The changing health care environment

Assess the changing health care environment that has created increased responsibilities for nurses in acute
care, ambulatory care, managed care, community and public health, and long-term care settings
Evaluate the potential liability for nurses when using technological advances and specialized equipment.
Compare and contrast the nurse’s responsibility for assessing, monitoring, and communicating in clinical
settings
Analyze violence as it exists today in the United States from a nursing perspective and potential interventions
to lessen its impact on victims
Distinguish the potential legal challenges associated with health maintenance organizational models
Compare and contrast the legal issues pertinent to various long-term care settings, including nursing homes,
assisted living centers, hospice, and elder day care centers.
Learning Materials:
Guido, G. W. (2014). Legal and ethical issues in nursing (6th ed.). Upper Saddle River, NJ: Prentice Hall.
(Chapters 17, 18, 19, and 20)
PowerPoint:
Guido:
Ch 17: Nursing in Acute Care Settings
Ch 18: Nursing in Ambulatory and Managed Care Settings
Ch 19: Public and Community Health Care
Ch 20: Nursing in Long-Term Care Settings
Summary:
This module began with a discussion of legal issues as they pertain to nurse practicing within acute care
settings, performing daily more highly skilled tasks and having responsibility for increasingly more acutely ill
patients. Employees who work in acute care settings are encountering the need for greater skills and facing
potentially more liability. Guidelines for competent, quality health care delivery were offered. The evolving field
of ambulatory care nursing was examined, with an emphasis on risk management, patient education, and the
concept of violence in health care. Legal considerations for nurses who donate their services, either through
disaster nursing or volunteer services were explored. Potential aspects of nursing in managed care
organization was detailed, with emphasis on identifying opportunities to achieve original managed care goals,
ensuring safe, quality health care for patients, and avoiding many of the potential legal challenges in managed
care. Community health settings include public health nursing, parish nursing, school health nursing,
occupational nursing, home health nursing, and hospice nursing. This module presented the potential legal
liability for nurses who are employed in these various community settings. Finally, the potential legal liability for
nurses practicing in long-term care settings was highlighted, and included newer models for long-term care
including rehabilitation centers, retirement homes, assisted living centers, and elder day care centers.
Assignment:
Professional Development Exercises :
Read the case study presented at the end of Chapter 17 (Guido, p. 362)
Was the nurse negligent for unlocking the bath-room door and allowing Judy to shower by herself?
Was it below the standard of care for the nurse to leave the bathroom door unlocked when the psychiatrist
came to see Judy?
How significant are the hospital policy and procedures in this instance?
How would you decide this case?
Read the case study presented at the end of Chapter 18 (Guido, p. 393)
Was the nurse negligent in the advice she gave Mr. Gonzales concerning his condition?
Did the nurse exceed her scope of practice in the advice she gave the patient?
Should the nurse have instructed Mr. Gonzales to go immediately to the local emergency center?
How would you decide this case? Who, if anyone, is liable in this case?
Read the case study presented at the end of Chapter 20 (Guido, p. 439)
What should the standards of care be for such a patient?
Even though the nursing care plan did not specify that the wound should be checked hourly, how should the
prudent nurse have acted?
Should the lawsuit center primarily on the surgeon for allowing this patient to be sent back to the nursing home
for post- operative care rather than insisting he be kept for 24 hours in an acute care facility post-operatively?
How would you decide this case?

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