NCLEX Review Guide: Leadership Management, Ethical & Legal Nursing Practice, HIPAA & Patient Rights

Delegation and Supervision

• Five Rights of Delegation: Right task, right person, right circumstances, right direction/communication, and right supervision/evaluation must all be considered before delegating.
• Scope of practice determines what tasks can be delegated to UAPs, LPNs, and other RNs based on their education, training, and legal authorization.
• RNs cannot delegate assessment, planning, evaluation, or teaching to unlicensed personnel as these require nursing judgment.

Conflict Resolution and Communication

• Chain of command should be followed when addressing workplace conflicts, starting with immediate supervisor before escalating to higher administration.
• Effective communication includes active listening, using "I" statements, and focusing on behaviors rather than personalities during conflict resolution.

Ethical Principles

• Autonomy respects patient's right to make informed decisions about their care, including the right to refuse treatment.
• Beneficence requires nurses to act in the patient's best interest and promote good outcomes.
• Non-maleficence means "do no harm" and requires nurses to avoid actions that could cause patient injury.
• Justice ensures fair distribution of resources and equal treatment regardless of patient characteristics.

Legal Considerations

• Informed consent requires that patients understand the procedure, risks, benefits, and alternatives before agreeing to treatment.
• Mandatory reporting laws require nurses to report suspected abuse, neglect, communicable diseases, and other specified conditions to appropriate authorities.
• Documentation must be accurate, timely, and objective to provide legal protection and ensure continuity of care.

HIPAA Privacy Rule

• Protected Health Information (PHI) includes any individually identifiable health information in any form (oral, written, electronic).
• Minimum necessary standard requires that only the minimum amount of PHI needed to accomplish the intended purpose should be used or disclosed.
• Patient authorization is required for most disclosures except for treatment, payment, and healthcare operations (TPO).

1. Verify patient identity before discussing PHI
2. Ensure conversations occur in private areas
3. Log off computers when not in use
4. Dispose of PHI in designated secure containers

Patient Rights

• Patients have the right to access their medical records and request amendments to incorrect information.
• Right to privacy includes protection from unauthorized disclosure of personal health information.
• Patients can designate a personal representative to make healthcare decisions if they become incapacitated.

Self-Assessment Checklist

• ☐ I can identify the five rights of delegation
• ☐ I understand when to use the chain of command
• ☐ I can apply the four ethical principles to clinical scenarios
• ☐ I know what constitutes PHI and how to protect it
• ☐ I understand patient rights under HIPAA
• ☐ I can differentiate between assault, battery, negligence, and malpractice