27. Health Law & Policy: A Survival Guide to Medicolegal Issues for Practitioners. The nurse should address which patient problem The nurse is caring for a team of patients at a rehab facility. The law assumes that an unconscious patient would consent to emergency care if the patient were conscious and able to consent. the role of the Health care provider (HCP)? A. Do you follow A gown is part of standard precautions when you are likely to By Bryan A. Liang, MD, PhD, JD, John and Rebecca Moores Professor and Director pro tempore, Health Law & and Policy Institute, University of Houston Law Center; Adjunct Professor of Medical Humanities, Institute for Medical Humanities, University of Texas Medical Branch, Galveston. I feel like just sneaking out and finding Full vs. room. to a geriatrics unit that is short staffed today. b. Stone v. Goodman, 271 N.Y.S. Liang BA. RegisteredNursing.org Staff Writers | Updated/Verified: Aug 29, 2022. v. Edmond, 506 N.E.2d 670 (Ohio 1986). 14. c. All microorganisms can survive in moist dark areas. 2. As indicated by the court: "What was the surgeon to do? Such an assessment should focus on appraising comprehension of information provided to the patient, including: Further, other tests of competence should be engaged, as relevant, including a mini-mental status examination, use of the mental status questionnaire, and/or other tests that may provide insight as to the cognitive function of the patient at the time.52-54. a. check with the nursing supervisor about the legality of the order. Accidental omissions of prescribed medications require an She got her bachelors of science in nursing with Excelsior College, a part of the New York State University and immediately upon graduation she began graduate school at Adelphi University on Long Island, New York. Which of the following clients is the highest priority? FDA Adopts Flu-Like Plan for an Annual COVID Vaccine. will, a. lift using my back muscles. Further, the court indicated that the patient, although a minor, could provide informed consent on the basis of her age, her ability to comprehend the circumstances surrounding the treatment and emergency situation, and her ability to understand the nature and consequences of the chosen procedure. The physician, or other licensed independent providers, the nurse and the client have roles and responsibilities in terms of informed consent. All clients have the legal right to autonomy and self-determination to accept or reject all treatments and interventions. Which of the following statements indicates an understanding of the use Which of the following 66. Generally, the physician must provide the patient with his or her diagnosis, and/or any steps that need to be taken to determine the diagnosis, if relevant. 1996:57. standards to the client.. 1987). . The concept is derived from the ideal that each patient has a right to determine what is done to his or her body.1, Of course, this concept also applies to emergency medicine and patients who present to the emergency department (ED). Akron Law Rev 1991;24:639-680. d. to frequently damp dust and vacuum to decrease microorganisms. . Contact the nursing staff supervisor and file an incident report. Glasser BL, Liang BA. 1. It is important that the physician in any informed consent discussion provide information on medically recognized alternative measures that could be performed other than the proposed treatment or diagnostic strategy, even if the physician feels these alternatives are less desirable. 55. A nurse is preparing to transfer a client from the emergency Department to a medical surgical unit using, the sbar communication tool which of the following information should the nurse include in the, A charge nurse is planning to evacuate clients on the unit because there is a fire on another floor which. Younts v. St. Francis Hosp. A nursing student is to provide patient care during clinical rotation. Answer call lights promptly These principles are summarized in the Table, Kapp MB. Should he have closed the incision on the inflamed appendix and subjected the patient, pregnant as she was, to the danger of a general spread of poison in her system, or to the alternative danger and shock of a second, independent operation to remove the appendix? You should wear a gown for everything. When consent, for any reason including the lack of majority, mental incompetence, and unconsciousness, cannot be obtained, other people can provide legal consent for the patient. Case #5: The Possibly Mentally Incompetent Patient. 1986). b. droplet Medical malpractice. b. a chronic illness. A female patient presented to the ED with significant abdominal pain. As one court indicated, "not even a parent has unbridled discretion to exercise their [sic] religious beliefs when the [S]tates interest in preserving the health of the children within its borders weighs in the balance."70. The purpose of infection control is to prevent cross-contamination of communicable organisms and health care-associated infections. State Department of Human Services v. Northern, 563 S.W.2d 197 (Tenn.Ct.App. 297 (Ct.App. Once the medical provider determines there is no immediate and imminent harm, the provider should seek parental informed consent.34. b. to use only immobilization techniques necessary to keep only the 282, 383 A.2d 785 (1978). lot of innocent people your disease. of informed consent even when he or she treats 46. Obtain consent from the client's employerC. These people include the parent or legal guardian of a minor and unemancipated minor child, a legally appointed representative for a developmentally disabled adult, for example, an emancipated minor, and the person who has been appointed as the client's durable power of attorney for healthcare decisions or their health care surrogate or proxy. Clinical description of the injury requiring They also confirm that the patient has sufficient knowledge to make a knowledgeable decision. Should he have left her on the operating table, her abdomen exposed, and gone in search of [a relative] to obtain express authority to remove the appendix? b. 7. going crazy cooped up in here. of parental medications. Informed consent can only be obtained from an adult patient who is mentally competent to do so except under some circumstances and situations. A typical state statute indicating this policy states that, in the emergent circumstance: "A [physician] shall not be liable for civil damages for injury or death caused in an emergency situation occurring in the [physicians] office or in a hospital on account of a failure to inform a patient of the possible consequences of a medical procedure . The nurse is aware that an individual who is more likely than others to As such, providers may be liable to the patient for unauthorized treatment, or even battery,14-17 which may include punitive damages against the provider.10, Limits. McKinney v. Nash, 120 Cal.App.3d 428, 174 Cal.Rptr. A 14-year-old boy was injured when the car in which he was riding with his parents was involved in a motor vehicle accident. A Variance or Incident is an event that occurs outside the usual expected normal events or activities of the client's stay, unit functioning, or organizational processes. 1964). Hib, pertussis, mumps, rubella, plague, streptococcal pneumonia, meningococcal pneumonia are disease that the nurse would need to implement droplet precautions for. In some cases, the legal counsel for the hospital may meet with the judge ex parte (i.e., in a judicial proceeding with only one party of interest present here, the provider) and receive a written order allowing transfusion at that time.67,68 In other situations, the judge may hold an emergency hearing at the hospital within hours of the request for judicial intervention for the transfusion with both providers and objecting family members present. hierarchy of needs. Upon admission, the patients blood alcohol level was found to be 0.233, a consequence of having imbibed more than 16 alcoholic beverages. Health Law & Policy: A Survival Guide to Medicolegal Issues for Practitioners. These state laws vary from state to state on how informed consent is obtained in an emergency. Rogers v. Sells, 178 Okla. 103 (1936). Hematol Oncol Clinics NA 2002;16:1365-1380. Information Technology: Receiving a Telephone Prescription. Some of the components of this education can include the elements associated with the American Hospital Association's Bill of Rights, the Patient Self Determination Act and the Health Insurance Portability and Accountability Act (HIPAA) in addition to the components of the American Hospital Association's patient responsibilities. Rapid diagnosis and treatment can be lifesaving, and any delay in obtaining consent may have devastating consequences to the patient. d. a patient with an infectious wound. b. d. use antibiotics properly. However, there may be an obligation to discuss possible experimental treatment if the information is readily available to a provider using reasonable efforts. Finally, patients can and do refuse treatments that may be lifesaving. These types of consent are implicit consent, explicit consent and opt out consent. 1. The patient adamantly refused. A female patient required an appendectomy. The information discussed and disclosed to However, upon awakening and being discharged, the girls mother brought suit against the hospital on the basis of a lack of informed consent. v. Heston, 58 N.J. 576, 279 A.2d 670 (1971). An unconscious client, bleeding profusely, is brought to the emergency department after a serious accident. The doctrine of informed consent, which is a fundamental ethical element and legal prerequisite in contemporary medicine, has encouraged patients to become actively engaged in their own health-decision-making processes [1,2,3,4].However, most trauma patients in the emergency department cannot choose their treating hospital or their healthcare providers. finally the legs. He was taken to the local ED, where a physician examined his right leg and found that the leg was "crushed and mangled; that the muscles, blood vessels, and nerves were torn and some of the nerves severed, and that the foot ha[d] no circulation." The ED physician treated the 17-year-old after discussing her condition and proposed treatment with her, and the treatment was successful. Craig v. Borcicky, 557 So.2d 1253 (Ala. 1990). if it is an adjective clause. The nurse is providing staff development about the purpose of the d. protective, 13. For DSR inquiries or complaints, please reach out to Wes Vaux, Data Privacy Officer, b. a. an acute illness. Lasley v. Georgetown University, 842 F.Supp. . Course Hero is not sponsored or endorsed by any college or university. v. Ramsey, 465 So.2d 666 (Fla. App. Your only role is as a witness to the person putting his or her signature on the form and dating the form. Surgery is required immediately to save the client's life. In the Matter of Edith Armstrong, 573 S.W.2d 141 (Mo.Ct.App. 32. The patient's consent should only be "presumed," rather than obtained, in emergency situations when the patient is unconscious or incompetent and no surrogate decision maker is available, and the emergency interventions will prevent death or disability. 35. In other situations, the courts have guardianship and the right to give informed consent for a client who is not able to consent on their own. The nurse may use which of the following measure(s) to reduce stress d. interferons. d. DNR protocols vary from state to state. In this section of the NCLEX-RN examination, you will be expected to demonstrate your knowledge and skills of informed consent in order to: As previously discussed with the section Client Rights, all clients have the right to be fully informed about their medical condition and they also have the innate right to knowledgeably consent to or reject all care and proposed treatments. Additional components include the verification that the client fully understands this information and their right in terms of refusing the treatment or procedure. ED Legal Letter illustrates the issues that emergency physicians encounter regarding informed consent and the exceptions that may apply. b. remove the device every 2 hours and change the patient's position. The provider must balance the "fullness" of disclosure with the potential harm that might occur due to the delay that concomitantly occurs during a full informed consent discussion. c. that protective devices are mandated for behavioral use only. 1993). Hence, providers must be aware that documentation of this condition clearly is requisite to obtaining any legal protections of treating a patient without his or her informed consent. 17. Coulson KM, Glasser BL, Liang BA. The general rule with regard to informed consent Clostridium difficile, herpes simplex virus, impetigo, MRSA, VRSA are disease that would require contact precautions. A nurse in the emergency Department is preparing to care for a client who arrived via ambulance the. After assessment, the examining surgeon amputated the boys foot without the permission of his parents. _____We looked for fireflies at night whenever we had time. a. to use the least amount of immobilization needed for the situation. "60, The court then dismissed the patients suit, indicating that to insist on traditional informed consent in such circumstances would make physicians "litigation-conscious instead of duty-conscious . 62. Recognizing the Client's Right to Refuse Treatments and Procedures, Discussing Treatment Options and Decisions with the Client: Informed Consent, Providing Education to Clients and Staff about Client Rights and Responsibilities, Evaluating the Client and Staff Understanding of Client Rights, Adult Gerontology Nurse Practitioner Programs (AGNP), Womens Health Nurse Practitioner Programs, Advanced Practice Registered Nurse (APRN), Collaboration with Interdisciplinary Team, Performance Improvement & Risk Management (Quality Improvement), Management of Care Practice Test Questions, RN Licensure: Get a Nursing License in Your State, Recognize the client's right to refuse treatment/procedures, Discuss treatment options/decisions with client, Provide education to clients and staff about client rights and responsibilities, Evaluate client/staff understanding of client rights, Fully know about their medical condition and treatments without any withholding of information, Make autonomous decisions about their medical care including their right to accept and reject any treatments, Manage and control their finances and personal property, Accurate bills for the care and services that are given to the person, Express their complains and have these complaints and concerns addressed, A legally appointed representative for a developmentally disabled adult, for example, The parent or legal guardian of a minor and unemancipated minor child, An emancipated minor who is independent of their parents and, The durable power of attorney for healthcare decisions or the health care surrogate or proxy, Provide healthcare providers with complete information relating to their signs, symptoms, health related concerns, and their past and current medical conditions, Report any lack of understanding relating to their care, treatments and procedures, Actively and collaboratively participate in all their care, treatments and procedures, Follow all the healthcare organization's policies and procedures related to patient behavior, demeanor and other patient related issues and behaviors such as cigarette smoking and illicit drug use. 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