Legal And Ethical Issues In Nursing Practice Ppt To Pdf

legal and ethical issues in nursing practice ppt to pdf

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Nursing morality is a summation of behavioral guild line and criterion that deals with rightly the relationship between a person and another person, individual and society during occupational activities.

Ethics in Physical Therapy guide the practitioners behavior in regards to the practice of their art. Image: unsplash. Google Scholar. Ethical issues do occur within the first session, the consciousness about ethical issues differs in Danish physiotherapy private practice, and reflections and acts are to a lesser extent based on awareness of ethical theories, principles and ethical guidelines. Chapter 1: Professionalism and Ethics.

Kladionice KORNER

Since patient safety is multidimensional and grounded in ethical and legal imperatives, both ethical and legal challenges should be taken into account. In this regard, a falling incident case of a day-old newborn was raised in the monthly ethics round in the Children's Medical Center of Tehran University of Medical Sciences, Iran, and the ethical and legal dimensions of patient safety were discussed by experts in various fields.

This report presents different aspects of patient safety in terms of root cause analysis RCA and risk management, the role of human resources, the role of professionalism, the necessity of informing the parents disclosure of medical errors , and forensic medicine with focus on ethical aspects. Thus, it has been the most emphasized component of the quality of health care services all around the world.

The Institute of Medicine IOM released a report in entitled "Man is fallible: create a safe health system" in relation to the incidence of medical errors in United States, and consequently, initiated widespread international change in the field of patient safety 2. Correspondingly, the Iranian health care system implemented special plans purposed to deliver standard health care services and prevent any mistakes and an organized approach to risk management, systematic deficiency, and patient safety improvement 3.

Although great emphasis has been placed on the importance of clinical governance by the MOHME, there are some challenges in achieving the desired outcomes 4. Studies showed that a non-negligible percentage of patients are exposed to health care-related injuries. Based on World Health Organization WHO report, the possibility of harming patients in the process of providing health care services is 1 out of , whereas the possibility of aviation accidents is 1 out of , Since , with the beginning of the patient safety project, so far countries have attempted to improve their patients' safety plans in their own health system 7.

The most common cause of injury is medication errors and falling. Meanwhile the neonatal falling statistics in the USA is 1. These cases are often the result of shortcomings in systems and processes, organizational complexity and ambiguity, and poor communication 8 , 9.

Despite various patient safety guidelines and standards, less attention is paid to the ethical and legal aspects of this issue. From a moral perspective, the main goal of patient safety in the health system can be studied from two aspects. It can be studied as a practical value, in the sense that the main focus is its positive outcomes and benefits. It can also be studied as a moral value by focusing on the protection and promotion of humanity and human dignity.

It should be emphasized that both aspects are important in the health system. From a professional point of view, moral values in patient safety are not separated from basic medical obligations, but are so central that they may be the source of other moral values emphasized in medicine. In other words, the responsibility of the health care staff and professional commitment, in general, are closely related to human dignity This case was raised in the monthly ethics round in the Children's Medical Center of Tehran University of Medical Sciences, Iran, and ethical dimensions of patient safety were discussed by experts in various fields.

The opinions expressed in this article are a summary of the views of experts in various fields including neonatology, medical law, ethics, and nursing. It is worth mentioning that the ethics round has been held every month for more than 5 years in the Children's Medical Center.

A complicated case is discussed in each session with the presence of different relevant experts. A day old newborn infant was hospitalized in the neonatal intensive care unit NICU because of multiple seizures. He was the first child of the family.

Seizures were controlled by medications, and diagnostic assessments including electroencephalography EEG were ordered. As the infant was stable and had tolerated breast feeding, it was planned to transfer him to the level II NICU, but it was postponed due to lack of available beds. On the evening shift of the third day of admission, his nurse heard a sudden noise and noticed that the incubator door was open and the baby was on the floor.

The in-charge nurse immediately announced the incident to the on-call physician. The newborn was examined thoroughly and no physical injuries were found. Moreover, the incident was reported to the chief physician of the department and the record of this incident was immediately sent to the hospital officials. Later, all other incubators were inspected to make sure they were secure enough. What are the factors leading to this incident? How could this incident been prevented?

What is the responsibility of the staff in dealing with this incident? Based on professional commitments, what is the duty of medical and nursing staff in such events? What are the ethical issues of patient safety in this case? What are the legal obligations and consequences of this case? Searching for the causes and finding the right solution, in other words, the basic analysis of the incident is one of the initial and essential measures taken to decrease the incidence of patient injuries.

It should be noted that the mentioned process must be free of any bias and should focus on finding the main cause and resolving it instead of identifying the responsible person. One way of preventing such events is to have a special guideline for reporting the event in a suitable organized ethical atmosphere without accusing anyone.

Indeed, fear of blame, penalties, limited organizational support, inadequate feedback, and lack of knowledge about the associated factors are some of the barriers to reporting medical errors in hospitals One way is the establishment of an organizational culture based on mutual trust and effective communication in all hospital levels 13 , From an ethical perspective, the value of trustworthiness is a prerequisite of successful risk management.

This value is connected to safety culture since it refers to physical safety, psychological safety, and cultural safety.

Furthermore, it is important for the managers to encourage multidisciplinary collaboration to facilitate transparent reporting In this case, the apparent reason was that the incubator door was left open by someone or was not correctly closed.

Questions raised in this context include the following: Was the nurse occupied with other emergency and essential actions? Was the incubator door latch broken? Why would the nurse forget to accurately examine the door? Is it possible that lack of guidelines for patient safety led to this incident? The most important step to reduce the possibility of such events in clinical settings is to establish policies and procedures that work best for each ward.

Furthermore, the continuous training of the personnel in patient safety, steady supervision, and controlling the efficacy level of the performed actions are some other steps that can be taken in this regard.

For instance, in this case, frequent checking of the incubator door, the use of two locks, and explanation of safety tips regarding the incubator to the staff are also important. Furthermore, evaluation and constant controlling of compliance with patient safety rules, and feedback are also necessary. The quantity of human resources is also noteworthy in the field of patient safety. In other words, quality assurance depends on the quantity of manpower. Therefore, in order to prevent similar incidents, providing an adequate number of staff at the bedside is essential Professional ethics and patient safety are intertwined fundamental concepts in medicine.

Patient safety is grounded in ethical principles which are considered as care quality indicators The realization of patient safety requires the provision and implementation of a professional code of ethics.

Based on the Iranian healthcare professional code of conduct, it is expected that all patients be treated with dignity and be protected from any possible harm Accordingly, adherence to ethical principles requires healthcare providers to identify potential safety failures to prevent falling incidents The establishment of patient safety has different individual, professional, and organizational aspects with a special focus on ethics.

It seems in case of any error made by the care team, the event must be announced to the parents honestly without blaming the care providers. Under circumstances in which errors were caused by inappropriate pattern of providing hospital services, parents should be reassured that all services will be paid for by the hospital.

It would be better if the parents were informed by the chief physician or the head nurse and given enough time to express their concern or anger. It should be considered that knowing the truth is one of the basic rights of patients and their family members. Furthermore, it should be noticed that primary conversations usually take place when there is not accurate and comprehensive information about the event, so recognizing, understanding, and explaining all the details in complicated clinical situations is not possible.

Thus, it is suggested that in such situations, information be given in several stages and by providing psychological support for the patient. Furthermore, while they may need supportive interventions, the patient's family can be considered as an important source of information in the process of root cause analysis RCA of similar incidents 17 - In addition, regarding the presented case, the father should be ensured that hospitalizing the newborn was necessary and the mother should not be blamed.

In fact, he should be ensured that the incident was entirely due to system error and not by the mother. Basically, maintaining the integrity of the family is essential and medical staff must consider family support at all stages, especially in such circumstances. Indeed, an important ethical point in this case is the necessity of offering an honest apology.

Laws and regulations related to patient safety, which may vary based on the legislation system of each country, should encourage the disclosure of medical errors while supporting the implementation of the ethical imperatives of patient safety. In general, based on the medical law, the patient who is a victim of negligence is supposed to be fairly compensated. In addition, these rules provide possibilities for promotion of transparency and open communications in all levels.

Reaching this goal requires regarding all stakeholders in the healthcare system In the mentioned case, some questions could be raised. Either the falling was in the presence of the mother or not. If it was in her presence, the hypothesis is that she dropped the baby intentionally. Accordingly, it should be considered that maternal postpartum sleepiness is one of the major risk factors for falling of newborns. Half of all newborn falling incidents in hospitals have occurred while the mother was holding the infant in a hospital bed.

Therefore, recognizing the risks of neonatal falling during mother—baby care situations and teaching the mothers is a major nursing responsibility If the mother is incapable of taking care of the hospitalized baby, she should be under supervision of the care team and should be educated.

Furthermore, notifying the father is an appropriate act if the complaint was raised by the father. The main task of the physician or nurse after a detailed examination and treatment is the detailed registration and description of all events without any assumptions. If the examinations found evidence of neglect, it would be a completely different discussion and calling the social services would be absolutely necessary.

There is an obligation to inform the patient or the family about every unwanted event in healthcare settings. The idea that there is no need to disclose errors which did not affect the patient is based on the traditional stance of the law. Despite increased attention toward the quality of health care services, there are still numerous threats to patient safety in healthcare settings. Reaching the ultimate goal of the healthcare system, which is to ensure quality and safety of the services, requires structured policies and processes to foster the safety settings based on mutual trust.

This can be facilitated by encouraging multidisciplinary collaboration for the transparent reporting of medical errors and also active participation of the patients and their families in detecting medical errors.

Furthermore, the provision of emotional support and legal protection of the staffs by the organization is essential to encourage voluntary reporting of incidents. Moreover, training and emphasizing on the professional code of ethics can be effective on deepening the understanding of and belief in the moral foundations of patient safety. National Center for Biotechnology Information , U. J Med Ethics Hist Med.


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Ethical issues happen when choices need to be made, the answers may not be clear and the options are not ideal. The result could be declines in the quality of patient care; problematic clinical relationships; and moral distress, which is defined as knowing the right thing to do but not being allowed or able to do it. Nurse managers, in particular, are susceptible to ethical issues in nursing and moral distress because of their leadership and mentoring roles. Nurses and other medical staff look to nurse managers for appropriate and ethical decisions. Before stepping into a role as a nurse manager, registered nurses RNs should understand the role ethical decision-making plays in the day-to-day work. The coursework not only covers the fundamentals of ethical nursing but delves deep into controversial case studies, giving students the chance to examine alternative viewpoints and develop reasoning skills.

Ethical Issues in Nursing: Explanations & Solutions

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Ethical and Legal Aspects of Nursing. Ethical and Legal Aspects of Nursing Objectives. Define the following terms: value, value system, ethics, ethical dilemma, ethical distress, ethical decision making Understand the meaning of the following terms: bioethics, clinical ethics, nursing ethics. Ethics is different from religion, law, custom and institutional practices. How do personal values influence ethical choices in nursing?

We will introduce influential ethical theories and perspectives, explore changing societal demands and expectations of media creation and media use, and we will elaborate on existing ethical norms for. Medical ethics career path? Lack of societal consensus on the parameters of a terminally ill person's right to die continues to confound at times the health care field.

4 Common Nursing Ethics Dilemmas

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code of ethics in nursing ppt

Since patient safety is multidimensional and grounded in ethical and legal imperatives, both ethical and legal challenges should be taken into account. In this regard, a falling incident case of a day-old newborn was raised in the monthly ethics round in the Children's Medical Center of Tehran University of Medical Sciences, Iran, and the ethical and legal dimensions of patient safety were discussed by experts in various fields. This report presents different aspects of patient safety in terms of root cause analysis RCA and risk management, the role of human resources, the role of professionalism, the necessity of informing the parents disclosure of medical errors , and forensic medicine with focus on ethical aspects. Thus, it has been the most emphasized component of the quality of health care services all around the world.

In caring for patients or clients, you must; Respect the patient or client as an individual Obtain consent before you give any treatment or care Protect confidential information Cooperate with others in the team Maintain your professional knowledge and competence Be trustworthy Act to identify and minimise risk to patients and clients. A patient is admitted to the Accident and Emergency Department. He is unconscious and requires an emergency operation.

Простое число. Джабба посмотрел на таблицу, что стояла на мониторе, и всплеснул руками. - Здесь около сотни пунктов. Мы не можем вычесть их все одно из другого. - Многие пункты даны не в числовой форме, - подбодрила людей Сьюзан.  - Их мы можем проигнорировать. Уран природный элемент, плутоний - искусственный. Ethics is not religion or law; Nurses have a duty to practice ethically and morally; Tells us how human Not an ethical issue, but is absolutely vital in ethical decision making.


Без воска… Этот шифр она еще не разгадала. Что-то шевельнулось в углу. Сьюзан подняла. На плюшевом диване, закутавшись в махровый халат, грелся на солнце Дэвид и внимательно за ней наблюдал. Она протянула руку, поманив его к. - Без воска? - тихо спросила она, обнимая. - Без воска.

Парень фыркнул. - Сегодня годовщина Иуды Табу. У всех такие… - На ней майка с британским флагом и серьга в форме черепа в одном ухе. По выражению лица панка Беккер понял, что тот знает, о ком идет речь. Мелькнул лучик надежды. Но уже через минуту парень скривился в гримасе.

Сквозь строй не позволял мне загрузить этот файл, поэтому я обошел фильтры.  - Глаза коммандера, сузившись, пристально смотрели на Чатрукьяна.  - Ну, что еще - до того как вы отправитесь домой. В одно мгновение Сьюзан все стало ясно. Когда Стратмор загрузил взятый из Интернета алгоритм закодированной Цифровой крепости и попытался прогнать его через ТРАНСТЕКСТ, цепная мутация наткнулась на фильтры системы Сквозь строй. Горя желанием выяснить, поддается ли Цифровая крепость взлому, Стратмор принял решения обойти фильтры.


 - Это что за фрукт. Соши пожала плечами.

Он по-прежнему показывал время, превышающее пятнадцать часов. Даже если файл Танкадо будет прочитан прямо сейчас, это все равно будет означать, что АНБ идет ко дну. С такими темпами шифровалка сумеет вскрывать не больше двух шифров в сутки. В то время как даже при нынешнем рекорде - сто пятьдесят вскрытых шифров в день - они не успевают расшифровывать всю перехватываемую информацию. - Танкадо звонил мне в прошлом месяце, - сказал Стратмор, прервав размышления Сьюзан.

Стоящая перед ним задача была крайне деликатна и требовала массу времени - вписать скрытый черный ход в сложный алгоритм и добавить невидимый ключ в Интернете. Тайна имела первостепенное значение. Любое подозрение об изменении Цифровой крепости могло разрушить весь замысел коммандера. Только сейчас она поняла, почему он настаивал на том, чтобы ТРАНСТЕКСТ продолжал работать.

 - Есть еще кое-что. Атомный вес. Количество нейтронов. Техника извлечения.

Professional, ethical and legal issues of nursing MN.ppt

Халохот замедлил шаги. Мгновение спустя появились еще двое - тучный мужчина и рыжеволосая женщина. Они также подошли к Танкадо. - Неудачный выбор места, - прокомментировал Смит.

Сьюзан решила не заводить деловых разговоров, чтобы не портить настроение ни ему ни. Она снова почувствовала себя школьницей. Это чувство было очень приятно, ничто не должно было его омрачить. И его ничто не омрачало. Их отношения развивались медленно и романтично: встречи украдкой, если позволяли дела, долгие прогулки по университетскому городку, чашечка капуччино у Мерлутти поздно вечером, иногда лекции и концерты.

Голос все звал его, а он безучастно смотрел на светящуюся картинку. Он видел ее на крошечном экране. Эту женщину, которая смотрела на него из другого мира.


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