UTA NURS3375 2020 October Full Course Latest

NURS3375 Health Policy & Legal Aspects

Module 1 Discussion

Click on this link: https://www.nursingworld.org/practice-policy/advocacy/federal/ (Links to an external site.)

Scroll down to, "Select a topic to learn more about Federal Issues." Choose 2 of the topics and read the information provided.  Then, post a 3-4 sentence summary for both of the topics you chose in the discussion board.  Remember to cite the website (using APA format).

Post your summaries of the 2 topics to the Discussion Board by 23:59, Wednesday of Module 1 ( please scroll to the module you want to post for---click on the link for that module and your coach discussion group).

Each week, you must have your initial post, which is due Wednesday at 2359, along with 2 questions to others or 2 responses to questions asked of you, or a combination of both which are due Saturday at 2359.  If no one asked you questions you will need to ask 2 questions to your classmates.

Please respond to each of the questions you are asked by your colleagues during the online discussion.

You will be evaluated on the quality of your summaries, questions, and responses to colleagues’ questions. Replies must be made by Saturday 2359 of Module 1.

 

NURS3375 Health Policy & Legal Aspects

Module 2 Discussion

Safe Harbor

Read this scenario then answer the questions that follow.

You, the RN, arrive early on your regular orthopedic unit. Your Charge Nurse comes to you and says that you need to go to the cardiac step-down unit. You protest, but she says she has no control over the situation and that you at least need to go to the step-down unit and see what is going on. You arrive at the step-down unit. The House Supervisor is present with the unit Charge Nurse. You are told that the unit is very understaffed that day and that you must take patients. You protest that you have worked only orthopedics for the past 10 years- that you do not know the current cardiac drugs and side effects, the current treatments and post-treatment care and that you have never had to read the type of cardiac monitoring strips that are generated on all the patients on this unit. The House Supervisor tells you to not worry. She explains as follows:

There are monitoring techs who are responsible for reading the strips.

You have access to a PDR and Pharmacy if you have questions about the drugs.

A nurse with recent experience on this floor will be able to go around with you to orient you for about two hours. (That nurse must return to his regular floor in two hours.)]

You again express concerns that you are not qualified to take this assignment. The House Supervisor takes you aside and says, “We need you to step up and help out here. We need team players in situations like this. If you refuse, I’m going to have to discuss your refusal with the Director of Nursing and your unit manager — it may not be good for your career here at this hospital. Besides, do you think you are the first nurse who ever had to take patients in a less than perfect circumstance? The patients are worse off if you refuse.”

Reluctantly, you accept the assignment. About 5 hours into the 12-hour shift, you mis-titrate a cardiac drug. The patient codes, never regains consciousness and is transferred to ICU. The patient dies 3 hours after being transferred.

Two weeks later, you are called to Human Resources. Your unit manager, the House Supervisor, and an HR representative are there. You are told that you are being reported to the state’s Board of Nursing due to the negative outcome of your patient

1). Was this a situation in which you should have claimed Safe Harbor?

2). How should you have responded (from a legal/patient safety/license protection perspective) in response to each of these statements?

“You will get a two-hour orientation.”

“The monitor tech will be responsible for reading the strips.”

“You need to be a team player or you may suffer employment consequences.”

Post your responses to the questions above on the Discussion Board by 23:59, Wednesday of Module 2.

You will be evaluated on the quality of your summaries, questions, and responses to colleagues’ questions.

Basic APA format is required.

 

NURS3375 Health Policy & Legal Aspects

Module 3 Discussion

In Texas, on his annual renewal form, an RN stated that he got a second DWI 9 months ago. What do you tell him will be the most likely decision as to his license? If you are not in the state of Texas, how would this license renewal situation be handled?

An RN with a current New York license has moved to Texas and has applied for a Texas license. On the application, she wrote that she was convicted of Medicaid fraud ($5,230.00) four years ago and will be off of probation in six months. What do you tell her will be the most likely decision as to a Texas license?

The BON has become stricter over the past several years concerning criminal convictions and a person’s ability to practice as an RN in Texas. Consult the Board’s “Disciplinary Guidelines for Criminal Conduct,” and consider the above scenarios. In each case, suppose you are an investigator with the Board.

Post answers to each of the RNs in the scenarios on the Discussion Board by 23:59, Wednesday of Module 3. Compare your responses to those of your colleagues, and explain your reasons or discuss details such as stipulations with at least two colleagues. ( please scroll to the module you want to post for---click on the link for that module and your coach discussion group).

 

 

NURS3375 Health Policy & Legal Aspects

Module 4 Discussion

Documentation Affected by Under Staffing or Misappropriation of Narcotics?

What sections of the Nursing Practice Act and the Board Rules address documentation?

The nurse cannot make more staff magically appear. What could the nurse have done, under these circumstances, to improve her documentation and perhaps avoid being reported to the Board? (NOTE: In the real case upon which this scenario is built, the nurse did testify that she felt that she had allowed herself to get lulled into the “that’s the way we do it” mentality for that unit!)

What do you feel is the best way to handle narcotic wastage if another nurse is not readily available?

Suppose you are an investigator with the Board. Open and read the sample background information and notice letter from the Board by clicking on the link. Then discuss the above questions with your colleagues.

Background Information and Sample Notice LetterPreview the document

Your participation in this Discussion will be graded upon the detail and accuracy of your contributions to the discussion.

 

NURS3375 Health Policy & Legal Aspects

Module 5 Discussion

Do you think your State Board of Nursing should impose limitations on the number of hours that nurses work due to nurse fatigue and the greater chance of making mistakes detrimental to patients?  Justify your thoughts with evidence-based research.

Do you think you will be more cognizant of professional boundary issues in your practice than you were prior to the course?  Justify your thoughts with evidence-based research. 

Your participation in this Discussion will be graded upon the detail and depth of analysis of your contributions to the discussion.

 

NURS3375 Health Policy & Legal Aspects

Module 1 Assignment  

Legislator E-mail Exercise

To take a proactive role in nursing policy, you will prepare an email to your legislatorabout a current nursing issue.  You must first identify your legislator. Then you will write a concise, professionally worded e-mail to one of the state-level legislators about a current nursing issue that is important to you.  You will:

1.            Find the legislator of the state you are licensed in.  You will only write your email to one legislator, even if many are listed. You must only use the legislator in the state you are licensed in.

2.            Complete the issue description and action plan section prior to composing the email as to organize your thoughts.

3.            Write your final e-mail in the space provided on this assignment document.

4.            You MUST include one personal example about how the issue personally affects your nursing career.

5.            Use at least 2 referencesfrom a scholarly article (dated within the past 5 years)with 2 in-text citations to support your thoughts and list in correct APA format.

6.            Upload and submit the email assignment you have prepared for your legislator intoCanvas.

It is not necessary for you to actually send your email to you legislator unless you choose to do so.

Performance Objective:

•             Identify the ways nurses can personally take part in shaping future nursing care.

A.            Identifying Your Legislators:Find out who your legislators are at the statelevel. Use a google search to locate your states legislative system, or here is a helpful link in which you can identify your state- https://www.congress.gov/state-legislature-websites

•             You only need one legislator that you are going to address your issue to.  If email information is not available then you would only place their physical address. In rare cases a physical address is not listed, please include webpage address.

Record their names, titles, and contact information here:

Name-

Title-

Contact Information-

B. IssueDecription and Action Plan: Identify a current nursing issue important to you and your practice. To help you begin organizing your thoughts, complete the following section.

1). State the nursing issue that affects you in 1-2 sentences.

Now, list three reasons or examples as to how this nursing issues personally affects your practice.

2). What help/assistance are you requesting from your legislator?

Now, list three reasons or examples as to why this assistance would positively impact nurses.

C.  Writing the E-mail: Write an e-mail explaining the importance of this issue to your practice. Limit the e-mail to one page. Choose details you developed above; use the ones that you think create the strongest and most persuasive e-mail. Remember to include a personal example from your practice.

Follow the format of the sample e-mail located in the assignment instructions textbox. (The format must be strictly followed, especially for how to address the legislator and inclusion of your home address to classify you as a constituent.)

Be sure to edit your e-mail for spelling, grammar, and word usage. Read it aloud, and/or get a friend or relative to read it and provide feedback. You will not be sending this to your legislator as part of this assignment but you may choose to send it to them on your own to make them aware of the issue you have addressed.For full credit, include two in-text citations from scholarly articles dated within past 5 years. “Scholarly artilces” are only classified as peer-reviewed journal articles are written by scholars or professionals who are experts in their fields.Magazine articles, administration documents, reports from different kinds of organizations, essays, opinion pieces, or Wikipedia resources are not scholarly articles.

Write your final e-mail in the space provided below.

Space for you to write your final e-mail to your legislator: Type directly below. 

D.  References:Please list references here. At least twofrom scholarly artilces (dated within the past 5 years) are required to support your thoughts. Please use correct APA formatting.

 

NURS3375 Health Policy & Legal Aspects

Module 2 Assignment  

Standards of Nursing Practice

In this Module 2 assignment, you will review your own understanding of standards of nursing practice and their applications to nursing.  The nurse must comprehend the minimum acceptable level of practice that is expected of them. Then, you will know if a rule or standard is being violated.

Refer to your course readings and lectures as you complete the assignment. The Standards of Practice Rule 217.11 can be found here- https://www.bon.texas.gov/rr_current/217-11.asp

Performance Objectives: 

•             Understand the TX BON Rule 217.11 Standards of Nursing Practice

•             Apply basic knowledge to practice

•             Awareness of nursing actions that fail to meet the rule

Part 1

TX BON Rule 217.11, Standards of Nursing Practice, is what the BON expects of you as a practicing nurse.  Define TX BON rule 217.11 in your own words.Why is this important?

Write 4 professionally written sentences for full credit.

Part 2

Patient safety is always our number one priority. A nurse has a duty to the patient to ensure safety. The “most important” actions a nurse can take is to follow the Rule 217.11 (1) (T) which- “holds the nurse accountable to accept only those assignments that are within the nurse’s educational preparation, experience, knowledge, and physical and emotional ability.”  Now that you are familiar with this rule, describe a time in which you were in a situation that violated this rule. What would you do if you were placed in those circumstances again? Write 4 professionally written sentences for full credit.

Part 3

Fill in the blanks

Complete the following fill in the blank sentences from your Module 2 Chapter 15 reading requirement. Each answer is worth 5 points.

1). Law and nursing are both professions devoted to helping patients/clients and society by advocating for ______________ improvements and justice.

2). The nurse has a _____________ to practice competently and to possess the knowledge, skills, and abilities required for lawful, safe, and effective practice.

3). Informed consent cases are a type of _____________ suit.

4). In terms of accountability, nurses must take responsibility for their actions and the actions of others involved in the _____________ process.

 

NURS3375 Health Policy & Legal Aspects

Module 3 Assignment  

Peer Review

In the Module 3 Reflection Assignment, you will reflect upon what you have learned about the Minor Incident Rule and Peer Review Committee processes as you consider the actions of fictitious nurses and committee members in scenarios.  REMEMBER, YOU ARE USING THE TEXAS BOARD OF NURSING RULES, NOT THE STATE YOU LIVE IN. Please use the link provided in the assignment for the Texas BON Rule 217.16.

Refer to your course readings and lectures as you complete the assignment.

Performance Objectives: 

•             Differentiate between the the Minor Incident Rule (217.16 a) vs. a Reportable Incident (217.16 h)

•             Describe the due process protections (Rule 217.19) for a nurse who is peer-reviewed.

Part 1: Applying Rule 217.16

Let’s review what deems a Minor Incident (217.16 a) vs. a Reportable incident- (217.16 h)-

A minor incident is- 217.16(a)- nurses’ actions may be a violation of a board rule, but does not indicate the nurses continued practice poses a risk of harm to a patient or another person.

A reportable incident is- 217.16(h)- conduct that falls outside of the definition of a minor incident and must be reported to a PRC or BON.

Let’s come up with an easy way to remember what is a minor incident- in case you are ever in this situation, whether this happens to you or you are participating on a peer review committee evaluating a fellow nurse’s actions. Think about the word “harp.”

•             H- no significant Harm

•             A- nurse must take Accountability

•             R- easily Remediated

•             P- no Pattern of this behavior

However, these minor incidents still must be documented, tracked and remedied. The nurse must be reported to the nursing peer review committee if a nurse commits five (5) minor incidents within a 12-month period.

Look at this case study scenario below.

“Nurse Karen is caring for a newly admitted 67-year-old male patient with infectious endocarditis due to a bacterial infection of his prosthetic heart valve.  After blood cultures come back positive for staphylococcus aureus, IV Vancomycin is ordered.  He tells Nurse Karen and the doctor that the last time he got this medication, he experienced hives and hot, itchy skin but he was not allergic to it. The doctor ordered the medication to be infused slowly as to avoid Red Man Syndrome (500 mg IV bag at a rate of two hours as opposed to the standard one hour).  Karen sets the IV pump incorrectly, and the infusion is given within a 30-minute period.  She calls the doctor and immediately gives 50 mg diphenhydramine and ranitidine 50 mg via IV with orders.  The patient experienced mild flushing, but the episode resolved within 20 minutes.  Karen is a well-seasoned nurse with over 20 years of experience and no prior history of incidents.  She took immediate responsibility for this error when meeting with the unit manager.  Karen will now need another RN to witness and sign when she administers IV medication for the next 60 days.  Karen agrees to this plan."

Using the Texas BON Rule 217.16, review (a) a Minor Incident vs. (h) a reportable incident. This information can be found at https://www.bon.texas.gov/rr_current/217-16.asp

Based on your assessment of the criteria, was this a Minor Incident or reportable event? Why or Why not? Please write four (4)professionally written sentences with examples from the Rule to support your thoughts for full credit.

Minor or Reportable?

Why? Or Why not? Include examples from the Rule.

Part 2: Applying Rule 217.19 Incident-Based Peer Review

First, review your learning about incident-based peer review. The purpose of an IBPR is to determine whether a nurse should be reported to the Texas Board of Nursing (BON) for professional misconduct or licensure violations based on one or more such events.

Please use the link provided at https://www.bon.texas.gov/rr_current/217-19.asp

to review. Apply the information to this case study-

"Nurse Sam is charting at the nurse’s station where there are co-workers, physicians and a unit secretary gathered.  Sam and the nurse manager have not been seeing eye to eye lately (verbal altercations both in the halls and in the cafeteria recently).  The nurse manager approaches Sam and loudly states, “I am glad you are here.  Just to let you know, the Incident Based Peer Review Committee is meeting tomorrow, and we are investigating your recent questionable behavior.  I know you have made many recent medication errors and safety violations noted by the Patient Safety Committee.  I also heard you are dating that patient who was in Room 256B last month.  I thought you would want to know this was happening, you could be in big trouble and probably fired.  I don’t have anything official to give you, but you better find a lawyer, although I doubt you can with this short notice.”

How did this nurse manager violate the IBPR? Refer to the Rule listed below and discuss in the text box.

Rule 219.19 a (2)Bad Faith- knowingly or recklessly acting without the supported of reasonable or legal basis, misrepresenting the facts surrounding the facts under review, acting out of malice or personal animosity towards the nurse, acting from a conflict of interest, or knowingly or recklessly denying due process. How did this nurse manager violate the IBPR based on this rule? Please write four (4) professionally written sentences with examples from the Rule to support your thoughts for full credit.

Part 3: Multiple Choice Questions

Answer the following multiple-choice questions according to the Module 3 readings and lectures. They are worth 5 points each, there is only 1 correct answer.

1). According to Clevette and colleagues, examples of unsafe, common disciplinary actions reviewed by boards of nursing include all of the following EXCEPT-

a). Destruction or alteration of patient records, including fraudulent charting and/or signatures and/or replacement of records with intent to mislead or deceive.

b). Physical patient abuse, such as when a nurse hits, strikes, or performs similar physical acts of aggression involving patient contact.

c). Practicing beyond the authorized scope, such as administering medications without a physician’s order.

d). Failure to implement safeguards to ensure patient confidentiality and integrity of patients protected health information, violating HIPPA.

2). Rule 217.19 in Texas, Incident Based Nursing Peer Review and Whistleblower Protections provides to the nurse being peer reviewed EXCEPT-

a). Minimum protection

b). Minimum due process

c). Minimum legal representation

d). Minimum rights afforded to nurse

3). If a nurse does not agree to the discipline set due to a complaint made against this nurse, after reviewing the proposed agreed order, they can request a-

a). Informal conference

b). Formal conference

c). Informal hearing

d). Formal hearing

4). Common nursing remedial education courses required if a nurse is being disciplined are-

a). medication refresher, ethics, geriatric care, nursing jurisprudence, care coordination.

b). ethics course, care coordination, documentation, medication refresher.

c). physical assessment refresher, critical thinking, documentation, medication refresher, geriatric care.

d). nursing jurisprudence, documentation, ethics, medication refresher, physical assessment refresher and critical thinking.

Submit this Assignment Document into Canvas for grading.

 

NURS3375 Health Policy & Legal Aspects

Module 4 Assignment  

Safe Harbor

Due to staffing shortages and the unpredictability of hospital needs, nurses are sometimes asked to take on assignments outside their normal routines.  As a healthcare professional, you must understand your options when asked to take on such assignments, the risks associated with accepting some assignments, and the protections afforded you by the law.  Reflect upon your learning about the Safe Harbor protection as well as any experiences you have had in this realm.  Then follow the instructions and complete the Safe Harbor form based upon a fictitious scenario.

Refer to your course readings and lectures as you complete the assignment.

Performance Objectives:

•             Explain and apply appropriate options regarding acceptance or rejectionof assignments, including the use of Safe Harbor.

•             Answer fill in the blank questions according to the readings this week.

Part 1: Safe Harbor Scenario and Questions

Nursing safe harbor is a law that nurses can use to absolve themselves of liability when forced to commit an act that the nurse believes violates Texas Board Statutes and Rules. Every nurse should be aware of the statutes and rules governing their profession. If a patient, supervisor or doctor asks the nurse to violate one of these rules, the nurse can invoke safe harbor before committing the act to ensure that they aren’t held legally responsible for what happens next. This protects them from facing punitive measures from their employer, losing their nursing license or being sued in court for putting a patient’s life in danger.

Explore the Case Study Scenario and place yourself in this situation. Answer the following questions according to your knowledge of Safe Harbor from the lectures and readings this week.

On Sunday, August 6th, you arrive to Saint Luke’s Hospital at 7pm for your night shift and clock into the ICU. Maria, the Charge Nurse, approaches you as you are putting your bag in a locker. “Thank goodness you are here”, she says. “You are going to have to take extra patients tonight. I am dealing with 2 nurses who just called in sick. Your assignment tonight will include the septic and stroke patients you had last night, but you also need to take on two more- one with a brain aneurysm and one that is post op major cardiac surgery.” You know that this is an impossible task and would be placing the patients in serious harm. You ask if anyone can float to the floor or if someone can be called in, but no one is available. “This is all on you. I need you to be a team player here,” says Maria. You decide to claim Safe Harbor and find Christine, the Nurse Supervisor, who will invoke the Quick Request form on your behalf?

1). What are the 4 choices every RN has when given an assignment?

2). Based on the scenario above, you have decided to claim Safe Harbor. Refer to Rule 217.11 Standard of Nursing Practice, specifically Rule 217.11 1(T). Type the Rule as it appears into the first text box. Based on this rule, why did you claim Safe Harbor? Type in second box.

https://www.bon.texas.gov/rr_current/217-11.asp

Rule 217.11 1(T)-

Why did you claim Safe Harbor?

3). Name the two forms that need to be completed both before and after your shift. ***Update Spring 2020, you can now invoke orally to supervisor who then can record the event, but forms still must be filled out***

Part 2: Safe Harbor Quick Request Form

Below you will find the Safe Harbor Quick Request Form that must be completed before you engage in the care of these patients. Fill out the text box portion as you are the nurse in the scenario.

Do NOT fax or mail this form to the BON. Give it to your supervisor.

BON Safe Harbor Quick Request Form

A valid Safe Harbor Quick Request must include the following information (  ):

•             ?? Name(s) of the nurse(s) invoking safe harbor:

•             ?? Name of the supervisor recording the safe harbor invocation on behalf of the nurse(s), if applicable [*Required if the nurse(s) orally invoke(s) safe harbor in accordance with NPR Law §303.005(b-1).]:

•             ?? Date and time of the safe harbor invocation:

•             ?? Location where the requested conduct or assignment that is the subject of the safe harbor invocation occurred:

•             ?? Name of the person who requested the nurse(s) engage in the conduct or made the assignment that is the subject of the safe harbor invocation:

•             ?? BRIEF explanation of why the nurse(s) is(are) requesting a nursing peer review committee determination [For assistance, please review Board Rules 217.11 &217.12.]:

?? Signature(s) of the nurse(s) invoking safe harbor [*This form must be signed by the nurse(s) invoking safe harbor even if the supervisor completes the form in accordance with NPR Law §303.005(b-1) & (b-2).]:

Your Typed Signature:

?? Signature of the supervisor recording the nurse’s safe harbor invocation, if applicable [*Required if the nurse(s) orally invoke(s) safe harbor.]:

Your Supervisors Typed Signature:

DO NOT FAX OR MAIL THIS FORM TO THE BON. GIVE THIS FORM TO THE SUPERVISOR WHO MADE THE ASSIGNMENT OR REQUESTED THE CONDUCT FOR WHICH YOU ARE INVOKING SAFE HARBOR, AND KEEP A COPY FOR YOUR RECORDS.

This Safe Harbor Quick Request Form is part 1 of 2 for valid invocation of safe harbor. Please complete part 2 of 2 (the Comprehensive Written Request for Safe Harbor Nursing Peer Review) before leaving the work setting at the end of the work period.

Submit this Assignment Document into Canvas for grading.

 

NURS3375 Health Policy & Legal Aspects

Module 5 Assignment  

Reflective Questions and Malpractice

According to the American Nurses Association, Standard 15- “the nurse is required to evaluate his or her own practice in relation to professional practice, standards, guidelines, relevant statutes, rules, regulations, organizational policies, and procedures.” Examples of competencies related to this standard include self-reflection and self-evaluation to identify areas of professional growth. In Part 1 of this assignment, you are asked to reflect on two specific key points for the course. Then, in Part 2, you will read a fictitious scenario and identify pertinent facts that pose risks for malpractice claims. Each year, nurses make themselves vulnerable for potential malpractice claims because they are not well-informed about malpractice elements. It is imperative you understand malpractice rules, regulations and facts to protect your nursing license.

Performance Objectives: 

•             Understand the benefits of reflection in professional practice.

•             Incorporate ANA Standard 15 into the writing assignment.

•             Recognize the importance of BON Rules and Legal protections and its impact on the nursing profession.

•             Synthesis of module topics into professional growth.

•             Malpractice implications for nursing.

•             Apply the four elements of a malpractice claim to specific incidents.

Key points:

1). What did you take away from the course?

2). Describe a TX BON Rule or legal topic. Choose one from the table below. Explain the implication it has on the nursing profession.

Topics to choose from-

•             217.11 Standards of Practice

•             217.12 Unprofessional Conduct

•             217.16 Minor Incident

•             217.19 Incident Based Peer Review and Whistleblower Protections

•             217.20 Safe Harbor

•             217.13 Peer Assistance Program

•             Policy and advocacy

•             Investigation and discipline

•             Boundaries and social media

•             Staffing

•             Nurse fatigue

•             Texas Peer Assistance Program for Nursing (TPAPN)

•             Legal duty to the patient

•             Malpractice

Part 1: Reflecting on Course Material

                Reflective Questions- type directly into this text box. Five professionally written sentences required for full credit for each Key Point.

Key Point 1:

What did you take away from this course?          

Key Point 2:Explain the topicchosen from the table and its implication for the nursing profession.

Topic Chosen:

Implications:

Part 2: Potential Malpractice Claim

Read this scenario. Decide if the situation presents potential elements of malpractice.

Nurse A was assigned to Mr. Jones, a post-surgical patient on the Medical-Surgical floor, who had been doing well on the day shift.  Nurse A was working a 7:00 P.M. to 7:00 A.M. shift.  (Dr. Grumpy, Mr. Jones’s treating physician, had screamed at Nurse A last month when Nurse A called him at 3:00 A.M. to report a change in status of another of Dr. Grumpy’s patients.) During this shift, Nurse A became uneasy about the status of Mr. Jones, which reflected a substantial change in blood pressure and pulse, but Nurse A did not call Dr. Grumpy, choosing instead to “watch” the situation.  At approximately 5:00 A.M., Mr. Jones had to be rushed to emergency surgery with internal bleeding.  Now, 1½ years later, Mr. Jones has not recovered from the second surgery.

List the 4 elements of a malpractice claim and, for each of the 4 elements, state the facts in the scenario support that specific element. All 4 elements and 4 corresponding facts must be stated for full credit.

Elements of Malpractice Claim   Pertinent Facts