The foundation of nursing science and requires specific knowledge and skills. It is person-centered. It includes the nurse practice act
Describe autonomy and accountability.
A nurse adheres to standards of practice and is responsible for care given. Allows nurse to act on their own and make individual decision to care for clients.
List parts of ethical standards.
1) Respect for human dignity, 2) Confidentiality, 3) Competence, 4) Advocacy, 5) Research, and 6) Promotion of public health
Describe how nurses respect human dignity.
Nurses give respectful service regardless of a client’s personal characteristics.
Describe how nurses use confidentiality.
Nurses do not discuss conditions with anyone not involved with care.
Describe how nurses use competence to care for clients.
A nurse uses knowledge and skills to provide care.
Describe how nurses use advocacy.
A nurse protects clients from incompetent or unethical practice.
Describe how nurses use research to care for patients.
Nurses participate in the process of scientific inquiry and EVB.
Describe how nurses promote public health.
Nurses are committed to local and global goals for the health of the community.
Describe how the nurse/patient relationship is professional.
Patient-centered, responsible, goal-oriented, and ethical
What characterizes the therapeutic nature of the nurse/patient relationship?
Genuineness. A nurse acts as a role model. A nurse copes with their own feels.
Describe how the nurse/patient relationship is a protected relationship.
The nurse provides privacy and confidentiality for the patient. Neither the nurse nor the client can be forced to reveal communication between them unless the person who would benefit from the relationship agrees to reveal it.
List the patient’s rights of privacy.
Right to be left alone. Right to make personal choices without interference. Right to have personal information kept confidential.
List parts of the client’s bill of rights.
Right to privacy, respectful care, current information, informed consent, confidentiality, refusal of treatment, reasonable response to a request for service, and right to know hospital/clinic regulations.
Describe how patients’ personal information can be used.
Can’t use data, photos, videos, or research data without explicit permission from the patient. Be cautious with release of information over the phone. Obtain patient’s permission before releasing information to family members or friends.
What are the requirements for informed consent?
Capacity, Voluntary, Understandable, and Not under the influence
Describe capacity with regards to informed consent
Patient must be an adult (or emancipated minor) and must be competent
Describe voluntary with regards to informed consent
Freedom of choice without force, fraud, deceit, duress, or coercion.
When is informed consent not required?
In an emergency situation.
List minors who can provide their own consent.
Married minors. Emancipated minors. Pregnant minor. Minors seeking birth control. Minors seeking outpatient psychiatric or voluntary inpatient psych services.
Describe what happens, with regards to consent, after a minor delivers.
The minor retains the right to provide consent for the infant, but losses consent for self unless another exception is present.
What does informed consent include?
Explanation of treatment, anticipated risk/discomfort, potential benefits, possible alternatives, answers to questions, statements that consent can be withdrawn at anytime.
Describe the legal responsibility with consent.
MD has legal responsibility, but RN can witness the signature and make sure that it is in the correct documentation
Patients have a right to privacy of records. Information should only be used for dx and treatment. Information not released to others without permission and ID verification.
What is the self-determination act?
Federal law requiring health care facilities to provide written information to adult clients about their rights to make health care decisions.
Describe aggressive treatment.
Extraordinary support (intubation, CPR, ventilator) used to maintain and individual’s physiologic process. May be withheld.
What happens if in individual refuses aggressive treatment?
Supportive care is provided to promote comfort and reduce suffering.
List 2 types of advanced directives.
Living wills and durable power of attorney for health care
Describe living wills.
Legal documents signed by competent individuals indicating treatment or life-saving measures to be used if the individuals are unable to make decisions. Legally binding in most states.
What does a living will indicate.
The individual who is authorized to make health care decisions if the individual becomes incapacitated.
Describe a durable power of attorney.
It permits a competent adult to appoint surrogate or proxy in the event the adult becomes incapacitated. Proxy can perform all legal actions needed to fulfill adult’s wishes.
What is the Omnibus Budget Reconciliation Act?
It provides patients with the right to b e free from physical and chemical restraints that are not required to treat medical symptoms.
Describe chemical restraints.
Psychotropic drugs cannot be used to control behavior but only for diagnoses-related conditions.
Describe inappropriate uses of chemical restraints.
Causes deep sedation, agitation, and combativeness.
When can restraints be used?
If informed consent is obtained by individual or proxy.
Describe false imprisonment.
The use of restraint without informed consent or sufficient justification.
List nursing considerations with regards to restraints.
Assess & document the need for restraints, consider & document alternative measures, get a physician’s orders, cannot order PRN restraints, monitor closely, remove for ROM exercises and skin care, use alternative measures (reorientation, family, frequent assistance)
How can a nurse act as a client’s advocate?
Actively support the client’s rights, defend the client’s decisions, communicate client needs to team (PT, OT, SW, MD), safeguard autonomy, provide options to help clients make an informed decision
What is negligence?
Unintentional failure of an individual to perform an act that a reasonable person would perform in a similar circumstance. Can be an act of omission or comission.
What is malpractice?
Unintentional professional negligence involving misconduct or lack of skill in carrying out responsibilities.
What is assault?
Intentional threat to cause harm.
What is battery?
Intentional touching without consent.
The nurse is responsible for using reasonable care in practicing nursing. A nurse needs to participate in lifelong learning to remain competent.
What is the Tarasoff Act?
The RN has the duty to warn of threatened suicide or harm to others. Not confidential.
List measures that protect nurses.
Physicians orders and notifying the RN supervisor.
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