JONA'S Healthcare Law, Ethics and Regulation

Before surgery, the informed consent process is the practical application of shared decision making between a surgeon and a patient. However, nurses, as enlightened patient advocates, also have an entrusted interest in fully understanding the legal and ethical considerations of the informed consent process. Some of the ethical principles impacting informed consent are existing cornerstones of professional nursing practice. Nevertheless, surgeons bear the ultimate responsibility for the informed consent process before surgery...

Patient-directed dying (PDD) will be an increasingly common issue faced by healthcare professionals. Nevertheless, few studies have explored nurses' attitudes toward PDD. This pilot project sets out to fill the gap regarding nurses' attitudes and values regarding PDD and perceptions of consistency or inconsistency with the American Nurses Association (2001) Code of Ethics for Nurses With Interpretive Statements (The Code). Thirteen subjects self-selected from a population of registrants attending a national ethics conference by completing an anonymous descriptive survey...

Moral distress is increasingly recognized as a problem affecting healthcare professionals. If not addressed, it may create job dissatisfaction, withdrawal from the moral dimensions of patient care, or even leaving the profession. Using the 21-Moral Distress Scale-Revised to assess moral distress, 323 surveys were received from 5 healthcare disciplines. The overall results showed that all disciplines experienced moderate to high actual moral distress, related to similar and/or different patient care situations...

This column provides executive summaries of developments in legal and regulatory issues related to healthcare, lists a bibliography of pertinent healthcare law-related articles, and discusses interesting health law court decisions.

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UNLABELLED: Patient-directed dying (PDD) (also known as physician-assisted suicide) has been a heavily debated issue in the United States since the passing of the Death With Dignity Act in Oregon in 1997. Previous research surrounding PDD has been limited to assessing the attitudes of physicians, nurses, and patients. The purpose of this study was to describe the intended actions of advanced practice registered nurses (APRNs) toward initiating PDD discussions and prescribing a lethal dose of medication under PDD legislation...

OBJECTIVE: The objective of this study was to determine the perceived level of horizontal hostility (HH) in a 220-bed acute care community hospital and whether the threat of or experience with HH influenced nurse behaviors directly related to patient safety. BACKGROUND: While the acknowledgement and presence of HH in nursing are gaining prominence, little is known about how a nurse's experience with HH directly influences his/her actions with patients under their care, even when the nurse realizes these actions may not be in the patient's best interest...

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UNLABELLED: This article is reprinted with permission from Nursing Administration Quarterly, Volume 36.3. This NAQ issue focused on Timeline 2020 and can be found at www.NAQJournal.com. ABSTRACT: The current health care environment has heightened the importance of achieving positive patient outcomes and excellent customer satisfaction. To remain competitive, health care organizations must adapt quickly to changing regulatory requirements, quality improvement initiatives, and customer expectations...

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The hallmark of professionalism is accountability, and this is necessary to consolidate the professional status of nursing. This article presents a review of the concept of professional accountability within the theoretical orientation of the role theory. It assumes that the nurse is performing roles that must be duly accounted for. It discusses the various areas of professional accountability with particular reference to primary healthcare nursing practice. It concludes that primary healthcare nurses are involved directly with the public on a daily basis, hence the need to be cognizant of their public position, level of responsibility, and professional accountability...

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On June 28, 2012, the US Supreme Court upheld the provisions of the Patient Protection and Affordable Care Act of 2010, as amended by the Healthcare and Education Reconciliation Act of 2010, with the exception that the Department of Health and Human Services may not withhold existing Medicaid funding from states that refuse to adopt the Medicaid expansion, but rather only new Medicaid funding associated with the expansion. This article will review the impact of this ruling on healthcare providers with a focus on the practice of the nurse executive...

This is an original case study highlighting the importance of careful collaboration and effective communication among healthcare providers. Amid the chaos of a new year, implementing a new healthcare act with an entirely new system of coding, patients are informed consumers interconnected through enhanced technological advances. This article describes a complicated situation involving long-term follow-up of a patient with a history of previous surgical removal of a rare tumor. The problem is one in which the patient is given exclusive access to a newly implemented electronic medical record system that has not fully completed the transition, including all healthcare specialties in the new system...

No abstract text is available yet for this article.

While Magnet® is a commitment to excellence and thus recognition, the accountable care organization (ACO) focus is to quality and reimbursement. Each can be built on a model of shared characteristics that in the end will prove a source of success for the creation of an organization that is both an ACO and Magnet. In an effort to align strategic initiatives as synergistic processes, not competing priorities, 10 shared characteristics of Magnet organizations and ACOs are presented.

Remediation for the professional licensed registered nurse is a topic sparsely written about in the nursing literature. The provision of remediation, however, is a common tool used to address registered nurse practice issues. This article seeks to describe the various stakeholders' roles in remediation and recommends that nurses in management roles should ensure the provision of remediation for registered nurses when warranted.

It is generally accepted that the Patient's Bill of Rights applies to all patients including prisoners. Yet, a prisoners' incarcerated status generally prohibits inmates from making any decision that may shorten his/her life, and as such, the de facto medical decision maker becomes the medical director of the state correctional facility. This case study highlights the challenges that arise when the ethically appropriate response to a hospitalized prisoner's terminal medical condition warrants decisions that are in conflict with that advocated by the correctional facility...