NSG 7220 Week 8 Discussion: Legal Evidence and Application

Sample Answer for NSG 7220 Week 8 Discussion: Legal Evidence and Application Included After Question

The discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered.

For this assignment, make sure you post your initial response to the Discussion Area by the due date assigned.

To support your work, use your course and text readings and also use the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible. Respond to at least two of your classmates’ initial postings. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite sources in your responses to other classmates. Complete your participation for this assignment by the end of the week.

Legal Evidence and Application

This will be the final week of collecting evidence. Visit the South University Online Library and retrieve two peer-reviewed research articles focusing on legal issues related to your topic of interest. Critique each article, highlighting the strengths and the weaknesses of each article. Interpret the statistical analysis and significance of results. Finally, analyze the feasibility of applying this evidence to your topic of interest in your current practicum setting. Both articles should support nursing standards and patient safety within your chosen topic.

A Sample Answer For the Assignment: NSG 7220 Week 8 Discussion: Legal Evidence and Application

Title: NSG 7220 Week 8 Discussion: Legal Evidence and Application 

This week, the focus of the discussion is to discuss legal factors that may relate to my project. The focused project is to develop a de-escalation training that will help nursing staff aid clients experiencing a mental health crisis. Various legal implications for nursing practice can apply to the proposed Doctor of Nursing (DNP) project. One of the legal factors that the nursing staff (project population) and I need to ensure is that it is vital to stay within our scope of practice and to continue to meet nursing care standards. Within the United States, the individual state decides the scope of nursing practice that the nurse is working in, and the scope is specific to whether the nurse is a licensed practice nurse, registered nurse, or an advanced practicing nurse.

In the state of Texas, The Texas Board of Nursing is the authority that holds nurses accountable for ensuring they are working within their individual scope of practice and following expected care standards (Texas Board of Nursing, n.d.). One professional organization to think of when thinking of standards of care is the American Nurses Association because they are a leading voice in the nursing community on educating nurses so they are meeting the minimum standards of care (Brunt & Russell, 2022). The American Psychiatric Nurses Association would be a relevant nursing association that relates to the project since they help to guide psychiatric nurses on the best care standards and provide continuing education to help achieve optimal care measures (American Psychiatric Nurses Association, n.d.). If nurses cannot meet the standards of care and patients are harmed, the nurses may be held responsible and charged criminally (Bieber, 2023). However, the place of employment and the medical provider may also be held responsible (Bieber, 2023).

One thing that I will have to make clear in a training course to de-escalate patients experiencing mental health crises is that the nurses must understand that the techniques may not always work. It will be necessary for them to ensure their patient’s safety. When thinking of when verbal de-escalation does not work, I think about possible harm to clients and themselves. The first article I will discuss is one that looks at safety. Since the lack of a safe environment or interventions can possibly cause harm to clients, it is essential to ensure that nursing staff are knowledgeable on how to provide safe care to help decrease the possibility of legal issues.

The authors emphasize how vital patient safety is and how the nursing staff should be able to confidently and proficiently provide care that will help psychiatric patients reach optimal care outcomes (Torkaman et al., 2022). The study in Iran involved working with nursing staff from two mental health hospitals (Torkaman et al., 2022). The sample size of study participants was a little over two hundred, and the only requirement was that they were working at one of the mental health facilities that was part of the study (Torkaman et al., 2022). The study involved having the research participants complete a survey to collect their demographic information and ability to care for clients psychologically and physically to determine care proficiency (Torkaman et al., 2022). Care proficiency is vital to help the nurse to be able to avoid lawsuits and situations that may cause the patient to be harmed whether it is intentional or not. The researchers used descriptive mathematical investigation methods to review the collected data and determine statistical importance (Torkaman et al., 2022).

Although there were only a little over two hundred research participants, the data was interesting to me since the researchers noted they were able to receive all of the surveys they were expecting (Torkaman et al., 2022). The majority of participants had a four-year degree in nursing, had nine years of experience in mental health nursing or less, and were not single (Torkaman et al., 2022). As far as care proficiency, there was a statistically significantly higher proficiency reported from individuals with more than a four-year degree and between ages “45-65” and those with more than 20 years of nursing experience (Torkaman et al., 2022, p. 2856). However, the care standards and proficiency among most nurses surveyed were at an average level of patient care proficiency (Torkaman et al., 2022). Therefore, more training techniques to help nurses become competent should help decrease poor outcomes and increase the patients’ psychological wellness (Torkaman et al., 2022). This type of surveying could be put in place to help evaluate acute care nurses’ level of care competency at the precepting site to help bring awareness to recognize where they stand and what could be done to improve their ability to care for patients better.

The second article pertains to admitting patients due to a severe mental illness that may adversely impact their ability to think logically, and the patient is at risk of harming themselves or others. This pertains to de-escalation and the project since, in my experience, clients who are involuntarily admitted are experiencing severe mental health illness that can cause them to become unstable and also because some had escalated to agitation and aggression when they were told they were going to be placed on an involuntary hold. This study involved collecting data over time from an emergency department in Los Angeles, California, to review patients who came to the hospital and determine differences in patients admitted against their will for psychological emergencies versus being discharged (Bhalla et al., 2022). It is important to note that there can be legal and ethical concerns involved with holding someone against their will when there is a mental health illness involved. The provider needs to evaluate the situation closely to ensure the patient’s and others’ safety is taken seriously so the patient can be taken care of and receive the help they need.

The population of people being brought to the emergency department was sometimes brought by law enforcement and already on an involuntary status of care for their safety (Bhalla et al., 2022). However, it was possible that the providers working in the emergency department could evaluate the patients and discharge them if they felt they did not meet the involuntary admission criteria (Bhalla et al., 2022). The study occurred between 2017 and 2018 and involved patients in the emergency department receiving psychological evaluations (Bhalla et al., 2022). The researchers excluded individuals who had been seen more than once during the study time, patients who needed more medical care than psychological, those who eloped before care started, passed away, or were released to law enforcement because the study was more interested in identifying factors for admission against the person’s wishes (Bhalla et al., 2022).

While working in mental health, the providers I worked with noted that when patients are admitted against their will, it is important to document exactly how the patient could be harmful to themselves or others to avoid legal issues such as an accusation of false imprisonment.  A lot of the data was retrieved from the medical chart (electronically) that the hospital used to collect information on discovering criteria for admissions against the person’s will (Bhalla et al., 2022). Therefore, it would have been necessary for the researchers to safeguard the patient data they retrieved to prevent any unintentional information sharing with individuals with no lawful right to it.

The researchers ended up collecting data on over two thousand patients who were evaluated psychologically in the emergency department, and almost half of those individuals were admitted against their will (Bhalla et al., 2022). Bhalla et al. (2022) found no significant differences in whether the involuntary persons were male or female, language preference, money earned, job status, were housed, or had medical coverage. However, for those being admitted involuntarily, there were some differences noted in relation to race, being brought in by law enforcement, having suicidal ideations, wanting to harm others, or lack of a system of support (Bhalla et al., 2022). Allowing individuals to be discharged if they are going to harm others would be a high alert and potentially bring up legal risks and implications for the provider or hospital if the patient was let go. I have experienced situations where the patient admitted that they know what to say to be released if they want to, meaning they might say they are not having suicidal thoughts or homicidal thoughts so that they will not be admitted. Regardless, legal risks can arise in many situations within mental health nursing. This type of retrospective research could be completed to collect data on what types of clients are escalating, but there is limited time for the project, so it does not seem like a span of several months would offer reliable data.

References

American Psychiatric Nurses Association. (n.d.). About APNA. Retrieved December 14, 2023,

from https://www.apna.org/about-apna/

Bhalla, I. P., Siegel, K., Chaudhry, M., Li, N., Torbati, S., Nuckols, T., & Danovitch, I. (2022).

Involuntary psychiatric hospitalization: How patient characteristics affect decision-

making. Psychiatric Quarterly, 93(1), 297–310. https://doi-org.su.idm.oclc.org/10.1007/s11126-021-09939-2

Bieber, C. (2023, April 13). Malpractice in nursing: Definition, examples & your rights. Forbes.

Retrieved December 14, 2023, from https://www.forbes.com/advisor/legal/personal-Injury/nursing-malpractice/

Brunt, A., & Russell, J. (2022, September 20). Nursing professional development standards. In

StatPearls [Internet]. StatPearls Publishing. Retrieved December 14, 2023, from

https://www.ncbi.nlm.nih.gov/books/NBK534784/

Texas Board of Nursing. (n.d.). Texas administrative code: Rule 217.11 standards of nursing

practice. Retrieved December 14, 2023, from https://www.bon.texas.gov/rr_current/217-11.asp.html

Torkaman, M., Momennasab, M., Yektatalab, S., & Eslami Shahrbabaki, M. (2022). Nurses’

            patient safety competency, a predictor for safe care in psychiatric wards?.

            Perspectives in Psychiatric Care, 58(4), 2854–2861. https://doiorg.su.idm.oclc.org/10.1111/ppc.13133

A Sample Answer 2 For the Assignment: NSG 7220 Week 8 Discussion: Legal Evidence and Application

Title: NSG 7220 Week 8 Discussion: Legal Evidence and Application 

Hello Kerrin. Legal and ethical issues form a critical element of modern research concerning the research participants and the researcher. The Declaration of Helsinki established the principles implemented in clinical studies concerning human subjects. The objective of clinical research is collecting and evaluating data to enable the researcher to come to a conclusion. The results can be generalized, enhancing clinical practice and improving patient outcomes. It is important to understand that ethical and legal issues are critical, especially when dealing with adolescent participants. For instance, Bauman et al. (2020) conducted a study concerning parental permission when dealing with adolescents of new behavioral and biomedical HIV preventive interventions.

Falcon et al. (2018) also conducted a study examining barriers to research concerning the implementation of an intervention for alcohol detection and BI for minors. It is important to understand that adolescents are a specially protected population with unmet health needs. There is less research on this population since they are perceived as vulnerable and require safeguards from research involvement (Loveday et al., 2022). As a result, research has sought to obtain parental consent, which prolonged the approval process and sometimes excluded them from adolescents. The question, therefore, is who should provide informed consent concerning health research involving adolescents.

References

Bauman, L. J., Mellins, C. A., & Klitzman, R. (2020). Whether to waive parental permission in HIV prevention research among adolescents: Ethical and legal considerations. Journal of Law, Medicine & Ethics, 48(1), 188–201. https://doi.org/10.1177/1073110520917010  

Falcón, M., Navarro-Zaragoza, J., García-Rodríguez, R. M., Nova-López, D., González-Navarro, M. D., Mercadal, M., García-Algar, O., & Luna Ruiz-Cabello, A. (2017). Perceived barriers to implementing screening and brief intervention for alcohol consumption by adolescents in hospital emergency department in Spain. Adicciones, 30(3), 189. https://doi.org/10.20882/adicciones.896  

Loveday, M., Goga, A., Dhai, A., Labuschaigne, M., Roussouw, T., Burgess, T., Strode, A., Wallace, M., Blockman, M., Daniels, B., Spooner, E., & Bekker, L.-G. (2022). Ethically acceptable consent approaches to adolescent research in South Africa. Southern African Journal of HIV Medicine, 23(1). https://doi.org/10.4102/sajhivmed.v23i1.1385