Ethical and legal aspects; Patient care Flashcards
Key words for patient care
-Pediatrics
-Trauma
-Geriatrics
Patient care tips
-common sense
-know protocols and standards
Consent
-Written
-oral
-implied
For an invasive procedure
-written/signed consent form
-Physicians responsibility to give patient all information to make informed consent
-They need to go over all the risks prior to the procedure and they have to sign off on it
Non Invasive
-When we take x-rays
-Oral consent
-When the patient follows your instructions during and x-ray that indicated implied consent
Confidentiality
HIPAA
Health insurance portability accountability act
Privacy
receive privacy practices, restrict the use of personal health information (PHI)
extent of care
Consent or refuse treatment
-DNR(Do not resuscitate)
-DNI (do not intubate)
Autonomy means
the right to refuse medical treatment
-you decide what happens to you
-peds: your parents decide
Access to information for a pt.
You have the right to review your medical records
Documents expressing patient wishes when the time comes…
-Living will
-health care proxy
-advanced directives
Research participation
The patient has the right to decline or except the research participation
Living will
written statement detailing a person’s desires regarding their medical treatment in circumstances in which they are no longer able to express informed consent, especially an advance directive.
Health care proxy
A health care proxy (also called a health care agent or Power of Attorney for Health Care) is the person you choose to make health care decisions for you if you’re too sick to make them for yourself .
American hospital Association(AHA) Patient care partnership (Patient’s Bill of rights)
-How you would be expected to be treated during your hospital stays
-high quality hospital care
-A clean and safe environment
-Involvement in your care
-Protection of your privacy
-Help when leaving the hospital
-help with billing claims
Orders must be written by…
MD or his/her agent
-Ordering MD responsible for ordering the CORRECT EXAM
-Results go to that MD who ordered it!
Required Requisition information… hint theres 5
- The patient to be examined
- The exact region or part to be radiographed
3.The suspected or existing diagnosis - The ordering physician
- Date of the requisition
Verification and Patient Identification
-Correct patient (2 identifiers)
-Correct body part
-Correct side
Assault
Threat
-words and tone
(A before B)
Battery
Touching
-x ray the wrong patient or the wrong body part
Invasion of privacy
HIPAA
Confidentiality
False imprisonment
Patient not allowed to leave
Restraints vs. Immobilization
Immobilization- used in x ray to reduce motion (sponge or tape). Used temporarily
Restraints- requires and MD orders, restricts patients freedom
Negligence
failing to provide reasonable care and caution
-you forget to put the bed rails up or forget to lock the wheel chair and then the patient falls
Tort
Act causing injury (unintentional or intentional)
Libel
written defamation
Slander
Verbal defamation
(Spoken)
Legal Doctrines
Respondeat Superior
“Let the master answer”
Res ipsa Loquitur
“The thing speaks for itself”
Respondeat Superior
The employer is held liable for the actions of the employee
Res ipsa Loquitur
The defendant (the individual being sued) to prove his/her innocence.
Immobilization used in x-ray to……
REDUCE MOTION
-used to temporarily maintain a position or procedure
-positioning aids used to eliminate motion artifact
Restraint require an
MD ORDER
-restricts patient from freedom
-not preformed by radiographer
what are the 7 C’s of Malpractice
-Competence
-Compliance
-Charting
-Communications
-Confidentiality
-Courtesy
-Carefulness
ARRT Code of ethics (11)
The Code of Ethics shall serve as a guide by which Registered Technologists and Candidates may evaluate their professional conduct as it relates to patients, healthcare consumers, employers,
colleagues, and other members of the healthcare team. The Code of Ethics is intended to assist Registered Technologists and Candidates in maintaining a high level of ethical conduct and in providing for the protection, safety, and comfort of patients.
The Code of Ethics is aspirational.
Radiographic Image requirements (Hint theres 4)
1.) Patient Identification
2.)Anatomic markings, including left and right markers
3.) Carefully placed markings on each radiograph using lead markers
4.) Date of exposure
Radiographic images are:
legal documents
-they belong to the institution that produced them (hospital) NOT THE PATIENT
Manipulation of electronic data
-Exposure indicator
-Processing algorithm
-brightness and contrast
-cropping or masking off anatomy
Exposure indicator
-know the EI range/target for your equipment. what is considered over/under exposed.
-CR it will be a S number
Processing algorithm
Image acquisition, image display and image processing
Brightness and contrast
window width for contrast
window level for brightness
-adjust BOTH post processing as a technologist after you take the x-ray
Cropping or masking off anatomy
Purpose of cropping/ masking is to reduce the eye fatigue of viewer by high brightness levels in the image.
-cropping shouldn’t be used on your image after. Don’t cone off!
-IF YOU EXPOSE ANATOMY IT SHOULD BE SENT AND READ!
The use of physical restraints on adult patients requires a/an
MD order
The joint commission requires that health care personnel to use at least _____ patient identifiers to validate identity before proceeding with the health care services
2
Another name for professional negligence is _______
Malpractice
Which part of the ARRT standards of ethics is aspirational? which part is enforceable?
Code of ethics is aspirational
Rules of ethics is enforceable
Select the violations of ARRT rules of ethics from the following:
1.Submitting misleading educational history
2.Revaling privileged patient communication
4.Failure to obtain pertinent information for the radiologist
5.Violating state/federal narcotics laws
1,2 and 5
What are the four conditions required for valid patient consent?
- legal age 18 +
- sound mind
3.consent freely - adequately informed
what AHA document identifies and lists the requirements for open and honset communication, respect for differences, and for personal and professional values required for optimal patient care?
A Patients of rights
Nonmaleficence
ethical term used to describe no evil, that is, our obligation not to inflict harm
Veracity
Describe faithfulness or loyalty
and truthfullness
-being honest
Confidenality
to describe patient protection concerning release of their private information
Patient consent can be____,______ and ______
-oral
-written
-implied
What is the name of a personal document naming the individual who is authorized to make all health care decisions
health care proxy
justice
obligation to treat all with equity
a patients pulse may be obtained by
palpating
-the axiallary artery
-the brachial artery
-common carotid artery
** arteries are used to evaluate pulse rates not veins
a healthy patient is having difficulty breathing and is in need of oxygen. the correct flow rate through the nasal cannula should be:
1-6 liters/ min
* patients with emphysema ( COPD) should receive oxygen at rated NO higher than 3 L/min
kinesthetic learning is what
tactile learning which is carried out by physical activity
what should be on a patients electronic medical record
-medical history
-informed consent forms
-procedure orders
-progress notes
-medications
-surgical reports
-results of examination and tests
viscosity
chacteristc of iodinated contrast agents is defined as the resistance of a liquid
osmolality
is the number of particles dissolved in 1 kg of water
miscibility
is the property a fully dissolving? 
toxicity
how harmful the contrast media is to the body 
implied consent
assumed the patient would approve of care if conscious 
informed consent
patient provides consent after being fully informed of need risks and alternatives 
patient’s bill of rights also known as patient care partnership 
establishes rights for patients regarding diagnosis, treatment, privacy, prognosis, and alternatives
The technologist notices the patient wears a purple wristband with the initials DNR on it, which means do not resuscitate. This is a form of what type of legal notification? 
Advance directive 
