Ethico-Moral Legal Obligations Flashcards
4 reasons for high instances of medical errors in the ICU
- Patients are very sick and need constant monitoring
- Complex cases
- Several consultants
- Life-and-death situations need to be made quickly
4 general domains for improvement of a patient safety program
- Ensuring compliance with patient safety regulations
- Responding to adverse events by performing root cause analyses
- Applying evidence-based risk reduction strategies
- Implementing strategies to meet and exceed patient safety metrics
Uses of 2 patient identifiers
- medications and blood products
- specimen collection
- imaging tests
- any type of treatment
NPSG
National Patient Safety Goals
Important patient safety issues (3)
- Proper patient safety goals
- Timely response
- Use of clinical alarms
A0 2020-0007
National Policy on Safety in All Health Facilities and No Blame Culture
AO 2008-023
Patient Safety Program
Major focus of an adverse event is system failure
Just Culture Concept
A well-established approach to preventing errors in critical errors
Team training
Components of good team training (3)
- Strong leadership
- Clear communication
- Ad hoc huddles
Ideal tool for ICU for teaching procedures or fostering teamwork
Simulation
Most important part of simulation
Debriefing
Use of financial incentives to reward hospitals that perform well on pre-established safety and quality measures
Pay-for-performance
A publicly displayed _________________ shows the hospital’s strengths and weaknesses
Report card
8 key elements of the Patient Safety Program
- Leadership and Governance
- Organizational Development
- Risk Management
- Teamwork and Communication
- Human Resource Development
- Documentation and Reporting
- Health Worker Safety
- Patient-Centered Care and Empowerment
4 proactive risk strategies
- Patient risk assessment
- Patient feedback survey
- Health technology assessment
- Use of safety checklist
Developed by the DOH and Health Facility Development Bureau
Safety checklists
Annual World Patient Safety Day
September 17
2 recent alerts provided by the American Association of Critical-Care Nurses
- Implement ABCDE bundle
2. Alarm practice management
3 unintended consequences being prevented by the ABCDE bundle
- Delirium
- Prolonged Mechanical Ventilation
- Excessive muscular deterioration
The interdependent components of the ABCDE bundle are designed to: (3)
- Improve collaboration among HCPs
- Standardize care processes
- Break the cycle of suboptimal sedation practices
ABCDE:
ABC component meaning
Awakening and Breathing Trial Coordination
ABCDE:
D component meaning
Delirium
ABCDE:
often goes undetected and untreated leading to negative long-term consequences
Delirium
ABCDE:
E component meaning
Early Exercise and Progressive Mobility
ABCDE:
Another term for daily Spontaneous Awakening Trials
Sedation vacation
The desensitization to alarms caused by sensory overload
Alarm fatigue
Describes what is expected in terms of right and correct and wrong
Ethics
ETHICS:
2 schools of though
Deontology
Utilitarianism
Ethics:
Both the means and the end goal are ethical
Deontology
Ethics:
End goal justifies the means
Utilitarianism
7 ethical principles
Justice Beneficence Nonmaleficence Accountability Fidelity Autonomy Veracity
Fairness
Justice
Doing good and the right thing
Beneficence
Doing no harm
Nonmaleficence
Accepting responsibility for one’s own actions
Accountability
Keeping one’s promises and responsibilities
Fidelity
When the nurse accepts the client as a unique person
Autonomy
Telling the whole truth
Veracity
2 most commonly occuring ethical issues and concerns in health care
Allocation of scarce resources
End of life issues
Addresses ethical concerns of advancing sciences and technology
Bioethics
Critical care nurse functions in accordance with common law, ordinance, and regulation
Legal Responsibilities
RA 9173
Philippine Nursing Law of 2002
Critical care nurse complies with the code of professional conduct, ethical principles, and accept accountability.
Ethico-Moral Responsibilities
Duty of the nurse accdg to RA 9173 (5)
- Provide nursing care
- Establish linkages with community resources
- Provide health education
- Teach, guide, and supervise nursing students
- Undertake nursing and health human resource development, training, and research
Written instruction made by a person before they become incapable of making decisions
Advanced directive
> Unepisodic and unanticipated
Life-threatening
Possible disability
Needs immediate medical intervention
Emergency
Measures taken by an HCP to determine, restore, or maintain patient status
Health Care
Devoted primarily to the maintenance and operation of facilities for the care of individuals in need of medical/nursing care
Health Care Institution
Any licensed individual trained in health care which includes supporting staff
Health Care Practitioner/Personnel
Any licensed entity that arranges health care coverages for a fixed prepaid premium
Health Care Organization
Departure from standard medical practice to obtain new knowledge
Human Experimentation
A patient with no visible means of income or income that is not sufficient for subsistence for his family
Indigent patient
Voluntary agreement of a person to undergo or be subjected to a procedure or other bodily interventions
Informed consent
Means of communication that reaches and influences large numbers of people
Media Practitioner
Service of procedure that could not be omitted without adversely affecting the patient’s condition
Medically Necessary
One who avails medical or health care service/s
Patient
State of well-being of the general population
Public health and safety
Active total care directed at maintaining or improving the comfort of a patient suffering from a terminal illness that does not hasten nor prevent death
Terminal Care
Illness or condition resulting in death within the foreseeable future
Terminal illness
Stage of illness where there is no prospect of recovery or remission of symptoms
Terminal Phase
Knowledge, skills, and practices outside of biomedicine
Traditional and Alternative health care
Person who practices non-allopathic healing methods
Traditional and Alternative Health Care Practitioner
Patient is being subjected to exposure without their consent
Unwarranted Public Exposure
13 patient rights
- Appropriate Medical Care and Human Treatment
- Informed Consent
- Privacy and Confidentiality
- Information
- Choose Healthcare Provider and Facility
- Self-Determination
- Religious Beliefs
- Medical Records
- Leave
- Refuse Participation in Medical Research
- Correspondence and Receive Visitors
- Express Grievances
- Informed of His Rights and Obligations as a Patient
5 societal Rights
- Right to Health
- Right to Access Quality Public Health Care
- Right to Healthy and Safe Workplace
- Right to Prevention and Education Programs
- Right to Participate in Policy Decisions
8 Patient Obligations
- Know rights
- Provide accurate and complete information
- Report unexpected health care changes
- Understand the purpose and cost of treatment
- Accept consequences of own informed consent
- Settle financial obligations
- Relation to others
- Exhaust grievance mechanism