Chapter 3 textbook notes [cna]-2 PDF

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Chapter 3: Legal and Ethical Issues Define the terms law and ethics and list examples • • • •

Ethics: knowledge of right and wrong Laws: tell people what they must do Laws based on ethics Be honest, protect residents privacy, report abuse, follow care plan, ect.

Explain the Omnibus Budget Reconciliation Act • • •

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OBRA passed due to responses of poor care and abuse in LTC OBRA requires the Nurse aide training and competency evaluation program must be 75 hours, include basic nursing skills, ect. OBRA requires NA to pass competency evaluation before they can be employed, must attend 12 hour info sessions a year, requires states to keep a current list of nursing assistants in a state registry OBRA requires that assessment must be done on every resident Minimum Data Set: resident assessment system that was developed in 1990 and revised periodically, detailed form with guidelines for assessing residents

Explain Resident’s Rights and Discuss why they are important • • • • •

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Residents rights: specify how residents must be treated while living in facility Quality of life o Right to best care available Services and activities to maintain a high level of wellness The right to be fully informed about rights and services The right to participate in their own care o Informed consent: process by which a person, with help of doctor makes informed decisions about his or her health care The right to independent choices o Can make choices about their doctors, care and treatments The right to privacy and confidentiality The right to dignity, respect and freedom The right to security of possessions Rights during transfers and discharges The right to complain The right to visits Rights with regards to social services

Discuss abuse and neglect and explain how to report abuse and neglect •

Neglect: failure to provide needed care that results in physical, mental or emotional harm to a person

Active neglect: purposeful failure to provide needed care, resulting in harm to a person o Passive neglect: unintentional failure to provide needed care resulting in physical, mental, or emotional harm to a person Negligence: actions or the failure to act or provide the proper care for a resident, resulting in unintended injury o Forgetting to lock a residents wheelchair o Malpractice: occurs when a person is injured due to professional misconduct through negligence, carelessness, or lack of skill Abuse: purposeful mistreatment that causes physical, mental or emotional pain or injury to someone o Physical abuse: treatment, intentional or unintentional that causes harm to a persons body o Psychological abuse: threatening, scaring, insulting a person o Verbal abuse: spoken or written words, pictures o Assault: threat to harm a person, resulting in the person feeling fearful that or she will be harmed o Battery: intentional touching of a person without his or her consent o Sexual abuse o Financial abuse o Domestic violence o Workplace violence: abuse by staff or other staff members o False imprisonment: unlawful restraint that affects a persons freedom of movement o Involuntary seclusion o Sexual harassment: unwelcome sexual advance or behavior that creates intimidating working environment o Substance abuse Reporting abuse is the law o NA are considered mandated reporters: people who are legally required to report suspected or observed abuse or neglect because they have regular contact with vulnerable populations o NA must follow chain of command, if no action is taken she can contact abuse hotline or the proper state agency o

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Describe what happens when a complaint of abuse is made against a nursing assistant • • • •

NA is suspended immediately, investigation Can request a hearing State agency will investigate the claims and if it is true, it will be noted in the state’s nurse aide registry Legal penalties, revocation of nursing assistants certification

Explain how disputes may be resolved and identify the ombudsman’s role • • • • •

Ombudsman: assigned by law as the legal advocate for residents Older American’s Act: federal law that requires all states to have an ombudsman program They visit facilities and listen to residents Can help resolve conflicts, gather information Advocate for residents, educate consumers and care providers, appear in legal hearings, give info to public, work with investigators

Explain HIPAA and list ways to protect residents privacy • • •

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Confidentiality: keep things private Health insurance Portability and Accountability Act HIPAA in 1996 o Under this law, a persons health information must be kept quiet Protected Health Information PHI o Information that can be used to identify a person and relates to the patients physical or mental condition, any health care that the person has had and payment for that health care ▪ Name, address, number, medical records Fines ranging from 100 to 1.5 million, prison sentences up to ten years

Explain the Patient Self Determination Act PSDA and discuss advance directives and related medical orders •

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PSDA: federal law passed in 1990 as an amendment to OBRA o Requires all healthcare agencies that receive Medicare and Medicaid funds to give adults, information about their rights related to advance directives ▪ Advance directives: legal documents that allow people to decide what kind of medical care they wish to have in the event they are unable to make those decisions themselves o Living will and power of attorney are examples of advanced directives o Living will: outlines the medical care a person wants/does not want in case he or she cannot make those decisions Durable power of attorney for health care: signed, dated, and witnessed legal document that appoints someone else to make the medical decisions for a person in the event he or she becomes unable to do so Different types of advance directives may be used together, or a person may only use one type or none at all o Not legally required According to PSDA, you have the right to accept or refuse treatment, the right to prepare an advance directive, information on the facility's policies Do not resuscitate DNR order Physician orders for life sustaining treatment (POLST): order specifies treatments to be used when a person is very ill...