Role & Scope – Week 15 – and Professional Practice

and the
Professional Nurse
Chapter 15

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Sources of
Statutory law
Administrative law (regulatory)
Case law
Enforcing the law
Civil
Criminal

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Civil Case Flowchart

Modified from Arizona Superior Court. (n.d.). Civil case flow. Retrieved from http://www.sc.pima.gov/?tabid=180

Scope and Standards
scope of practice describes who, what, where, when, why, and how of nursing practice.
Standards of nursing practice defined as “authoritative statements of the duties of all registered nurses, regardless of role, population or specialty, are expected to perform competently.”

Professional Performance Standards
Ethics
Education
Evidence-based practice and research
Quality of practice
Communication
Leadership
Collaboration
Professional practice evaluation
Resource utilization
Environmental health
Cultural congruence

Standards: State Boards of
Develop scope of practice statements for licensure.
Expand scope statements for advanced practice nurses.
Make decisions about new practices and procedures.
Define new categories of licensure, recognition, and certification.
Determine appropriateness and level of discipline.
Define state accreditation of nursing educational programs.

Evidence of Standards of Care
Used in Court
Statutes
Agency regulations
Accreditation standards
Facility documents such as policies and procedures, job descriptions
Professional nursing guidelines
Manufacturers’ instructions related to medical equipment
literature
Expert testimony

Negligence and Malpractice
Negligence is defined as the failure to act as a reasonably prudent person would have acted in a specific situation.
Malpractice is the failure of a professional to use such care as a reasonably prudent member of the profession would use under similar circumstances, which leads to harm.

Elements to Prove in Successful Malpractice Case
Duty owed to the patient
Breach of the duty owed the patient
Foreseeability
Causation
Injury or harm
Damages

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Avoiding Malpractice and Negligence
Manage stress.
Adhere to standards of care.
Work in environments that encourage examination of incidents.
Change systems to lower the risk of malpractice.

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Licensure
Registration
Mandatory licensure
Certification
Endorsement
Nurse Licensure Compact
National Council of State Boards of initial licensure exam (NCLEX)

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The Licensure Compact Explained Video

https://www.ncsbn.org/364.htm

Transitioning to the Enhanced Nurse Licensure Compact (eNLC): Original Compact States

https://www.ncsbn.org/10802.htm

Transitioning to the Enhanced Nurse Licensure Compact (eNLC): New Compact States

https://www.ncsbn.org/10799.htm

State Boards of
Obligation to protect safety of public
Nurse Practice Acts
Disciplinary actions
Alternative programs

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Board of Complaint Process: Investigation to Resolution Video

https://www.ncsbn.org/426.htm

Informed Consent
A brief but complete explanation of the patient diagnosis and proposed treatment or procedure
The name and qualifications of the person who will perform the procedure or treatment
Information related to available alternatives to the recommended treatment
Information related to possible complications of the treatment or procedure
An explanation related to the patient’s right to refuse treatment without having care discontinued

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Standards of Informed Consent
The medical standard—what is regarded as a material risk in the medical community
What a reasonable patient would need to know
What a particular patient needs to know

Nurse’s Role in Informed Consent
Facilitating informed consent for patient care as a part of providing patient-centered care
Advocate for patient
Witness to patient signature

Transparent Health−The Story of Michael Skolnik Video

Privacy and Confidentiality
Privacy is the right of a person to be free from unwanted intrusion into the person’s personal affairs.
Confidentiality of patient information is the obligation of all healthcare providers.

HIPAA (1 of 2)
Patients must be informed of their privacy rights.
Patients must be informed as to who will see their records and for what purpose.
Patients have the right to inspect and obtain a copy of their medical records.
Personal data may not be used for marketing.

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HIPAA (2 of 2)
Valid authorization to release health information must contain certain information, such as a copy of the signed authorization given to the patient, in understandable language, and information about how the patient may revoke this authorization.
Although information may be used for research purposes to assess outbreak of a disease, all individual identifiable data must be removed.

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Your New Rights Under HIPAA Video

HIPAA Complaint Process

Reproduced from U.S. Department of Health and Human Services. (n.d.). HIPAA privacy and security rule complaint process. Retrieved from http://www.hhs.gov/ocr/privacy/hipaa/enforcement/process/index.html

Five Rights of Delegation
The right task
The right circumstances
The right person
The right direction and communication
The right supervision and evaluation

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