A registered nurse is caring for an adult client admitted with a deep vein thrombosis. The client suddenly becomes frustrated, packs their belongings, and states, 'I am leaving this hospital right now, no matter what.' The client is alert, oriented, and legally competent. Arrange the following nursing actions in the correct sequence to ensure the client's legal rights are protected while minimizing facility liability. (Place the first action at the top and the final action at the bottom.)
- 1Assess the client's reasons for wanting to leave and attempt to resolve their concerns.
- 2Notify the attending healthcare provider regarding the client's intent to leave against medical advice.
- 3Ensure the client is informed of the specific medical risks and potential complications of leaving the facility.
- 4Request that the client sign the official facility Against Medical Advice (AMA) form.
- 5Document the client's departure, the education provided, and the refusal of treatment in the medical record.
Answer
The correct sequence prioritizes client advocacy and assessment first, followed by chain-of-command notification, ensuring an informed refusal, obtaining legal documentation, and finally comprehensively documenting the event.
The legally sound process for an Against Medical Advice (AMA) discharge requires the nurse to first act as an advocate by assessing the client's concerns. If the issue cannot be resolved, the nurse must notify the provider. Next, the client must be educated on the risks to ensure an 'informed refusal.' Only after risks are explained should the AMA signature be requested. Finally, the nurse must document the entire objective sequence in the medical record to protect against liability.
Step-by-Step Solution
Key Concept
Against Medical Advice (AMA) Procedure and Legal Liability