve surprise visits to the alleged doctors’ to find out how they treat their patients. Reluctant witnesses will be identified and interviewed.
5. Required Personnel and Resources- The process will involve a wide range of personnel and resources. Experts and lawyers for the victims and the accused personnel will be required in the process. Medical Psychologist and Psychiatrist will also be invited to help identify the validity of statements from the complainants as well as the accused. Enough time, rooms, and other facilities such as remunerations for the panel members will also be considered and made available.
6. Milestones and Timelines- This whole process goal is to only take two months to get to completion and.
Should Nurses Blow the Whistle or Just Keep QuietCarolyn Bupper.docxedgar6wallace88877
Should Nurses Blow the Whistle or Just Keep Quiet?
Carolyn Buppert, MSN, JD
June 24, 2014
Confused? I'm Not Surprised
Apparently, a lot goes on in healthcare that makes nurses uncomfortable, because I am asked this question, in some form, frequently. The answer is complicated. People may differ in their opinions of what falls into the realm of incompetent, unethical, or unsafe practice, and the laws of every state are different. And even though I read law every day, I had trouble figuring out what to advise, given the current law governing nurses. No wonder nurses aren't sure what to do.
Nurses are told that they have a duty to protect patient safety. They learn this from language such as this, in one state's (Maryland) nursing regulations. Under "Ethical Responsibilities," it says: "A nurse shall...Act to safeguard a client and the public if health care and safety are affected by the incompetent, unethical, or illegal practice of any person."[1]
The implication is that when a nurse becomes aware of a patient safety threat, the nurse is supposed to do something.
Maryland is not alone in making such pronouncements. Here is language from the Texas Board of Nursing Website:
Situations involving potential risk of harm to patients or the public are referred to as "violating the nurse's duty to the patient" because all nurses have a duty under Rule 217.11(1)B to maintain a safe environment for patients/clients and others for whom the nurse is responsible.[2]
It makes sense to tell nurses that they are expected to safeguard patient safety. It would be even better if nurses who try to do something were better rewarded for their efforts. However, according to nurses I hear from, when a nurse reports a patient safety problem, the nurse often is surprised to find that he or she is considered the "bad guy." A nurse who raises quality issues that require a change of policy, practice, or staffing can be seen as a disruptor rather than someone who is making constructive criticism. Some nurses who have identified problems have found themselves out of a job.
This is bothersome. It's perfectly legal for a hospital to terminate a nurse, for any reason or for no reason. The only job protections are those granted by contract between the nurse and the hospital (whether it is an individual contract or a contract offered through a labor union) and those granted by the US Constitution and civil rights laws. The latter include the right to be free of discrimination on the basis of age, sex, national origin, race, sexual orientation, and religious preference. If the hospital isn't firing the nurse because of age, sex, national origin, race, sexual orientation, or religious preference, in general the firing is legal. A possible exception is a whistleblower law, which may, in some situations, provide protection for nurses who report patient safety problems. We will get to that shortly.
Although it is legal to fire a nurse for raising a patient safety issue (with a poss.
Millions Involved in False Claims Act Cases: Medical Fraud and Recent Court D...Conference Panel
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The legal implications of nursing practice are tied to licensure, state and federal laws, scope of practice and a public expectation that nurses practice at a high professional standard. The nurse's education, license and nursing standard provide the framework by which nurses are expected to practice.
ANS: A
Rationale: A is correct because the Health Insurance Portability and Accountability Act ensures the confidentiality of patients’ personal health information. B is incorrect because the Patient Self-Determination Act allows patients to inform care providers of their preferences regarding medical treatment and end-of-life care. C is incorrect because the Emergency Medical Treatment and Active Labor Law prohibits emergency rooms from refusing care for indigent or uninsured patients and the transfer of unstable or pregnant women to another facility. D is incorrect because the Americans With Disabilities Act prevents discrimination against persons with disabilities by removing barriers that prevent them from enjoying the same opportunities as persons without disabilities.
Level of Difficulty: Application
ANS: B
Rationale: B is correct because this is a sentinel event in which the nurse unintentionally injured the infant, resulting in death. Unintended outcomes such as paralysis, coma, or permanent loss of function are also considered sentinel events. A is incorrect because criminal negligence is behavior that demonstrates a complete disregard for another, and in this situation, the nurse accidentally harmed the infant. C is incorrect because res ipsa loquitur means “the thing speaks for itself,” and in this situation, the nurse did not have control of the events that resulted in the infant’s injury and subsequent death. D is incorrect because in a negligent act, the nurse would have failed to act in a manner in which any prudent nurse would act in a similar unintentional circumstance that resulted in harm.
Level of Difficulty: Analysis