...Nurses Manage Patients Who Refuse Nursing Care Procedures Grand Canyon University: NRS 433V March 9, 2014 Nurses Mange Patients Who Refuse Nursing Care Procedures This paper will critique a qualitative research study about how nurses manage patients who refuse nursing care procedures. These articles also explains how nurses view informed consent as not being essential to nursing care procedures. PROBLEM STATEMENT The clinical problem being examined in the research study is the way in which nurses obtain consent prior to administering nursing care procedures, and the way nurses manage patients who refuse any nursing care procedures. By stating that nurses “do not regard obtaining consent as an absolute requirement” also stating that “consent is preferred but no considered essential” the significance is established and a clinical problem identified (Aveyard, 2004). The author identifies the need for further education of nurses on the need to obtain informed consent for nursing care procedures, and the need for more research of this topic. The role of persuasion in situations of informed consent has been widely commented on. Many commentators argue that the health care provider has a duty not only to give information but also to persuade the recipient of care to accept the course of action considered most appropriate for the patients’ safety. PURPOSE and RESEARCH QUESTIONS The study clearly identifies the aim of the study as “to examine the way in which...
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...Informed consent Name Course Date Informed consent Informed consent is the procedure of getting permission to take part in a research study or medical procedure founded on access to all vital and easily understandable information about the consequences of participation in terms of benefits and harms (Dolgoff et al, 2009). A healthcare provider may demand informed consent from a patient before providing care or a researcher may request it from a participant before enrolling the individual into a research trial. Informed consent is based on guidelines provided by research and medical ethics. To give informed consent, the person involved must have sufficient reasoning faculties and have all the relevant facts. However, not all individuals may have capacities for informed consent due to impairments to reasoning and judgment such as mental immaturity, severe intellectual disabilities, mental illnesses, high stress levels, being in a coma, Alzheimer’s disease, and severe sleep deprivation. Medical and research actions may be carried out due to lack of informed consent. When a person is considered unable to give informed consent, another person can be authorized to give consent on behalf of that person (Manson & O'Neill, 2007). For instance, legal guardians or parents may give informed consent for young children and the mentally ill. In case a person is given insufficient information to make a reasoned decision, severe ethical issues may arise. In clinical trials...
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...personal learning outcomes. The term ‘critical’ introduces a further dimension to analysis, in that judgements are made about the strengths and weaknesses of the different parts, as well as of the whole, Burns (2000). Reflection follows on from this by encouraging the analysis of clinical practice, this in turn, helps the healthcare professional to develop his/her knowledge and to acquire a deeper level of understanding about the complexities of nursing practice. Boud et al (1985) suggests that this type of learning contributes to the development of clinical competence. The critical incident is taken from my recent clinical practice within the Endoscopy Unit. I will be reflecting upon and critically analysing gaining informed consent prior to the patient’s emergency Endoscopy and when to act within patient’s best interests. My rational for the chosen clinical incident is because of the impact it had on me. I realised I was not fully informed on the process of obtaining informed...
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...Applied Legal Concepts in Healthcare Law Brewster v. University Hospital This paragraph will include a summary from the case which was obtained from the Healthcare Law Writing Assignment. In December 31, 1987 the Brewster’s had a daughter Emma that was born a week premature. Emma was transported to Children’s Hospital Medical Center the next day when she began showing signs of respiratory distress. She was treated by Dr. Craig Jackson, a neonatologist employed by the University of Washington. Emma suffered from hyperbilirubinemia, or jaundice, caused by elevated levels of bilirubin, a substance that is released into the bloodstream. Jaundice is not uncommon among infants as approximately a third or more of all newborns at the intensive care unit at Children’s hospital have jaundice. Greatly elevated bilirubin levels can result in permanent in brain damage. When Emma was admitted to Children’s Hospital, her serum bilirubin level was 4.2 micrograms per deciliter. It gradually increased to as high as 22.0 mcg/dl on January 7, 1988, then decreased to 5.7 mcg/dl on January 18, 1988. The type of jaundice Emma experience is generally treated with phototherapy. More serious cases are treated with a transfusion of all the blood in the infant’s body, a treatment entailing greater risks including cardiac arrhythmia, bleeding, bacterial infection and the development of air bubbles in the circulatory system. Dr. Martin prescribed phototherapy for Emma, which was unsuccessful, and Emma...
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...nursing care procedures. The article explains how nurses view informed consent as not being essential to nursing care procedures. Problem Statement The clinical problem being examined in the research study is the way in which nurses obtain consent prior to administering nursing care procedures, and the way nurses manage patients who refuse any nursing care procedures. By stating that nurses “do not regard obtaining consent as an absolute requirement” also stating that “consent is preferred but no considered essential” the significance is established and a clinical problem identified.(Aveyard, 2004, p. 346) The author identifies the need for further education of nurses on the need to obtain informed consent for nursing care procedures, and the need for more research of this topic. Purpose and Research Questions The study clearly identifies the aim of the study as “to examine the way in which nurses manage patients who refuse nursing care procedures.”(Aveyard, 2004, p. 346) The study identifies two main purposes for the research study as: 1- To examine how consent is obtained prior to nursing care procedures, 2- To explore the ways in which consent could be approached by clinical nurses.”(Aveyard, 2004, p. 347) The author provided clear purpose or aim of the research problem, “the way in which nurses manage patients who refuse nursing care procedures.”(Aveyard, 2004, p. 346) And related the problem to the questions of how consent is obtained, how obtaining consent can be approached...
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...Accountability of Professional Nurses: Informed Consent Informed consent is used as a safeguard to ensure the patient’s understanding of the care or procedure needed to treat a medical issue. It also ensures the patient’s understanding of any adverse effects that can occur due to the care or procedure needed. Verbal consent is usually obtained at the bedside when discussing what minor procedures or tasks need to be done, drawing blood, for example. Signed informed consents are mainly used for nonemergent invasive procedures or surgery (Smeltzer, Bare, Hinkle, & Cheever, 2008). According to the Agency for Healthcare Research and Quality (AHRQ), various procedures used for obtaining informed consent can be insufficient. One problem that arises from obtaining informed consent is the patient’s comprehension of the informed consent. They may not truly understand what is said because of the technical terms used. Many times a frightened patient’s state of mind does not allow them to comprehend what the doctor is telling them, or truly understand the risks involved, making the patient not really informed at all (Cunningham, 1996). Another problem is that there are over forty million illiterate adults in America (Kirsch, Jungblut, Jenkins, et al., 1993). This heightens the problem of these patient’s increased potential of not understanding what they are giving consent for. Some patients do not read the consent at all. According to one of several different studies...
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... * My CEUs * My Reports * Support * Main Menu › VA Human Subjects Protection › Informed Consent Informed Consent Content Author * Diane Paul, M.S., RN National Comprehensive Cancer Network Introduction It is important to understand that informed consent is a process that begins with the recruitment and screening of a subject and the signing of the consent document, continues throughout the subject's involvement in the research, and continues beyond study termination. It includes: * Recruitment efforts encompassing the means of first creating awareness or contact and spanning everything from medical record review to advertisements and other recruitment materials. * Providing specific information and answering questions about the study to subjects in a way that is understandable to them while giving subjects adequate time to consider participation. * Obtaining the voluntary agreement of subjects to take part in the study. While the subject may agree to participate in the study, subjects may withdraw at any time. Part of the ongoing nature of the consent process is verifying the subject's continued interest in participating in the study. * Making plans for the provision of new information to be shared with former subjects, even after the study ends. There is consensus regarding the importance of informed consent. Informed consent is a demonstration of how investigators and those involved in human subjects research show respect to research...
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...Confidentiality and Informed Consent Raul Delgado PSY/305 December 16, 2015 Gina Craft, MS, MA Confidentiality and Informed Consent Informed consent is usually a practice between a patient and his provider, it is a permission established prior to a procedure after gaining knowledge of the risks that are going to be involved with in the procedure. Although implications could occur with the informed consent, these including; “1) medical emergencies, where there is immediate danger to life and the delay that would be necessary to obtain consent might be harmful; 2) incompetency, where die patient is unable to give a legally valid consent; 3) therapeutic privilege, where there is discretion to withhold information which might have a detrimental effect on patient health if disclosed; 4) waiver, where die patient can waive his or her right to be informed, to make the treatment decision, or both; and 5) mentally ill and dangerous, where mentally ill patients who are imminently in danger of harming themselves or others may be involuntarily committed and treated” (Faden & Beauchamp, 1986; Sprung & Winick, 1989; Alberta Mental Health Act, 1990) Confidentiality holds similar characteristics to an informed consent. Just as informed consent, confidentiality could also be between a physician and his or her patient, anything the patient may reveal is usually upheld in confidentiality unless permission is permitted by the patient to send his or her information to a third party...
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...| Informed Consent in Emergency Situations | By | | Liz Marotz | 3/1/2016 | | I. Introduction A. Explanation of an Informed Consent B. Type of Informed Consent C. How to use an Informed Consent in Emergency Situations II. Elements of Full informed consent A. Assessment of patient understanding B. The Nature of the decision/Procedure III. Interventions that require Informed Consent A. Cancer Screening test B. Clinical Decision IV. Waive Informed Consent Form A. Reason to waive B. Who gives the approval of waiver V. Conclusion A. Summary Informed consent means that permission is granted in the knowledge of the possible consequences, typically that which is given by a patient to a doctor for treatment with full knowledge of the possible risks and benefits. However, informed consent in an emergency situation can only be presumed rather than obtained when the patient is unconscious or incompetent and no surrogate decision maker is available and the emergency interventions will prevent death or disability. In general, the patient's presence in the hospital ward, ICU or clinic does not represent implied consent to all treatment and procedures. The patient's wishes and values may be quite different from the values of the physician. While the principle of respect for the patient obligates the physician to do their best to include the patient in the health care decisions that affect the patient’s life and body, the principle...
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...specifically recruited as participants, or * participants will be recruited through a residential facility such as a prison or nursing home, or * participants who are less than fluent in English will be specifically recruited as participants, or * individuals aged 65+ will be specifically recruited as participants, or * economically disadvantaged individuals will be specifically recruited as participants, or * military personnel will be specifically recruited as participants YES, if: * your data collection consists only of surveying/interviewing non-vulnerable adults, or * your data was/will be created as part of an organization’s standard operating procedures, or * data collection will be completely anonymous (i.e., without a signature line on consent form and even the researcher won’t know who participated and who didn’t). Even if you meet criteria above, in some situations the Institutional Review Board (IRB) may require you to complete the Standard Ethics Approval Application. The IRB staff will notify you if another form is necessary. INSTRUCTIONS: To request ethics approval from Walden University’s Institutional Review Board (IRB), a researcher must complete the orange columns A and B of the table below to document how the research proposal addresses the university’s 40 ethical standards. * Column A:...
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...Doctrine of Informed Consent ME1231_Jesarela_Module3_Lab1.doc October 3, 2015 Shepard Valley Out-Patient Surgery Clinic. 46873 East Revenue Lane 45263 Patient Must Be Awake, Alert and Oriented When Signing Date: _____________ Time: ____________ Consent of the surgery 1. The purpose of this form is to verify that you have received this information and have given your consent to the surgery or special procedure recommended to you. It’s the obligation of the surgeons to provide you with the information you need in order to decide whether to consent to the surgery or special procedure that your surgeons have recommended. You should read this form carefully and ask questions of your surgeons so that you understand the operation or procedure before you decide whether or not to give your consent. 2. The type of procedure to be performed: ________________________________ 3. Type of anesthesia: ________________________________________________ 4. Name of the surgeons who will be performing the surgery:_____________________________________________________ 5. All operations and procedures carry the risk of unsuccessful results, complications, injury or even death, from both known and unforeseen causes, and no warranty or guarantee is made as to result or cure. You have the right to be informed of: ▪ The nature of the operation or procedure, including other care, treatment or medications; ▪ Potential benefits, risks...
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...Informed consent: Dates back to the early part of this century, and centers on the principle of battery. Courts have clearly ruled that most states now have specific informed consent statutes, physicians have a common law duty to ensure that diagnostic, medical, and surgical procedures are authorized by the knowledgeable consent of the patient or his or her legal representative. A physician who fails to obtain his or her patient’s consent to treatment commits a battery. Informed Consent Standards: • This standard requires the physician to disclose to the patient everything that is customary in the profession to disclose under the same or similar circumstances. • In court, plaintiffs in these states must produce an expert witness to testify that the defendant’s actions fell below the standard of customary disclosure. Required Elements: There are five basic elements that must be disclosed to patients in language that a lay individual reasonably can be expected to understand: • The diagnosis, including the disclosure of any reservations the provider has concerning the diagnosis • The nature and purpose of the proposed procedure or treatment • The risks and consequences of the proposed procedure or treatment. This includes only those risks and consequences of which the physician has, or reasonably should have, knowledge. It is not necessary to disclose every potential minor risk or side effect. • Reasonable treatment alternatives. This includes other treatment modalities...
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...The article Understanding Perry V. Shaw- Making informed consent Better, written by Carolyn Oill in 2002, addresses the topic of informed consent and the rights of the patient. Within this article a patient lost an immense amount of weight and the physician suggested breast enlargement as a solution but the patient didn’t wish to have this procedure performed. On the day of the surgery for which the patient was supposed to have excess skin removed the patient signed a consent for breast enlargement assuming that the physician would follow her wishes and when the physician had done the procedure she claimed that she had basically been forced to have the breast enlargement, and that the agreement was not valid because she was being prepped for...
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...medical professional (NHS, 2014). Nurses have to follow the nursing midwifery code, which states nurses should “make sure appropriate informed consent is given and documented before carrying out any action” (NMC,2015). Therefore, prior to any treatment given, the person must give consent for the nurse to carry out the treatment. In order for consent to be valid, it must be voluntary. The person must have come to the decision themselves, with no influence from medical staff, family or friends (Griffith et al, 2013). The consent must be informed, the person must have knowledge and understanding about the what the treatment involves, including risks and benefits or alternative treatments and what will happen if the patient does not have the treatment. For the consent to be valid the person must have mental capacity, meaning they are able to understand the information given and make an informed decision based on the information given to them. Consent can be written, however, signing a form is not valid consent. The person need to have the opportunity to gain knowledge about the treatment, as well as ask a medical professional, with the correct knowledge, any questions they may have involving the treatment. Written consent is normally used where a procedure is invasive, such as surgery or immunisations. A nurse will need to gain written consent from the patient before giving an injection. The nurse will need to explain what the injection is for, why the patient needs it and what is...
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...Informed Consent Informed Consent is defined as consent by a patient to undergo a medical or surgical treatment or to participate in an experiment after the patient understands the risks involved. (wordnetweb.princeton.edu/perl/webwn 2011) This concept is based in general on a patient’s right to self-determination when given adequate disclosure of a specific treatment plan. Informed consent is a legal procedure to ensure that a patient or client knows all of the risks and costs involved in a treatment. The elements of informed consent include informing the client of the nature of the treatment, possible alternative treatments, and the potential risks and benefits of the treatment. As well as making sure the patient quantifies the in layman’s terms the risks and outcomes/prognosis if procedure or treatment is refused. Informed consent is especially important in high risk procedures as in procedures that are more likely to generate a lawsuit. In order for informed consent to be considered valid, the client must be competent and the consent should be given voluntarily.(http://psychology.about.com/od/iindex/g/def_informedcon.htm 2011) Informed consent is a legal document in all 50 states, prepared as an agreement for treatment, non-treatment, or for an invasive procedure that requires physicians to disclose the benefits, risks, and alternatives to the treatment, non-treatment, or procedure. Another important aspect of informed consent is that it should be attained both...
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