Leadership/Management Nursing HESI

Laws Governing Nursing
Nurse Practice Acts
Nurse Practice Acts
provide the laws that control the practice of nursing in each state.
Mandatory Nurse Practice Acts
authorize that, under the law, only licensed professionals an practice nursing.
Nurse’s Responsibility in making assignments
governed by Nurse Practice Acts. 1. Assignments should be commensurate with the nursing personnel’s educational preparation, experience, and knowledge. 2. The nurse should supervise the care provided by nursing personnel for which he or she is administratively responsible. 3. Sterile or invasive procedures should be assigned to or supervised by a professional nurse (RN).
Torts
An act involving injury or damage to another (except breach of contract) resulting in civil liability (i.e., the victim can sue) instead of criminal liability
Unintentional Torts
Negligence and malpractice
Negligence
performing an act that a reasonable and prudent person would not perform. The measure of negligence is “reasonableness” (i.e., would a reasonable and prudent nurse act in the same manner under the same circumstances?)
Malpractice
negligence by professional personnel (e.g., professional misconduct or unreasonable lack of skill in carrying out professional duties)
Four elements necessary to prove negligence or malpractice
duty, breach of duty, injury/damages, causation
Duty
Obligation to use due care (what a reasonable, prudent nurse would do); failure to care for and/or to protect others against unreasonable risk. The nurse must anticipate foreseeable risks. Example: If a floor has water on it, the nurse is responsible for anticipating the risk for a client’s falling.
Breach of duty
failure to perform according to the established standard of conduct in providing nursing care
Injury/damages
failure to meet standard of care, which causes actual injury or damage to the client, either physical or mental.
Causation
a connection exists between conduct and the resulting injury referred to as “proximate cause” or “remoteness of damage”
Hospital policies
provide a guide for nursing actions. They are not laws, but courts generally rule against nurses who have violated the employer’s policies. Hospital can be liable for poorly formulated or poorly implemented policies
Incident reports
alert administration to possible liability claims and the need for investigation; they do not protect against legal action being taken for negligence or malpractice
Examples of negligence or malpractice
1. Burning a client with a heating pad. 2. Leaving sponges or instruments in a client’s body after surgery. 3. Performing incompetent assessments. 4. Failing to heed warning signs of shock or impending MI. 5. Ignoring signs and symptoms of bleeding. 6. Forgetting to give a med or giving the wrong med
Intentional Torts
Assault and battery, Invasion of privacy, False imprisonment, Exposure of a person, Defamation, Fraud
Assault
Mental or physical threat (e.g., forcing [without touching] a client to take a medication or treatment)
Battery
touching, with or without the intent to do harm (e.g., hitting or striking a client). If a mentally competent adult is forced to have a treatment he or she has refused, battery occurs.
Invasion of privacy
Encroachment or trespassing on another’s body or personality
False imprisonment
confinement without authorization
Exposure of a person
Exposure or discussion of a client’s case. After death, a client has the right to be unobserved, excluded from unwarranted operations, and protected from unauthorized touching of the body.
Defamation
divulgence of privileged information or communication (e.g., through charts, conversations, or observations)
Fraud
willful and purposeful misrepresentation that could cause, or has caused, loss or harm to a person or property. Examples of fraud include: 1. Presenting false credential for the purpose of entering nursing school, obtaining a license, or obtaining employment. 2. Describing a myth regarding a treatment (e.g., telling a client that a placebo has not side effects and will cure the disease or telling a client that a treatment or diagnostic test will not hurt, when indeed pain is involved in the procedure)
Crime
An act contrary to a criminal statute. Wrongs punishable by the state, committed against the state, with intent usually present. The nurse remains bound by all criminal laws.
Commission of a crime involves…
1. A person commits a deed contrary to criminal law. 2. A person omits an act when there is a legal obligation to perform such an act (e.g., refusing to assist with the birth of a child if such a refusal results in injury to the child). 3. Criminal conspiracy occurs when two or more persons agree to commit a crime. 4. Assisting or giving aid to a person in the commission of a crime makes that person equally guilty of the offense (awareness must be present that the crime is being committed). 5. Ignoring a law is not usually an adequate defense against the commission of a crime (e.g., a nurse who sees another nurse taking narcotics from the unit supply and ignores this observation is not adequately defended against committing a crime). 6. Assault is justified for self-defense. However, to be justified, only enough force can be used as to maintain self-protection. 7. Search warrants are required prior to searching a person’s property. 8. It is a crime not to report suspected child abuse (i.e., the nurse’s legal responsibility is to report suspected child abuse)
Psychiatric Nursing Practice and the Law
Civil procedures, Voluntary admission, Involuntary admission, Emergency admission, Legal and civil rights of hospitalized clients, competency hearing, insanity, inability to stand trial.
Civil procedures
methods used to protect the rights of psychiatric clients
Voluntary admission
client admits himself or herself to an institution for treatment and retains civil rights
involuntary admission
someone other than the client applies for the client’s admission to an institution. 1. This requires certification by a health care provider that the person is a danger to self or others (Depending on the state, one or two health care provider certifications are required). 2. Individuals have the right to a legal hearing within a certain number of hours or days. 3. Most states limit commitment to 90 days. 4. Extended commitment is usually no longer than 1 year.
Emergency admission
Any adult may apply for emergency detention of another. However, medical or judicial approval is required to detain anyone beyond 24 hours. 1. A person held against his or her will can file a writ of habeas corpus to try to get the court to hear the case and release the person. 2. The court determines the sanity and alleged unlawful restraint of a person.
Legal and civil rights of hospitalized clients
1. The right to wear their own clothes and to keep personal items and a reasonable amount of cash for small purchases. 2. The right to have individual storage space for one’s own use. 3. The right to see visitors daily. 4. The right to have reasonable access to a telephone and the opportunity to have private conversations by telephone. 5. The right to receive and send mail (unopened). 6. The right to refuse shock treatments and lobotomy.
Competency hearing
Legal hearing that is held to determine a person’s ability to make responsible decisions about self, dependents, or property. 1. Persons declared incompetent have the legal status of a minor–they cannot: vote, make contracts or wills, drive a car, sue or be sued, hold a professional license. 2. A guardian is appointed by the court for an incompetent person. Declaring a person incompetent can be initiated by the state or the family.
Insanity
legal term meaning the accused is not criminally responsible for the unlawful act committed because he or she is mentally ill.
Inability to stand trial
person accused of committing a crime is not mentally capable of standing trial. He or she: 1. Cannot understand the charge against himself or herself. 2. Must be sent to psychiatric unit until legally determined to be competent for trial. 3. Once mentally fit, must stand trial and serve any sentence, if convicted
HESI Hint#1
Surgical procedures should be explained by the health care provider. Remember that it is the nurse’s responsibility to be sure that the operative permit is signed and is on the chart. It is not the nurse’s responsibility to explain the procedure to the client.
Patient Identification
A. The Joint Commission has implemented new patient identification requirements to meet safety goals. B. Use at least two patient identifies whenever taking blood samples, administering meds, or administering blood products. C. The patient room number may not be used as a form of identification.
Surgical Permit
Consent to operate (surgical permit) must be obtained prior to any surgical procedure, however minor it might be. Must be 1. written. 2. obtained voluntarily. 3. explained to the client (i.e., informed consent must be obtained).
Informed consent
operation has been fully explained to the client including: 1. Possible complications and disfigurements 2. Removal of any organs or parts of the body.
Surgery permits must be obtained as follows
1. They must be witnessed by an authorized person, such as the HCP or a nurse. 2. They protect the client against unsanctioned surgery, and they protect the HCP and surgeon, hospital, and hospital staff against possible claims of unauthorized operations. 3. Adults and emancipated minors may sign their own operative permits if they are mentally competent. 4. Permission to operate on a minor child or an incompetent or unconscious adult must be obtained from a legally responsible family member or guardian.
Consent
The law does not require written consent to perform medical treatment. 1. Treatment can be performed if the client has been fully informed about the procedure. 2. Treatment can be performed if the client voluntarily consents to the procedure. 3. If informed consent cannot be obtained (e.g., client is unconscious) and immediate treatment is required to save life or limb, the emergency laws can be applied
Verbal consent
a notation should be made. 1. It describes in detail how and why verbal consent was obtained. 2. It is placed in the client’s record or chart. 3. It is witnessed and signed by two persons.
Verbal or written consent can by given by:
a. Alert, coherent, or otherwise competent adults. b. A parent or legal guardian. c. A person in loco parentis (a person standing in for a parent with a parent’s rights, duties, and responsibilities) in cases of minors or incompetent adults.
Consent of minors
1. Minors 14 years of age and older must agree to treatment along with their parents or guardians. 2. Emancipated minors can consent to treatment themselves. Be aware that the definition of an emancipated minor may change from state to state.
Emergency Care
A. Good Samaritan Act. B. A nurse is required to perform in a “reasonable and prudent manner”
Good Samaritan Act
Protects health practitioners against malpractice claims for care provided in emergency situations (e.g., the nurse gives aid at the scene to an automobile accident victim)
HESI Hint #2
Often questions are asked regarding the Good Samaritan Act, which is the means of protecting a nurse when she or he is performing emergency care.
Prescriptions and HCPs
A nurse is required to obtain a prescription (order) to carry out medical procedures from a HCP.
Verbal telephone prescriptions
should be avoided, the nurse should follow the agency’s policy and procedures. Failure to follow such rules could be considered negligence. The Joint Commission requires that organizations implement a process for taking verbal or telephone orders that includes a read-back of critical values. The employee receiving the prescription should write the verbal order or critical value on the chart or record it in the computer and then read back the order or value to the HCP.
If a nurse questions a HCP’s prescription because he or she believes that it is wrong:
1. Inform the HCP. 2. Record that the HCP was informed and record the HCP’s response to such information. 3. Inform the nursing supervisor. 4. Refuse to carry out the prescription.
If the nurse believes that a HCP’s prescription was made with poor judgment:
1. Record that the HCP was notified and that the prescription was questions. 2. Carry out the prescription because nursing judgment cannot be substituted for a HCP’s judgment.
If a nurse is asked to perform a task for which he or she has not been prepared educationally or does not have the necessary experience:
1. Inform the HCP that he or she does not have the education or experience necessary to carry out the prescription. 2. Refuse to carry out the prescription
HESI Hint #3
If the nurse carries out a HCP’s prescription for which he or she is not prepared and does not inform the HCP of his or her lack of preparation, the nurse is solely liable for any damages.
If the nurse informs the HCP of his or her lack of preparation in carrying out a prescription and carries out the prescription anyway, the nurse and the HCP are liable for any damages
The nurse cannot, without a HCP’s prescription:
alter the amount of drug given to a client. For example, if a HCP has prescribed pain medication in a certain amount and the client’s pain is not, in the nurse’s judgment, severe enough to warrant the dosage prescribed, the nurse cannot reduce the amount without first checking with the HCP. Remember nursing judgment cannot be substituted for medical judgment.
HESI Hint #4
Assignments are often tested on the NCLEX-RN. The Nurse Practice Acts of each state govern policies related to making assignments. Usually, when determining who should be assigned to do a sterile dressing change, for example, a licensed nurse should be chosen–and RN or LPN who has been checked off on this procedure.
Restraints
Clients may be restrained only under the following circumstances: 1. in an emergency. 2. for a limited time. 3. for the purpose of protecting the client from injury or from harm
Nursing responsibilities with regard to restraints
1. The nurse must notify the HCP immediately that the client has been restrained. 2. The nurse should document the facts regarding the rationale for restraining the client.
When restraining a client, the nurse should do the following:
1. Use restraints (physical or chemical) after exhausting all reasonable alternatives. 2. Apply the restraints correctly and in accordance with facility procedures. 3. Check frequently to see that the restraints do not impair circulation or cause pressure sores or other injuries. 4. Allow for nutrition, hydration, and stimulation at frequent intervals. 5. Remove restraints as soon as possible. 6. Document the need for and application, monitoring, and removal of restraints.
HESI Hint #5
Restraints of any kind may constitute false imprisonment. Freedom from unlawful restraint is a basic human right and is protected by law.
Health Insurance Portability and Accountability Act of 1996
A. HIPAA privacy rules pertain to health care providers, health plans, and health clearinghouses and their business partners who engage in computer-to-computer transmission of health care claims, payment and remittance, benefit information, and health plan eligibility information and who disclose personal health information that specifically identifies an individual and is transmitted electronically, in writing, or verbally. B. Patient privacy rights are of key importance. Patients must provide written approval of the disclosure of any of their health information for almost any purpose. HCP must offer specific information to patients that explains how their personal health information will be used. Patients must have access to their medical records, and they can receive copies of them and request that changes be made if they identify inaccuracies. C. HCPs who do not comply with HIPAA regulations or make unauthorized disclosures risk civil and criminal liability.
What types of procedures should be assigned to professional nurses?
Sterile or invasive procedures
Negligence is measured by reasonableness. What question might the nurse ask when determining such reasonableness?
Would a reasonable and prudent nurse act in the same manner under the same circumstances?
List the four elements that are necessary to prove negligence
Duty. Breach of duty. Causation. Damages
Define an intentional tort, and give one example
Conduct causing damage to another person in a willful or intentional way without just cause. Example: Hitting a client out of anger, not in a manner of self-protection
Differentiate between voluntary and involuntary admission
Voluntary: Client admits self to an institution for treatment and retains his or her civil rights; he or she may leave at any time. Involuntary: Someone other than client applies for the client’s admission to an institution (a relative, a friend, or the state); requires certification by one or two HCPs that the person is a danger to self or others; the person has a right to a legal hearing (habeas corpus) to try to be released, and the court determines the justification for holding the person.
List five activities a person who is declared incompetent cannot perform
vote, make contracts or wills, drive a car, sue or be sued, hold a professional license.
Name three legal requirements of a surgical permit
voluntary, informed, written
Who may give consent for medical treatment?
alert, coherent, or otherwise competent adults; a parent or legal guardian; a person in loco parentis of minors or incompetent adults
What law protects the nurse who provides care or gives aid in an emergency situation?
The Good Samaritan Act
What actions should the nurse take if he or she questions a HCP’s prescription–that is, believes the prescription is wrong?
Inform the HCP; record that the HCP was informed and the HCP’s response to such information; inform the nursing supervisor; refuse to carry out the prescription.
Describe the nurse’s legal responsibility when asked to perform a task for which he or she is unprepared.
Inform the HCP or person asking the nurse to perform the task that he or she is unprepared to carry out the task; refuse to perform the task.
Describe nursing care of the restrained client
Apply restraints properly; check restraints frequently to see that they are not causing injury and record such monitoring; remove restraints as soon as possible; use restraints only as a last resort.
Describe 6 patient rights guaranteed under HIPAA regulations that nurses must be aware of in practice
A patient must give written consent before HCPs can use or disclose personal health information; HCPs must give patients notice about providers’ responsibilities regarding patient confidentiality; patients must have access to their medical records; providers who restrict access must explain why and must offer patients a description of the complaint process; patients have the right to request that changes be made in their medical records to correct inaccuracies; HCPs must follow specific tracking procedures for any disclosures made that ensure accountability for maintenance of patient confidentiality; patients have the right to request that HCPs restrict the use and disclosure of their personal health information, though the provider may decline to do so.
Leadership and Management
Nurses act in both leadership and management roles. A. A leader is an individual who influences people to accomplish goals. B. A manager is an individual who works to accomplish the goals of the organization. C. A nurse manager acts to achieve the goals of safe, effective client care within the overall goals of a health care facility.
Skills of the Nurse Manager
Communication, Act as a liaison between clients and others, Engage in conflict resolution as needed with staff. Organization, Plan overall strategies to address client problems, Review management outcomes. Delegation, Identify roles/responsibilities of health care team members. Supervision, Supervise care provided by others. Critical thinking, Serve as resource person to other staff
Communication Skills
Assertive communication: A. Includes clearly defined goals and expectations. B. Includes verbal and nonverbal messages that are congruent. C. Is critical to the directing aspect of management.
HESI Hint#5
Assertive communication starts with “I need” rather than with “You must”
HESI Hint #6
Motivation comes from within an individual. A nurse leader can provide an environment that will promote motivation through positive feedback, respect, and seeking input. Look for responses that demonstrate these behaviors.
Organizational Skills
encompass management of: A. people. B. time. C. supplies
HESI Hint #7
NCLEX questions often include examples of nursing interventions that do or do not demonstrate these skills and characteristics
HESI Hint #8
Effective leadership involves assertive management skills. Look for responses that demonstrate that the nurse is using assertive communication skills
Leadership styles and behaviors associated
Democratic (participative)–Assertive. Authoritarian (autocratic)–Aggressive. Laissez-faire (permissive)–Passive.
Delegation skills
The authority, accountability, and responsibility of the RN are based on the state Nurse Practice Act, standards of professional practice, the policies of the health care organization, and ethical-legal models of behavior.
The nurse transfers responsibility and authority for the completion of delegated tasks, but the nurse retains accountability for the delegation process. This accountability involves ensuring that the five rights of delegation have been achieved
Delegation
the process by which responsibility and authority are transferred to another individual
Responsibility
the obligation to complete a task
Authority
the right to act or command the actions of others
Accountability
the ability and willingness to assume responsibility for actions and related consequences.
Five Rights of Delegation
1. Right task: Is this a task that can be delegated by a nurse? 2. Right circumstance: Considering the setting and available resources, should delegation take place? 3. Right person: Is the task being delegate by the right person to the right person? 4. Right direction/communication: Is the nurse providing a clear, concise description of the task, including limits and expectations? 5. Right supervision: Once the task has been delegate, is appropriate supervision maintained/
HESI Hint #9
Delegating to the right person requires that the nurse be aware of the qualifications of the delegatee: Appropriate education, training, skills, experience, and demonstrated and documented competence.
HESI Hint #10
UAPs generally do not perform invasive or sterile procedures
Supervision Skills
Direction/guidance. Evaluation/monitoring. Follow-up.
Direction/guidance
1. Clear, concise directions. 2. Expected outcome. 3. Time frame. 4. Limitations. 5. Verification of assignment
Evaluation/monitoring
1. Frequent check-in. 2. Open communication lines. 3. Achievement of outcome
Follow-up
1. Communication of evaluation findings to the LPN or UAP and other appropriate personnel. 2. Need for teaching or guidance.
HESI Hint #11
The RN is accountable for adhering to the 3 basic aspects of supervision when delegation to other health care personnel, such as LPNs, graduate nurses, inexperienced nurses, student nurses, and UAPs.
HESI Hint #12
Remember the nursing process: Assessments, analysis, diagnosis, planning, and evaluation (any activity requiring nursing judgment) may not be delegated to UAP. Delegated activities fall within the implementation phase of the nursing process.
Critical Thinking Skills
Nurses are accustomed to using the nursing process as the model for problem-solving in client care situations.
Critically thinking model
1. Assessment: What are the needs or problems? 2. Analysis: What has the highest priority? 3. Planning: What outcomes and goals must be accomplished? What are the available resources? (1) Nursing staff (2) Interdisciplinary team members (3) Time (4) Equipment (5) Space (client rooms, home environment, etc.). 4. Implementation: Communication expectations. Is documentation complete? 5. Evaluation: Were the desired outcomes achieved? Was safe, effective care provided?
HESI Hint #13
Priorities often center on which client should be assessed first by the nurse. Ask yourself: Which client is the most critically ill? Which client is most likely to experience a significant change in condition? Which client requires assessment by an RN?
HESI Hint #14
The nurse manager must analyze all the desired outcomes involved when assigning rooms for clients or assigning client care responsibilities. A client with an infection should not be assigned to share a room with a surgical or immunocompromised client. A nurse’s client care management should be based on the nurse;s abilities, the individual client’s needs, and the needs of the entire group of assigned clients. Safety and infection control are high priorities
Skills Needed by Change Agents
A. Problem-solving B. Decision-making C. Interpersonal relationships
Collaborative health care teams require;
1. Shared goals, commitment, and accountability. 2. Open and clear communication. 3. Respect for the expertise of all team members.
Critical pathways:
1. Are interdisciplinary plans of care. 2. Are used for diagnoses and care that can be standardized. 3. Are guides to track client profess. 4. Do not replace individualized care
Case management:
1. Coordination of care provided by an interdisciplinary team. 2. Manages resources effectively. 3. Uses critical pathways to organize care
Quality assurance:
1. Involves continuous quality improvement (CQI)/total quality management (TQM). 2. Is an organized approach to the improvement of: Outcome achievement, Quality of care provided.
HESI Hint #15
Change causes anxiety. An effective nurse change agent uses problem-solving skills to recognize factors such as anxiety that contribute to resistance to change and uses decision-making and interpersonal skills to overcome that resistance. Interventions that demonstrate these skills include seeking input, showing respect, valuing opinions, and building trust.
Nurse Leaders and Managers as Change Agents
Unfreezing–Initiation of a change. Moving–Motivation toward a change. Refreezing–Implementation of a change
By what authority may RNs delegate nursing care to others?
State Nurse Practice Act
A UAP may perform care that falls within which component of the nursing process?
Implementation
Which type of communication is necessary to implement a democratic leadership style?
Assertive communication skills
What are the five rights of delegation?
Right task, right circumstance, right person, right direction or communication, and right supervision.
Which tasks can be delegated to a UAP? A. Inserting a Foley catheter. B. Measuring and recording the client’s output through a Foley catheter.C. Teaching a client how to care for a catheter after discharge. D. Assessing for symptoms of a UTI
A. Is a sterile invasive procedure and should not be delegated to a UAP. B. Falls within the implementation phase of the nursing process and dose not require nursing judgment. Evaluation of the I&O must be done by the nurse. C. Client teaching requires the abilities of a nurse and should not be delegated. The UAP may be instructed to report anything unusual that is observed and any symptoms reported by the client, but this does not replace assessment by the nurse. D. Assessment must be performed by the nurse and should not be delegated. The UAP may be instructed to report anything unusual that is observed, or any symptoms reported by the client, but this does not replace assessment by the nurse
What are the essential steps of effective supervision?
direction, evaluation, and follow-up
Which of the following is an example of assertive communication? A. “You need to improve the way you spend your time so that all of your care gets performed.” B. “I’ve noticed that many of your clients did not get their care today.”
A. Aggressive communication, which causes anger, hostility, and defensive attitude. B. Assertive communication begins with “I” rather than “you” and clearly states the problem.
The role of the nurse takes place at all three levels of disaster management:
1. Disaster preparedness. 2. Disaster response. 3. Disaster recovery
To achieve effective disaster management:
1. Organization is the key. 2. All personnel must be trained. 3. All personnel must know their roles.
Primary prevention in Disaster Management
1. Participate in the development of a disaster plan. 2. Train rescue workers in triage and basic first aid. 3. Educate personnel about shelter management. 4. Educate the public about the disaster plan and personal preparation for disaster
Secondary prevention in Disaster Management
1. Triage. 2. Treatment of injuries. 3. Treatment of other conditions, including mental health. 4. Shelter supervision.
Tertiary prevention in Disaster Management
1. Follow-up care for injuries. 2. Follow-up care for psychological problems. 3. Recovery assistance. 4. Prevention of future disasters and their consequences
Triage
A French word meaning “to sort or categorize.” Goal: Maximize the number of survivors by sorting the injured according to treatable and untreatable victims. Primary criteria used: Potential for survival, Availability of resources.
Nursing Interventions and Roles in Triage
A. Triage duties using a systematic approach such as the START method. B. Treatment of injuries. 1. Render first aid for injuries. 2. Provide additional treatment as needed in definitive care areas. C. Treatment of other conditions, including mental health. 1. Determine health needs other than injury. 2. Refer for medical treatment as required. 3. Provide treatment for other conditions based on medically approved protocols.
Shelter Supervision
A. Coordinate activities of shelter workers. B. Oversee records of victims admitted and discharged from shelter. C. Promote effective interpersonal and group interactions among victims in shelter. D. Promote independence and involvement of victims housed in the shelter.
Triage Color Code System
Red–Most urgent, first priority. Life-threatening injuries. No delay in treatment. Yellow–Urgent, second priority. Injuries with systemic effects and complications. May delay treatment for 30-60 min. Green–Third priority. Minimal injuries with no systemic complications. Several hours. Black–Dying or dead. Catastrophic injuries. No hope for survival, no treatment
Simple triage and rapid treatment (START)
Assess Respirations. Assess Circulation. Assess Mental Status
Bioterrorism
A. Learn the symptoms of illnesses that are associated with exposure to likely biologic and chemical agents. B. Understand that they could appear days or weeks after exposure. C. Nurses and other HCPs would be the first responders when victims seek medical evaluation after symptoms manifest. First responders are critical in identifying an outbreak, determining cause of outbreak, identifying risk factors, and implementing measures to control and minimize the outbreak.
Possible agents.
Biologic agents. Chemical agents. Radiation.
Biologic agents
A. Anthrax. B. Pneumonic plague. C. Botulism. D. Smallpox. E. Inhalation tularemia. F. Viral hemorrhagic fever
Chemical agents
A. Biotoxin agents: ricin. B. Nerver agents: sarin
HESI Hint #16
It is important to remember that in disaster and bioterrorism management, the nurse must consider both the individual and the community.
Nursing Assessment Disaster
A. Community-disaster risk assessment. B. Measures to mitigate disaster effect. C. Exposure symptom identification.
Nursing Plans and Interventions Disasters
A. Participate in development of disaster plan. B. Educate the public on disaster plan and personal preparation for disaster. C. Train rescue workers in triage and basic first aid. D. Educate personnel for shelter management. E. Practice triage. F. Treat injuries and illness. G. Treat other conditions, including mental health. H. Supervise shelters. I. Arrange for follow-up care for injuries. J. Arrange for follow-up care for psychological problems. K. Assist in recovery. L. Work to prevent future disasters and their consequences.
List the three levels of disaster management
Disaster preparedness, disaster response, disaster recovery.
List examples of the three levels of prevention in disaster management
Primary: Develop plan, train and educate personnel and public. Secondary: Triage, treatment-shelter supervision. Tertiary: Follow-up, recovery assistance, prevention of future disasters.
Define triage
To sort or categorize
Identify three bioterrorism agents
Anthrax, pneumonic plague, botulism, smallpox, inhalation tularemia, viral hemorrhagic fever, ricin, sarin, radiation.
Code of Ethics
A set of principles that all members of a profession generally accept. Guidelines to assist nurses and other professionals when conflict or disagreements arise about correct practice and /or behavior.
Who has the code of ethics for LPN’s and LVN’s?
(NAPES) National Association for Practical Nurse Education and Service. This is the World’s oldest association.
Malpratice
Negligence ( professional misconduct or unreasonable lack of skill) by a professional person with a license. (Can be sued for this once you have your LPN license) Client also must accrue damages as a result of the injury.
Good Samaritan Laws
States that no person shall be liable in civil damages for administering emergency care or treatment at a scene outside of a hospital, dr’s office or other place having proper medical care, for acts performed at the scene of such emergency, unless such acts constitute willful or Wanton misconduct.
Invasion of Privacy
Covers the right to be left alone, to chose care based on one’s personal beliefs.
False Imprisonment
Preventing movement or making a person stay in a place without obtaining consent. Physical or non physical means. (physical- pt is in danger to self or others). Requires a physician’s order AND permission of the pt or the pt’s family members. Restraints use as a last resort.
Board of Nursing
Develops and enforces the rules and regulations of nursing practice in the state. Also responsible for nursing practice, nursing licensure, nursing education for the state and disciplinary action.
State Board of Nursing
The power organization regarding nursing in every state.
Has the right to refuse to allow students to sit for NCLEX.
Breach of Confidentiality
Occurs when data or information provided in confidence to you by a client is disclosed to a third party without your client’s consent.
Felony
Fraud that is deliberate and results in personal gains
Libel
Defamation that is written such as a negative or hostile remarks that is malicious and false.
Assault
An intentional threat of unlawful touching of another, giving the person a reasonable fear of harmful conduct. (No actual contact is required for this to occur) ex: threaten to restrain a person for refusing consent.
Licensing Examination