Legal & Regulatory Aspects of Health Care Delivery

In some cases, the legal and regulatory environments of health care can seem like labyrinths of red tape that hinder more than help; however, with sufficient knowledge of health care regulation and legislation, you can acquire the tools needed to effectively navigate this labyrinth. Gaining an understanding of the legal and regulatory systems allows you to stay current with changes in the health care field and more easily and successfully advocate for new measures designed to improve the health of the public. Such understanding also assists you in understanding how to proceed when seeking changes to policy to address a specific population.

This week, you will examine regulatory principles and professional nursing standards. You will also analyze the effects of legal and regulatory processes on health care policy advocacy and implementation.

Learning Objectives

Apply laws, regulations, and professional nursing standards to an ethical dilemma

Analyze the effects of legal and regulatory processes on health care policy advocacy

Milstead, J. A. (2013). Health policy and politics: A nurse's guide (Laureate Education, Inc., custom ed.). Sudbury, MA: Jones and Bartlett Publishers.

Chapter 4, "Government Regulation: Parallel and Powerful" (pp. 73-109)

This chapter explains the major concepts of the regulation of health professionals, with emphasis on advanced practice nurses (APN) and the process of licensure and credentialing.

ANA's Foundation of Nursing Package - (Access this resource from the Walden Library databases through your NURS 6050 Course Readings List)

Guide to the Code of Ethics: Interpretation and Application

This guide details the history, purpose and theory, application, and case studies of this must-have Code of Ethics.

Nursing Social Policy Statement

The Nursing Social Policy Statement provides an understanding of the social framework and obligations of the nursing profession.

Nursing: Scope & Standards of Practice

This book contains several national standards of practice that can be used to inform the decision-making process, development, implementation, and evaluation of several functions and aspects of advanced practice nursing.

Gallagher, T. H. (2009). A 62-year-old woman with skin cancer who experienced wrong-site surgery: Review of medical error. JAMA: Journal of the American Medical Association, 302(6), 669-677.

Retrieved from the Walden Library databases.

The article showcases the different sides of medical error, from a 62-year-old patient who suffered and the components of the medical error's impact and aftermath.

Reinhardt, U. E. (2010, Jan 30). Repercussions of simplicity. New York Times, p. A14.

Retrieved from the Walden Library databases.

This article determines that the government should take low-income families into account when determining mandatory health insurance because many Americans choose to go without insurance despite preexisting conditions presumably no longer being an issue.

Board on Health Care Services. (2007). Preventing medication errors: Quality Chasm Series. Washington, DC: The National Academies Press.

Retrieved from http://www.nap.edu/openbook.php?record_id=11623&page=43

Part 1, "Understanding the Causes and Costs of Medication Errors" (pp. 43-49)

As emphasized in this week's media presentation, all nurses need to be familiar with the laws and regulations that govern their practice: their state's Nurse Practice Act, ANA's Nursing: Scope and Standards of Practice, specialty group standards of practice, etc. In addition, basic ethical principles guide nurses' decision-making process every day. ANA'sCode of Ethics and ANA's Social Policy Statement are two important documents that outline nurses' ethical responsibilities to their patients, themselves, and their profession. This said, there is a dilemma: The laws are not always compatible with the ethical positions nurses sometimes take. This week's Discussion focuses on such a dilemma.

To prepare:

Review this week's Learning Resources, focusing on the information in the media presentation about the relationship between the law and ethics.

Consider the ethical responsibility of nurses in ensuring patient autonomy, beneficence, non-malfeasance, and justice.

Read the following scenario:

Lena is a community health care nurse who works exclusively with HIV-positive and AIDS patients. As a part of her job, she evaluates new cases and reviews confidential information about these patients. In the course of one of these reviews, Lena learns that her sister's boyfriend has tested HIV positive. Lena would like to protect her sister from harm and begins to consider how her sister can find out about her boyfriend's health status.

Consult at least two resources to help you establish Lena's legal and ethical position. These resources might include your state's Nurse Practice Act, the ANA's Code of Ethics, ANA's Nursing: Scope and Standards of Practice, and internal or external standards of care.

Consider what action you would take if you were Lena and why.

Determine whether the law and the ANA's standards support or conflict with that action.

Post a description of the actions you would take in this situation, and why. Justify these actions by referencing appropriate laws, ethical standards, and professional guidelines.

ONE PAGE, APA FORMAT.