Ch 9,10,11,2,12,13,14,15 Flashcards
This for physicians emphasizes the importance of improving medical knowledge and skills, ultimately for the benefit of the patient
The code of medical ethics
How is the structure of the medical staff organization accomplished?
Through bylaws, rules and regulations, application and credential in process, and committee structure
Who oversees the activities of the medical staff and is responsible for recommending to the governing body such things as medical staff structure
Executive committee
What describes the functioning of the medical staff and must be reviewed and approved by the organizations governing body?
Bylaws committee-
This committee oversees the application process for medical staff applicants, requests for clinical privileges and reappointment to a medical staff
Credentials committee
This committee develops policies and procedures as they pertain to the management of medical records
Medical records committee
This committee monitors and evaluates utilization issues such as medical necessity and appropriateness of admission and continued stay, as well as delay in the provision of diagnostics, therapeutic, and supportive services
Utilization review committee
Who serves as the liaison between the medical staff and the organizations governing body and management? They provide guidance and leadership for the medical staff and play a major role in quality improvement activities
Medical director
What is restricted to those professions who fulfill the requirements as described in an organizations medical by laws?
Medical staff privileges
NPBD
National practitioner Data Bank-
Who created the NPDB and why?
Congress with the purpose of facilitating a comprehensive review of physicians and other healthcare practitioners professional credentials
This is the process by which the medical staff determines precisely what procedures a physician is authorized to perform
Delineation of clinical privileges
Who has the ultimate responsibility for granting medical staff privileges?
Governing body responsibility
What is the beginning point for preparing a patients treatment plan?
History and physical
What is a tool for communicating between disciplines?
Medical record
A plaintiff who claims that a physician failed to order proper diagnostic tests must show what?
- Standard practice to use certain test for that circumstance
- The physician failed to use the test and failed to diagnosis the patient
- Patient suffered harm
To recover damages in a case of physician has a duty to refer their patient whom he or she knows needs to be referred to a physician familiar with patient ailments, the plaintiff must show?
Prof must be shown that the physician deviated from the standard of care and that the failure to refer resulted in harm
This is the process in determining a patients disease?
Medical diagnosis
What is the most frequent cited injury event in malpractice suits against physicians?
Misdiagnosis
Will a physician be held liable for exercising his or her judgement in applying a course of treatment supported by a reputable and respected body of medical experts even if another expert would of favored another course of treatment?
No- the two schools of thought doctrine is only applicable in medical malpractice cases in which there is more than one method of accepted treatment for a patients disease or injury
This when applied to physicians refers to their duty to disclose known risks, benefits, and alternatives with a proposed course of treatment.
The doctrine of informed consent
A failure to disclose known and existing risks of proposed treatment when it might affect the patients decision to forgo treatment could constitute what?
Prima facie violation of a physicians duty to disclose
What is a leading cause of injury and unnecessary deaths?
Nosocomial infections
What is one of the most vulnerable medical specialties with significant risk exposure to malpractice suits?
Obstetrics
For a proven suit of intentional infliction of emotional distress requires four elements to be proven:
- The defendants conduct was intentional or reckless
- The conduct was extreme and outrageous
- The conduct caused emotional distress to the plaintiff
- The emotional distress was severe
What are the major risk with psychiatry?
Commitment, electric shock, duty to warn, and suicide
This is often the subject of legal action for abandonment; the unilateral termination of a physician patient relationship by the physician without notice to the patient
Premature termination of treatment
6 elements needed to recover damages for a patient for abandonment:
- Care was unreasonably discontinued
- D/c of medical care was against the patients will
- The termination was unilateral by the physician
- MD failed to arrange for care by another physician
- Foresight indicated that d/c might result in physical harm to the patient
- Actual harm suffered by the patient
4 basic methods for board to license out of state nurses:
- Reciprocity
- Endorsement
- Waiver
- Examination
This is a formal or informal agreement between states whereby a nurse licensing board in one state recognizes the license of another state if the board of that state extends this type of recognition from the first state;
Reciprocity
This term can be used at times by states interchangeable with reciprocity however, in licensing by this boards determine whether out of state nurses qualifications are equivalent to their own state requirements at the time of initial licensure.
Endorsement
This occurs when applicants do not meet all the requirements for licensure but have qualifications, the specific prerequisite of education, experience, or examination can be waived
Waiver
Suspension and revocation proceedings are _______ rather than judicial and do not carry criminal sanctions.
Administrative
This is a qualified Rn who has administrative authority, responsibility, and accountability for the activities and training of the nursing staff.
CNO
How is an organization responsible for the negligence of a special duty nurse?
Only if a master-servant relationship can be established between the organization and the nurse
If a master-servant relationship exists between the organization and the special duty nurse then the doctrine of ____ _____ may be applied to impose liability on the organization for the nurses negligent acts.
Respondeat superior
This one is trained in the delivery of primary healthcare ad the assessment of psychosocial and physical health problems such as the performance of routine examinations and the ordering of routine diagnostic tests
Nurse practitioner
This is a professional RN with an advanced academic degree, experience, and expertise in a clinical specialty and acts as a resource for the management of patients with complex needs and conditions
CNS
What was the first expanded role for nurses that required certification?
Nurse administered anesthesia
These are the standards or codes of conduct established by the membership of a specific profession.
Professional ethics
Why are codes of ethics created?
They are created in response to actual or anticipated ethical conflicts
In a laboratory’s code of ethics what do they pledge?
Accuracy and reliability in the performance of their tests
What does EMTALA mean for hospitals?
Patients must be treated and transferred if such is necessary for the patients well being regardless of ability to pay
When was EMTALA passed?
1986 by congress
2 principle obligations under EMTALA:
- The appropriate medical screening requirement
2. The stabilization requirement
When can patients be transferred?
Only after having received a medical screening by a physician, stabilized, and cleared for transfer by the receiving institution
This term means wth respect to an emergency medical condition to provide such medical treatment of the condition as may be necessary to assure, within reasonable medical probability that no material deterioration of the condition is likely to result from or to occur during the transfer of the individual from a facility
Stabilized
What is the single most fatal mistake in emergency departments?
Not taking any patients complaint lightly
This is an unlicensed person who provides administrative, clerical, and/or technical support to a licensed practitioner
Medical assistant
This is the art and science of preventing and treating neuromuscular or musculoskeletal disabilities through the evaluation of an individuals disability and rehabilitation potential, the use of physical agents (heat, cold, U/S,electricity, water, and light)
Physical therapy
What are the areas of liability for physical therapists?
Failure to obtain a complete prescription from prescribing MD
Failure to follow MD orders or clarify orders
Aggressive treatment
Burns from hot packs
This is a medical professional who is a graduate of an accredited educational training program and is nationally certified and state licensed to practice medicine with the supervision of a physician
Physician assistant
This is the branch of philosophy that seeks to understand the nature, purposes, justification, and the founding principles or moral rules and the systems they comprise
Ethics aka moral philosophy
______ involves the individuals view of what’s right and wrong
Microethics
______ involves the more global view of what is right and wrong
Macroethics
______ addresses difficult situations as the nature of life, the nature of death, what sort of life is worth living, how we should treat these who are especially vulnerable, and the responsibility that we have to others
Bioethics
_____ is a code of conduct, a guide to behavior that all rational persons put forward for governing their behavior, a class of rules held by society to govern the conduct if its individual members
Morality
_____ are ideas about what’s right and what’s wrong
Morals
_____ ______ are those that are concerned with what an individual or group believes to be the right or proper behavior in a given situation
Moral judgement
____ of ____ prescribe the standards of conduct, states principles, expresses responsibilities and defines rules expressing the duties of professionals to whom they apply
Codes of conduct
_____ are used to guide human conduct by stating desireable traits to be exhibited and undersirable ones to be avoided
Standards
_____ describe responsibilities that don’t specify what the required conduct should be
Principles
______ specify conduct, they don’t allow for individual professional judgement
Rules
This theory of ethics is the attempt to determine what moral standards should be followed so that human behavior and conduct may be morally right
Normative theory
This form of ethics is the critical study of major moral precepts of such matters as what things are right and what things are good and what things are genuine
General normative
This is the application of normative theories to practical moral problems, attempts to explain and justify moral problems
Applied ethics
This is also known as comparative ethics and deals with what people believe to be right and wrong
Descriptive ethics
____-____ seeks to understand ethical terms and theories and their applications
Meta-ethics
This theory of ethics emphasizes that the morally right action is whatever actions leads to the maximum balance of good over evil
Consequentialism theory
This theory involves the concept that the moral worth of an action is solely determined by its contribution to overall usefulness
Utilitarian ethics
This theory denies that the consequences of an action are the only criteria for determining in the morality of an action
Nonconsequential theory
This is attributed to the german philosopher immanuel kant that even though doing good is the right thing, it may or may not lead to or increase the good and right thing sought after
Deontological ethics
This theory holds that morality is relative to the norms of ones culture
Ethical relativism
These are universal rules of fondues, derived from ethical theories that provide a practical basis for identifying what kinds of actions, intentions, and motives are valued
Ethical principles
Describes the principle of doing good, demonstrating kindness, showing compassion, and helping others
Beneficence
_____ is a form of beneficence, sometimes people believe they know what’s best for another and make decisions for them in their best interest
Paternalism
_____ ___ involved making decisions for patients who are capable of making their own choices
Medical paternalism
_____ the obligation to be fair in the distribution of benefits and risks
Justice
_____ focus on the inherent characters of a person rather than on the specific actions that he or she performs
Virtues
_____ are standards of conduct, they are used for judging the goodness or badness of some actions
Values
___ value is something that has value in and of itself (happiness)
Intrinsic value
_____ value is something that helps to give value to something else
Instrumental
____ has to do with orderliness and moderation in everything said and done
Temperance
_____ ethics are based on codes developed by societies that have relied on customs to formulate their codes unlike religious ethics
Secular
____ ethics is concerned with the outcome or consequences of an action in which the ends justify the means
Situational
Ethical ___ occurs when ideas of right and wrong conflict
Dilemmas
____ reasoning describes a person who has already made up his or her mind on a particular issue and sees no need for deliberation
Circular
_____ the voluntary agreement by a person who possesses sufficient mental capacity to make an intelligent choice to allow a medical procedure or treatment by another to be performed on himself or herself
Consent
This is a legal doctrine that provides that a patient has the right to know the potential risks, benefits, and alternatives of a proposed procedure
Informed consent
This is an individual who by law is vested with the power and charged with the duty of taking care of a patient by protecting their rights and managing the patients estate
Guardianship
What are the most cited conditions indicative of incompetence in an individual to make decisions?
Mental illness Mental retardation Senility Physical incapacity Chronic alcohol and drug abuse
This authorizes someone to make decision for emergency care for injured people
Limited power of attorney
This act provides that each person has a right under state law to make decisions concerning their medical care, including the right to accept or refuse medical or surgical treatment
Patient self determination act of 1990
