Krupa Patel Case Studies: Legal Dimensions of Nursing Practice 1. As the team leader on the floor where you practice nursing, you are covering another RN’s group of patients while she is away at lunch. As you make your rounds, you notice her LPN (who is not certified for IV medication administration) administering a syringe of fluid via an IV line to a patient. (Learning Objectives 3, 6, 8, and 10) a. What data in the scenario are pertinent? RN is delegating task to LPN and going for lunch. The LPN is not certified to administer a syringe of fluid via an IV line to a patient. RN is not monitoring and did not assign proper task to her team members. b. Is there a nursing practice violation? If so, what is it? Yes, the LPN who is not certified to administer IV is being given this task. RN cannot delegate the nursing process itself. c. What regulations and/or standards address these issues? American Nursing Association address these issues. Nursing practice states the scope of practice for a RN and LPN. The RN needs to competent. d. How does licensure and certification apply to this case study? Licensure in this case study is being mis-used. The license is a legal documents which permits to practice their skills and knowledge in a particular jurisdiction, where such practice would be unlawful without a license The RN in this case study didn’t use her license like she should, instead she passed her task to a unlicensed personnel. This task was not within scope of practice of the LPN. Licensure measures entry-level competence, whereas certification validates speciality knowledge, experience, and clinical judgment. Also, the LPN is not certified to permorm this task. e. What purpose would an incident report play in this scenario? Incident report is used to document an occurrence report, used by health care facilities to document the occurrence of anything out of ordinary that results in, harm to patient, employee, or visitor. In this scenario the patient may be at a harm because an unlicensed personnel is performing the task (LPN). In this case the RN would be at fault. 2. Your patient, a 22-year-old man, was involved in a motor vehicle accident and has spent a week in the ICU. He is restless, continually shedding his covers---even while being transported for diagnostic tests. Due to his condition, you have help in transporting him for his tests and engage in conversation regarding his evolving condition in the public elevator. While waiting for the scanner to be ready for him, the diagnostics nurse begins to ask questions regarding his condition while in the crowded, curtained holding area. After your clinical, you discuss your day of care in the nurses’ lounge while awaiting your classmates for your clinical wrap-up, using the patient’s room number as an identifier. (Learning Objectives 9 and 11) a. What data in the scenario are pertinent? 22-year-old man, motor vehicle accident, 1 week in ICU, restless and shedding his cover. Engaging in a conversation regarding patient’s evolving condition in the public elevator, diagnostics nurse ask questions about his condition in crowd, discussing about the patient in nurses’ lounge using the patient’s room number. b. Applying what you know of patient privacy rights, were there potential violations committed in the case study? If so, outline the violations. Yes, the violations have occurred in protecting the patients rights to have the information kept confidential. Talking in the elevator, asking questions in crowded are, and using patient’s room number while talking about his condition, these are all invading patient’s rights for privacy. c. How could the violations have been avoided? The violations could have been avoided by not discussing about the patient’s condition in elevator, not asking questions about his condition, and not using patient’s room number. Do not use identifiers. d. Were there actions committed in the case study that were successful in protecting the patient’s privacy rights? If so, what were they? The nurse didn’t protect any patient’s right. I do no think there were any actions successful in protecting the patient’s privacy.