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Chapter 8 Legal Aspects of Gerontological Nursing

Chapter 8 Legal Aspects of Gerontological Nursing. Older Adults: Legal Issues. Older Adults may be easy victims of unscrupulous practices due to: The multiple problems faced by older adults. A high prevalence of frailty. A lack of familiarity with laws and regulations.

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Chapter 8 Legal Aspects of Gerontological Nursing

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  1. Chapter 8Legal Aspects of Gerontological Nursing

  2. Older Adults: Legal Issues • Older Adults may be easy victims of unscrupulous practices due to: • The multiple problems faced by older adults. • A high prevalence of frailty. • A lack of familiarity with laws and regulations.

  3. Advocacy: An Integral Part of Gerontological Nursing • Nurses need to be concerned about protecting the rights of their elderly patients. • Nurses must have knowledge of basic laws and ensure that their practice falls within legally sound boundaries.

  4. Legal Risks Associated with Gerontological Nursing • Working in highly independent roles. • Having responsibility for nonprofessional staff. • Working with patients with multiple and complex conditions. • Giving advice or guidance to patients and families in difficult situations.

  5. Laws Governing Gerontological Nursing Practice • Public Laws: govern relationships between private parties and the government. • The scope of nursing practice. • The requirements for being licensed as a home health agency. • Private Laws: involve relationships between individuals and organizations. • Involves contracts and torts.

  6. Examples of Torts • Wrongful acts against another party: • Assault • Battery • False imprisonment • Invasion of privacy

  7. Factors Increasing Liability for Nurses • Working without sufficient resources. • Not checking agency policy or procedure. • Bending a rule. • Giving someone a break. • Taking shortcuts. • Trying to work when physically or emotionally exhausted.

  8. Malpractice: Conditions That Warrant Damages • Duty: a relationship between the nurse and the patient in which the nurse has assumed responsibility for the care of the patient. • Negligence: failure to conform to the standard of care. • Injury: physical or mental harm to the patient, or violation of the patient’s rights resulting from the negligent act.

  9. Consent • Patients are entitled to know the full implications of procedures. • Patients make an independent decision as to whether or not they choose to have a procedure performed. • Consent must be obtained before performing any medical or surgical procedure. • Performing procedures without consent can be considered battery.

  10. Procedures Requiring Consent • Any entry into the body, either by incision or through natural body openings. • Any use of anesthesia. • Use of cobalt or radiation therapy. • Use of electroshock therapy or experimental procedures. • Any type of research participation, invasive or not. • Any procedure, diagnostic, or treatment, that carries more than a slight risk.

  11. Elements of an Informed Consent Form • Written description of the procedure and its purpose also explained by the person performing it. • List of alternatives to the procedure. • List of expected consequences and risks. • Witnessed and dated signature of the patient. • Consent obtained by the person performing the procedure.

  12. Competency Issues • Persons who are mentally incompetent are unable to give legal consent. • Often staff will turn to the next of kin to obtain consent for procedures. • The appointment of a guardian is the responsibility of the court. • Staff should encourage family members to seek legal guardianship of the patient.

  13. Legal Risks for Nurses • Permitting unqualified or incompetent persons to deliver care. • Failing to follow up on delegated tasks. • Assigning tasks to staff members for which they are not qualified or competent. • Allowing staff to work under conditions with known risks.

  14. Potential Areas of Liability for Nurses • Administering Medications. • Using restraints. • Accepting phone orders. • Following no-code orders. • Dealing with end-of-life issues. • Pronouncing death.

  15. Advance Directives • Advance directives express the desires of a competent adult regarding: • Terminal care • Life-sustaining measures • Other acts pertaining to death and dying

  16. Examples of Elder Abuse • Inflicting pain or injury. • Stealing or mismanaging funds. • Misusing medications. • Causing psychological distress. • Withholding food or care; or sexually abusing • Exploiting, or confining a person.

  17. Signs of Elder Abuse • Delay in seeking necessary medical care • Malnutrition • Dehydration • Skin breaks, bruises • Poor hygiene and grooming • Urine odor, urine-stained clothing/linens • Excoriation or abrasions of genitalia

  18. Signs of Elder Abuse (cont.) • Inappropriate administration of medications • Repeated infections, injuries, or preventable complications from existing diseases • Elder’s evasivenss in describing condition, symptoms, problems, and home life • Unsafe living environment • Social isolation • Anxiety, suspiciousness, and depression

  19. Source • Eliopoulos, C. (2005).  Gerontological Nursing, (6th ed.).  Philadelphia: Lippincott, Williams & Wilkins (ISBN 0-7817-4428-8).

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