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Chemically Impaired Nurses Numbers of nurses illegally using drugs/ abusing alcohol continues to increase ~10-15% (even 20%

)"Impaired nursing": under influence of drugs/alcohol Is unsafe & unprofessional; a violation Nurse Practice Act State Boards are using Disciplinary Diversion Act Includes: voluntary treatment & rehab License suspension; permanent license loss Chemical dependence excuses r/t stress; easy access Nurses are legally liable for their practice Seek immediate help: Refer self or another to SBN (state board of nursing) Disciplinary Process Receipt of letter from SBN alleging breaches of the standard of care or infractions of pt safety practices Licensure issues fall under administrative law Variations by state but generally: Investigation of allegations Meeting with investigators Hearings with the SBN Appeal process What happens to Nursing License after process done? Charge dismissed Investigations agreement Letter of reprimand (formal or informal) Probation with stipulations (education, fines, monitoring, tx) Mandated diversion treatment program Suspension of license; Revocation of license Medical errors: Most common: medication 1 of 5 doses of meds observed at one facility US: 7,000 deaths/yr 770,000 injuries/yr d/t med errors Malpractice Insurance: Institution policies cover liability only if Ns on duty & acting within proper capacity Personal malpractice insurance provides protection for nurse on & off duty

Unintential Torts Negligence: commission or omission of act that a reasonable prudent person would have done in a similar situation, causing harm Malpractice: failure to meet a legal duty, thus causing harm to another Legal name for "professional " negligence Conduct or pt care that falls below the accepted standard of care Malpractice 4 elements MUST be present and proven for a case to be decided against defendant (nurse, hospital, physician): Duty Breach of Duty Harm Proximate Cause To defend against a malpractice suit, It must be proven that one or more of the elements is not met Contributary/comparative negligence: clients at least partly responsible for own injuries: choose not to follow health care worker's advice 4 elements of Malpractice Duty exists- nurse-patient relationship establishes a duty, defined by standards of care Breach of the duty- failure to perform the duty in a reasonable, prudent manner Harm has occurred- this does not have to be physical injury Proximate cause- the occurrence of harm depended directly upon the occurrence of the breach

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