advocacy in nursing

1. Advocacy in Nursing
Patient’s Bill of Right
Prof. Dr. Ram Sharan Mehta
Medical Surgical Nursing Department
Prof. Dr. RS Mehta 1

2. Patient’s Bill of Right
Prof. Dr. RS Mehta 2

3. Prof. Dr. RS Mehta 3

4. Patients right
 A patient's bill of rights is a list of guarantees for those
receiving medical care.
 It may take the form of a law or a non-binding declaration.
 A patient's bill of rights guarantees patients information, fair
treatment, and autonomy over medical decisions among other
rights.
4
Prof. Dr. RS Mehta

5. Definition
 Patient rights are the basic rule of conduct between patient and
medical care givers as well as the institutions and people supporting
them.
 It is a general statement adopted by most healthcare professionals,
covering matters such as access to care, patient dignity,
confidentiality, and consent to treatment.
5
Prof. Dr. RS Mehta

6. Contd…
People often don’t realize
their specific rights at time
of care as these rights are
not clearly defined or included
in the written form.
6
Prof. Dr. RS Mehta

7. Contd…
 Patient rights encompasses legal and ethical issues in the
provider- patient relationship, including a person’s right to
privacy, right to quality medical care without prejudices, right
to make informed decisions about care and treatment
options, and right to refuse treatment.
- US ADVISORY COMMISSION (1998)
7
Prof. Dr. RS Mehta

8. Contd…
 Rights vary among different countries and in different
juridictions often depending upon prevailing cultural and
social norms.
 Rights are guaranteed by federal law.
8
Prof. Dr. RS Mehta

9. Patient’s rights
To receive reasonable,
respectful and safe access
to health services by
competent personnel.
9
Prof. Dr. RS Mehta

10. Contd…
Right to respect for cultural,
psychosocial, spiritual and
personal values, beliefs and
preferences.
10
Prof. Dr. RS Mehta

11. Right to freedom of choice
 Patient has right to choose freely, change his/her physician and
hospital or health service institution.
 Patient has right to ask for opinion of another physician at any
stage.
11
Prof. Dr. RS Mehta

12. Right to self-determination
• The patient has right to self determination, to
make free decisions.
• The patient should understand clearly purpose of
any test or treatment.
• The physician will inform the patient of the
consequences of his/her decisions.
12
Prof. Dr. RS Mehta

13. Contd…
 The patient has the right to refuse to participate in research or
the teaching of medicine.
 However, patient do not have the right to demand
inappropriate or medically unnecessary treatment or services.
 A mentally competent adult patient has the right to give or
withhold consent to any diagnostic procedure or therapy.
13
Prof. Dr. RS Mehta

14. Right to know identity of person treating the patient
 To be informed of the names and roles of all practitioners
and/or other clinical practitioners who are providing direct
care to the patient.
 The medical personnel shall introduce themselves by
wearing a name tag.
14
Prof. Dr. RS Mehta

15. Contd…
 The patient also has the right to know the identity and
functions of the institutions.
 The patient shall be informed of the hospital rules and
regulations applicable to his/her conduct as a patient.
15
Prof. Dr. RS Mehta

16. Right to participate in development and
implementation of care
Patient have the right to effective communication and to
participate in ethical questions that arise in the course of care,
withholding resuscitative services, and withdrawing life-
sustaining treatment.
16
Prof. Dr. RS Mehta

17. Right to receive information
Patient has right to receive information about his or her complete
medical condition, recommended treatment, risk of the
treatment, expected results ,and reasonable medical alternatives
in the terms the patient understands.
17
Prof. Dr. RS Mehta

18. Contd…
 If the patient is not capable of understanding the information, the
explanation shall be provided to his or her guardian and be
documented in the patient’s personal medical record.
 To receive from the health facility an explanation of the reasons
for transferring the patient to another facility, information about
alternatives to the transfer.
18
Prof. Dr. RS Mehta

19. Contd…
 To be free from physical, mental abuse, neglect,
sexual harassment, sexual violence, exploitation.
 Right to be free from restraints , except when it is
temporarily necessary to prevent injury to patient or
others.
 Such emergency restraints is used in a safe manner
with respect.
19
Prof. Dr. RS Mehta

20. Right to privacy
• To have personal and physical privacy during medical
treatment, procedure and personal hygiene functions,
such as bathing and using toilet, unless patient needs
assistance for his or her own safety and when hospital
personnel are discussing the patient;
• They have right to have visitors leave prior to an
examination and when treatment issues are being
discussed.
• Privacy curtains should be used in semi-private rooms.
Prof. Dr. RS Mehta 20

21. Contd…
To get confidential treatment, information in the patient’s
records:
oInformation, including medical records by the patient or by
the patient’s legally authorized representative and hospital
charges shall not be released to any one outside the
hospital except in the following situations; if the patient has
approved the request, if the request is permitted by law etc.
Prof. Dr. RS Mehta 21

22. Contd…
 Patient have right to be involved in
development and implementation of
discharge plan.
 Upon their request, a friend or family
member may be provided this
information.
Prof. Dr. RS Mehta 22

23. Patient’s rights during medication
 To be informed of drug’s name, purpose, action
potential undesired effects.
 To refuse a medication regardless
of the consequences.
 To have qualified nurses, physicians
assess medication history, allergies
use of herbals.
23
Prof. Dr. RS Mehta

24. Contd…
 To be properly advised of experimental nature of medication
therapy and to give written consent for its use.
 To receive labeled medications safely.
 To receive appropriate supportive therapy in relation to
medication therapy.
 Not to receive unnecessary medications.
 To be informed if medication are a part of a research study.
24
Prof. Dr. RS Mehta

25. 25
Prof. Dr. RS Mehta

26. BILL OF RIGHTS FOR PATIENTS
•American Hospital Association has adopted a
“Patient’s Bill or Rights” as a national policy
statement and distributed it to its member
hospitals throughout the country.
•Summary of 12 rights:
Prof. Dr. RS Mehta 26

27. 1. The patient has the right to considerate and respectful care.
2. The patient has the right to obtain from his physician complete
current information concerning his diagnosis, treatment and
prognosis in terms the patient can be reasonably expected to
understand.
3. The patient has the right to receive from his physician
information necessary to give informed consent prior to the
start of any procedure and / or treatment.
4. The patient has the right to refuse treatment to the extent
permitted by law, and to be informed of the medical
consequences of his action.
Prof. Dr. RS Mehta 27

28. 5. The patient has the right to every consideration of his privacy
concerning his own medical care program.
6. The patient has the right to expect that communications and
records pertaining to his care should be treated as confidential.
7. The patient has the right to expect that within its capacity a hospital
must make reasonable response to the request of a patient for
services.
8. The patient has the right to obtain information as to any
relationship of his hospital to other health care and education
institutions insofar as his care is concerned.
Prof. Dr. RS Mehta 28

29. 9. The patient has the right to be advised if the hospital proposes to
engage in or perform human experimentation affecting his care
or treatment.
10. The patient has the right to expect reasonable continuity of care.
11. The patient has the right to examine and receive an explanation of
his bill regardless of source of payment.
12. The patient has the right to know what hospital rules and
regulations apply to his conduct as a patient.
Prof. Dr. RS Mehta 29

30. EUROPEAN CHARTER OF PATIENTS’ RIGHTS
•FOURTEEN RIGHTS OF THE
PATIENT
Prof. Dr. RS Mehta 30

31. 1-Right to Preventive Measures
•Every individual has the right to a proper service
in order to prevent illness.
Prof. Dr. RS Mehta 31

32. 2-Right of Access
•Every individual has the right of access to the
health services that his or her health needs
require.
•The health services must guarantee equal
access to everyone, without discriminating on
the basis of
•financial resources, place of residence, kind of
illness or time of access to services.
Prof. Dr. RS Mehta 32

33. 3-Right to Information
•Every individual has the right to access
to all kind of information regarding their
state of health,
•the health services and how to use
them, and all that scientific research
and technological
•innovation makes available.
Prof. Dr. RS Mehta 33

34. 4-Right to Consent
• Every individual has the right of access to all
information that might enable him or her to
actively
•participate in the decisions regarding his or
her health; this information is a prerequisite
for any
•procedure and treatment, including the
participation in scientific research.
Prof. Dr. RS Mehta 34

35. 5-Right to Free Choice
•Each individual has the right to freely choose
from among different treatment procedures and
providers on the basis of adequate information.
Prof. Dr. RS Mehta 35

36. 6-Right to Privacy and Confidentiality
• Every individual has the right to the
confidentiality of personal information, including
information regarding his or her state of health
and potential diagnostic or therapeutic
procedures, as well as the protection of his or her
privacy during the performance of diagnostic
exams, specialist visits, and medical/surgical
treatments in general.
Prof. Dr. RS Mehta 36

37. 7-Right to Respect of Patients’ Time
•Each individual has the right to receive
necessary treatment within a swift and
predetermined period
•of time. This right applies at each phase of
the treatment.
Prof. Dr. RS Mehta 37

38. 8-Right to the Observance of Quality Standards
•Each individual has the right of access to
high quality health services on the basis of
the
•specification and observance of precise
standards.
Prof. Dr. RS Mehta 38

39. 9-Right to Safety
•Each individual has the right to be free from
harm caused by the poor functioning of
health services,
•medical malpractice and errors, and the
right of access to health services and
treatments that meet high safety standards.
Prof. Dr. RS Mehta 39

40. 10-Right to Innovation
•Each individual has the right of access to
innovative procedures, including
diagnostic procedures, according to
international standards and
independently of economic or financial
considerations.
Prof. Dr. RS Mehta 40

41. 11-Right to Avoid Unnecessary Suffering and Pain
•Each individual has the right to avoid as much
suffering and pain as possible, in each phase of
his or her illness.
Prof. Dr. RS Mehta 41

42. 12-Right to Personalized Treatment
•Each individual has the right to diagnostic or
therapeutic programmes tailored as much
as possible to his or her personal needs.
Prof. Dr. RS Mehta 42

43. 13-Right to Complain
•Each individual has the right to complain
whenever he or she has suffered a harm
and the right to receive a response or other
feedback.
Prof. Dr. RS Mehta 43

44. 14-Right to Compensation
•Each individual has the right to receive sufficient
compensation within a reasonably short time
whenever he or she has suffered physical or
moral and psychological harm caused by a health
service treatment.
Prof. Dr. RS Mehta 44

45. Consumer Bill of Rights and Responsibilities
1. Information Disclosure.
2. Choice of Providers and Plans.
3. Access to Emergency Services.
4. Participation in Treatment Decisions.
5. Respect and Nondiscrimination.
6. Confidentiality of Health Information.
7. Complaints and Appeals.
8. Consumer Responsibilities.
Prof. Dr. RS Mehta 45

46. Advocacy in Nursing
Prof. Dr. RS Mehta 46

47. Advocacy in Nursing
Client Advocate:
It is the role of the nurse to protect the client.
They assist clients in exercising their rights and help
them speak out for themselves.
Prof. Dr. RS Mehta 47

48. Prof. Dr. RS Mehta 48

49. Prof. Dr. RS Mehta 49

50. Nurse as Client Advocate
• When acting as client advocate, the nurse’s first step is
to develop a meaningful relationship with the client.
• The nurse is then able to make decisions with the client
based on the strength of the relationship.
Prof. Dr. RS Mehta 50

51. Nurse as Whistleblower
• Whistleblowing refers to calling attention to unethical, illegal, or
incompetent actions of others.
• Whistleblowing is based on the ethical principles of veracity and
non-maleficence.
• Federal and state laws (to varying degrees) provide protection,
such as privacy, to whistleblowers.
Prof. Dr. RS Mehta 51

52. Questions for Whistleblowers
• Whose problem is this?
• Must I do anything about it?
• Is it my fault?
• Who am I to judge?
• Do I have the facts straight?
Prof. Dr. RS Mehta 52

53. Errors Due To Human Factors
• Poor Training
• Fatigue
• Staffing level
• Communication
• Distractions
• Punitive culture
Nurses
Many Roles One Profession
Prof. Dr. RS Mehta 53
Thank You