LE001: Legal Requirements and Ethics Short Answer Submission Form Your Name: First and last Your E-Mail Address: Your email here Instructions Write your responses where it reads “Enter your response here.” Write as much as needed to satisfy the requirements indicated. Each item contains the Rubric which will be used to evaluate your responses. ©2015 Walden University 1 Short Answer 1 Define what is meant by the legal definition of “standard of care.” (1–2 paragraphs) Your Response Enter your response here Rubric 0 1 Not Present Needs Improvement Sub-Competency 1: Analyze medical ethical issues and legal concepts. Learning Objective 1.1: Definition of standard of Response inaccurately Define standard of care is missing. defines standard of care or care. includes irrelevant information regarding the legal definition of standard of care. 2 Meets Expectations Response accurately defines standard of care in legal terms, including relevant information regarding implication in the course of negligence or litigation. 3 Exceeds Expectations Response demonstrates the same level of achievement as “2,” plus the following: Response includes an example of how standard of care was used in the course of litigation and/or a court decision. Short Answer 2 Describe the differences between negligence, criminal negligence, comparative negligence, and contributory negligence. (1–2 paragraphs) Your Response Enter your response here Rubric 0 1 Not Present Needs Improvement Sub-Competency 1: Analyze medical ethical issues and legal concepts. ©2015 Walden University 2 Meets Expectations 3 Exceeds Expectations 2 Learning Objective 1.2: Describe the differences between negligence, criminal negligence, comparative negligence, and contributory negligence. Description of the differences between negligence, criminal negligence, comparative negligence, and contributory negligence is missing. Response is incomplete or inaccurately describes the differences between negligence, criminal negligence, comparative negligence and contributory negligence or includes irrelevant information. Response accurately describes the differences between negligence, criminal negligence, comparative negligence and contributory negligence. Response demonstrates the same level of achievement as “2,” plus the following: Response provides an authentic and succinct example that illustrates the differences between negligence, criminal negligence, comparative negligence and contributory negligence. Short Answer 3 Describe the immediate responsibility as a healthcare administrator in an organization when you receive a subpoena duces tecum. (1–2 paragraphs) Your Response Enter your response here Rubric 0 1 Not Present Needs Improvement Sub-Competency 1: Analyze medical ethical issues and legal concepts. Learning Objective 1.3: Description of immediate Response inaccurately or Describe responsibilities is missing. incompletely describes the responsibilities related immediate responsibilities to receiving a of a healthcare ©2015 Walden University 2 Meets Expectations Response accurately describes the immediate responsibilities of a healthcare administrator 3 Exceeds Expectations Response demonstrates the same level of achievement as “2,” plus the following: 3 subpoena duces tecum. administrator related to receiving a subpoena. related to receiving a subpoena. Response offers little or no information related to appropriate decisions regarding release of information. Response offers information related to appropriate decisions regarding release of information. Response provides an authentic and succinct example that illustrates the responsibilities of a healthcare administrator related to receiving a subpoena duces tecum. Short Answer 4 Define the concepts of morals and ethics, and differentiate between the two. Give an example of how the two can come into conflict in a healthcare setting. (2–3 paragraphs) Your Response Enter your response here Rubric 0 1 Not Present Needs Improvement Sub-Competency 1: Analyze medical ethical issues and legal concepts. Learning Objective 1.4: Definitions of morals and Response provides partial Define morals and ethics are missing. or incomplete definitions ethics. of morals and ethics. Response provides a partial explanation of the difference between morals and ethics. ©2015 Walden University 2 Meets Expectations 3 Exceeds Expectations Response provides accurate and thorough definitions of morals and ethics. Response demonstrates the same level of achievement as “2,” plus the following: Response explains the difference between morals and ethics. Through more than one example, Response demonstrates a nuanced understanding of the difference between morals 4 0 Not Present ©2015 Walden University 1 Needs Improvement Response provides an unclear or incomplete example of how morals and ethics can come into conflict in a healthcare setting. 2 Meets Expectations Response includes a relevant example of how morals and ethics can come into conflict in a healthcare setting. 3 Exceeds Expectations and ethics as they apply to healthcare settings. 5 Short Answer 5 Define “standards,” “principles,” and “rules,” and give an example of each as they might be applied when making treatment decisions about noncompliant patients. (2–3 paragraphs) Your Response Enter your response here Rubric 0 1 Not Present Needs Improvement Sub-Competency 1: Analyze medical ethical issues and legal concepts. Learning Objective 1.5: Definitions and examples Response provides partial Define standards, for standards, principles or inaccurate definitions principles, and rules. and rules are missing. for standards, principles and rules. Response provides an incomplete or irrelevant example of how each term might be applied when making decisions about noncompliant patients. ©2015 Walden University 2 Meets Expectations 3 Exceeds Expectations Response provides accurate and thorough definitions of standards, principles, and rules. Response demonstrates the same level of achievement as “2,” plus the following: Response provides a relevant example of how each term might be applied when making decisions about noncompliant patients. Response provides more than one example to demonstrate a deep understanding of the relevance of standards, principles, and rules in a healthcare setting. 6 Short Answer 6 An 83-year-old diabetic male, Mr. Jones, is brought in to the emergency department because of respiratory distress by his care-giving daughter, with whom he lives. In examining him, the emergency department physician discovers that Mr. Jones has gangrene on his right foot up to his ankle. Mr. Jones' daughter reports that her father has been diagnosed with Alzheimer's disease. A preliminary capacity assessment is consistent with mild dementia but one of the nurses suggests that Mr. Jones' confusion might be the result of his respiratory distress, coupled with the disorienting atmosphere of the emergency department. The clinical recommendation is to perform a below-the-knee amputation. The patient refuses this surgery, saying he has lived long enough and wants to die with his body intact. Does the father have autonomy to make this decision? Why or why not? Discuss the principle of nonmaleficence as it relates to actions of the providers. (1–2 pages) Your Response Enter your response here Rubric 0 1 Not Present Needs Improvement Sub-Competency 1: Analyze medical ethical issues and legal concepts. Learning Objective 1.6: Definitions of the Response provides partial Define the principles of principles of respect for or inaccurate definitions of respect for autonomy autonomy and the principles of respect and nonmaleficence. nonmaleficence are for autonomy and missing. nonmaleficence. ©2015 Walden University 2 Meets Expectations 3 Exceeds Expectations Response provides thorough and accurate definitions of the principles of respect for autonomy and nonmaleficence. Response demonstrates the same level of achievement as “2,” plus the following: Response uses one or more examples to demonstrate an understanding of how the principles of respect for autonomy and nonmaleficence can conflict. 7 Learning Objective 1.7: Explain the prioritization of respect for autonomy and nonmaleficence. Explanation of how to choose which principle to prioritize is missing. Response provides a partial or unclear explanation of which principle to prioritize or fails to provide support for reasoning about which principle to prioritize. Response provides an irrelevant example of information the hospital would use to determine whether to prioritize respect for autonomy or nonmaleficence. Response clearly explains which principle to prioritize when patients refuse care Response demonstrates the same level of achievement as “2,” plus the following: Response provides at least one relevant example of information the hospital would use to determine whether to prioritize respect for autonomy or nonmaleficence. Response identifies other principles or philosophies that could guide decisions about how to prioritize principles of respect for autonomy and nonmaleficence. Short Answer 7 Clinical ethics requires grasping ethical issues, such as informed consent, truth-telling, confidentiality, end-of-life care, treatment futility, pain relief, and patients’ rights to self-determination. For each hypothetical situation described below, identify the conflicting ethical principles involved, and select at least one appropriate action to resolve conflicting ethical principles in each case. (1–2 paragraphs each) • • • An elderly patient suffers cardiac arrest and enters the intensive care unit. Her son insists that “everything possible” be done for her, and yet, she slips into a coma and is nonresponsive for months. As a healthcare administrator who oversees the organization, what steps would you recommend to address the son’s concerns? You are a healthcare administrator in a community with many devout Jehovah’s Witnesses. Many people in this faith refuse to receive blood transfusions. A mother calls your office to say that her 11-year-old son has been struck by a car, and asks for your reassurance that he won’t receive a transfusion if she brings him in. How will you respond? You are a healthcare administrator reviewing statistics on lab tests ordered, and realize that a few physicians account for the majority of orders of a certain very expensive lab test. You do a bit of research, and realize that these physicians have relationships with the manufacturers of this testing equipment. What are your next steps? ©2015 Walden University 8 Your Response Enter your response here Rubric 0 1 Not Present Needs Improvement Sub-Competency 1: Analyze medical ethical issues and legal concepts. Learning Objective 1.8: Identification of conflicting One or more responses Identify conflicting ethical principles is inaccurately identify a ethical principles. missing. conflicting ethical principle, or response does not address each scenario individually. Learning Objective 1.9: Select actions to resolve conflicting ethical principles. There is no response available. Response selects inappropriate actions for one or more scenarios. 2 Meets Expectations Response accurately identifies at least one conflicting ethical principle in each scenario. Response selects appropriate actions to resolve the conflicting ethical principles in each scenario. 3 Exceeds Expectations Response demonstrates the same level of achievement as “2,” plus the following: Response justifies the importance of each of the principles in conflict. Response demonstrates the same level of achievement as “2,” plus the following: Response provides compelling justification and reasoning to support the selected action in each scenario. ©2015 Walden University 9 Short Answer 8 Justify whether healthcare in the U.S. is a right or a privilege. Apply ethical standards and state and federal laws to support your position. (1–2 pages) Your Response Enter your response here Rubric 0 1 Not Present Needs Improvement Sub-Competency 2: Justify whether healthcare is a right or a privilege. Learning Objective 2.1: Justification of whether Response provides an Justify whether healthcare is a right or a unclear or unjustified healthcare is a right or privilege is missing. explanation of whether a privilege. healthcare is a right or a privilege. Response chooses incorrect or irrelevant citations or does not provide citations. ©2015 Walden University 2 Meets Expectations 3 Exceeds Expectations Response provides a logical justification for whether healthcare is a right or a privilege. Response demonstrates the same level of achievement as “2,” plus the following: Response appropriately cites from academic resources to support the justification. Response references a specific court case and/or Supreme Court decision to support the justification. 10 Short Answer 9 A hospital finds that hypodermic needle-stick injuries have increased over the last year and, when they conduct an audit, they find evidence that there is wide variation in practice from unit to unit. Some rooms have sharps boxes and others do not, the sharps boxes are of different sizes, and there is variation in how often they are emptied. Using the seven-step risk assessment framework described by the Joint Commission (available at http://www.beckersasc.com/asc-quality-infection-control/7-steps-to-comply-with-joint-commission-risk-assessmentrequirement.html) outline each of the steps to illustrate how a hospital might use a risk assessment framework to manage the risk of needlestick injuries. (2 pages) Your Response Enter your response here Rubric 0 1 2 3 Not Present Needs Improvement Meets Expectations Exceeds Expectations Sub-Competency 3: Analyze challenges underpinning healthcare organizations’ delivery of quality and management of risks. Learning Objective 3.1: Seven-step risk assessment Response completes some Response accurately Response demonstrates Use the seven-step risk framework is missing. of the seven steps completes each of the the same level of assessment framework incorrectly or fails to seven steps to illustrate achievement as “2,” plus described by the Joint complete all seven steps. how the hospital in the the following: Commission. scenario might use a risk assessment framework. Response includes a thorough reflection on the value of the Joint Commission standards and their impact on providers and patients. ©2015 Walden University 11 Short Answer 10 You are an executive in a small rural healthcare facility. Explain how each of the following scenarios will challenge your ability to deliver quality care and manage risks; discuss specific regulatory guidelines that may apply and explain your approach to mitigating each. • A shortage of three certified nursing assistants (CNAs) due to influenza and one registered nurse (RN) scheduled leave for a family wedding (2–3 paragraphs) • Changing reimbursement rules have a negative impact on revenue that will potentially eliminate the budget for planned renovation to the patient rooms equipped with a winch to lift patients over 200 lbs. (2–3 paragraphs) Your Response Enter your response here Rubric 0 1 2 3 Not Present Needs Improvement Meets Expectations Exceeds Expectations Sub-Competency 3: Analyze challenges underpinning healthcare organizations’ delivery of quality and management of risks. Learning Objective 3.2: Explanation of how Response provides an Response clearly explains Response demonstrates Explain how shortages shortages of healthcare unclear or partial how shortages of the same level of of healthcare workers workers impact the ability explanation of how healthcare workers impact achievement as “2,” plus impact the ability to to deliver quality care and shortages of healthcare the ability to deliver the following: deliver quality care and manage risks is missing. workers impact the ability quality care and manage manage risks. to deliver quality care and risks for each scenario Response provides more manage risks for each presented. than one appropriate scenario presented. explanation of how to Response includes at least mitigate the impact of Response includes an one appropriate shortages of healthcare inappropriate explanation explanation of how to workers on the delivery of of how to mitigate the mitigate the impact of quality care and the impact of shortages of shortages of healthcare management of risk for healthcare workers on the workers on the delivery of each scenario presented. delivery of quality care and quality care and the the management of risk management of risk for each scenario presented. ©2015 Walden University 12 for each scenario presented. Learning Objective 3.3: Explain how revenue and resource constraints may limit the ability to deliver quality care and manage risks. Explanation of how changing reimbursement rules for Medicare impacts the ability to deliver quality care and manage risks is missing. Response provides an unclear or partial explanation of how changing reimbursement rules for Medicare impacts the ability to deliver quality care and manage risks for each scenario presented. Response makes an inappropriate explanation regarding how to mitigate the impact of changing reimbursement rules for Medicare on the delivery of quality care and the management of risk for each scenario presented. Response clearly explains how changing reimbursement rules for Medicare impacts the ability to deliver quality care and manage risks for each scenario presented. Response makes at least one appropriate explanation regarding how to mitigate the impact of changing reimbursement rules for Medicare on the delivery of quality care and the management of risk for each scenario presented. Response demonstrates the same level of achievement as “2,” plus the following: Response provides more than one appropriate explanation regarding how to mitigate the potential impact of changing reimbursement rules for Medicare on the delivery of quality care and the management of risk for each scenario presented. Short Answer 11 You are the CEO of a new hospital. Write a 1-page persuasive executive summary to the board of trustees outlining your proposal for a code of conduct and ethics to govern clinician and doctor behavior. Include a statement with a code of conduct for your staff for each of the following: • • • Quality of care and patient rights Confidentiality of protected health information (PHI) Protection of information ©2015 Walden University 13 • Legal and regulatory compliance Your Response Enter your response here Rubric 0 1 2 Not Present Needs Improvement Meets Expectations Sub-Competency 4: Create codes of conduct and ethics statements to promote organizational integrity. Learning Objective 4.1: Executive summary is Executive summary Executive summary Develop proposals for a missing. includes partial or includes concise and code of conduct and inappropriate statements appropriate statements ethics to govern regarding standards of regarding standards of behavior in healthcare conduct, quality of care conduct, quality of care settings. and patient rights, and patient rights, confidentiality of confidentiality of protected health protected health information, protection of information, protection of information, and legal and information, and legal and regulatory compliance, or regulatory compliance. addresses only some of these. ©2015 Walden University 3 Exceeds Expectations Executive summary demonstrates the same level of achievement as “2,” plus the following: Executive summary includes specific detail that incorporates specific risks that may impact board members. 14