Ethical and legal aspects; Patient care Flashcards by julianna marsh

Key words for patient care

-Pediatrics
-Trauma
-Geriatrics

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Patient care tips

-common sense
-know protocols and standards

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Consent

-Written
-oral
-implied

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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

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Non Invasive

-When we take x-rays
-Oral consent
-When the patient follows your instructions during and x-ray that indicated implied consent

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Confidentiality

HIPAA
Health insurance portability accountability act

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Privacy

receive privacy practices, restrict the use of personal health information (PHI)

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extent of care

Consent or refuse treatment
-DNR(Do not resuscitate)
-DNI (do not intubate)

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Autonomy means

the right to refuse medical treatment
-you decide what happens to you
-peds: your parents decide

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Access to information for a pt.

You have the right to review your medical records

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Documents expressing patient wishes when the time comes…

-Living will
-health care proxy
-advanced directives

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Research participation

The patient has the right to decline or except the research participation

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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.

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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 .

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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

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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!

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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

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Verification and Patient Identification

-Correct patient (2 identifiers)
-Correct body part
-Correct side

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Assault

Threat
-words and tone
(A before B)

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Battery

Touching
-x ray the wrong patient or the wrong body part

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Invasion of privacy

HIPAA
Confidentiality

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False imprisonment

Patient not allowed to leave

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Restraints vs. Immobilization

Immobilization- used in x ray to reduce motion (sponge or tape). Used temporarily
Restraints- requires and MD orders, restricts patients freedom

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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

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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

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?

1. legal age 18 + 2. sound mind 3.consent freely 4. 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