Ethics Flashcards
When should an ethics committee be used to resolve disputes about a patient’s end of life?
Only when the patient does not have an advanced directive
5 exceptions to need for legal guardian consent in care of minors?
Emergency, Contraception, STD treatment, Substance abuse, Prenatal care
Purpose of Medicare part A?
Covers inpatient visits
Purpose of Medicare part B?
Covers outpatient visits
Purpose of Medicare part C?
Covers enrollment in private insurance
Purpose of Medicare part D?
Covers prescription drugs
4 aspects of a decision-specific capacity assessment?
Understands medical condition and proposed treatment, Appreciates consequences of treatment options, Communicates choice, Provides rationale for decision
4 aspects of obtaining informed consent?
Explain patient’s diagnosis, Describe proposed treatment, Discuss risks + benefits of proposed treatment, Provide treatment alternatives
5 steps of a Root Cause Analysis?
Collect data, Create causal factor flow chart, Identify root causes, Generate recommendations + Implement change, Measure success of changes
Quality improvement tool used to identify what-how-why an undesirable outcome occurred?
Root Cause Analysis
Physician obligation in setting of physician impairment due to drug use?
Mandatory reporting to physician health program, or state licensing board
What is the only criteria for a patient to receive hospice care?
Estimated life expectancy < 6 months
If patient cannot consent to hospice care due to AMS, but estimated life expectancy is < 6 months – should patient still receive hospice care?
Family may act as patient’s surrogate decision maker … if they agree to hospice care, patient will be eligible
Approach to informed consent in non-emergency situations?
Informed consent should be obtained from a parent/guardian before medical intervention in a minor
How can mistakes in healthcare be avoided in the Swiss Cheese Model?
Increase redundancy + Double checks
At what point should a hospital ethics committee become involved in a patient’s care plan?
When conflict arises between multiple family members regarding the appropriate course of care … despite adequate initial mediation by the physician
First step when members of patient’s family disagree about appropriate course of care?
Organize family meeting
Best initial management of elder abuse?
Separate patient from abuser ASAP
In which situation are patients able to refuse care?
If patient is competent
Normal Mini Mental Status Exam (MMSE) score?
MMSE > 26
Primary goal of management in a brain-dead organ donor?
Maintain a euvolemic, normotensive, normothermic state
Best approach to situation in which breach of privacy occurs with patient PHI?
Patient must be notified in writing; Notification should include description of breach, what information was disclosed, what actions are being take to mitigate breach, prevent future disclosure
____ is a law that prohibits discrimination by health insurers and employers on the basis of genetic information
Genetic Information Nondiscrimination Act (GINA)
4 questions included in CAGE screening for ETOH abuse?
C – cut down use, A – annoyed by people criticizing your drinking, G – guilty about drinking, E – eye-opener
Best management of needle stick, in which patient refuses to be tested for HIV?
Initiate HIV post-exposure prophylaxis for healthcare provider who experienced needle-stick
Description of an active error?
Involves actions of frontline personnel
Description of a latent error?
Involves organizational vulnerabilities; Occurs at level of system
3 examples of latent errors?
Inadequate staffing, Organizational policies, Patient complexitiy
Description of a sentinel event?
Unexpected outcome, usually involving serious injury or death
What is the initial phase of a root cause analysis?
Collecting relevant data, creating a causal factor flow chart
Role of morphine in palliative care?
Pain control, control dyspnea
2 AEs of morphine use in palliative care?
Miosis, respiratory depression
Description of pre-contemplative stage?
Patient is not ready for change
Motivational strategy during pre-contemplative stage?
Have patient evaluate the consequences of current behavior
Description of contemplative stage?
Patient is thinking of change
Motivational strategy during contemplative stage?
Have patient discuss pros + cons of behavior
Description of preparation stage?
Patient is ready for change
Motivational strategy during preparation stage?
Encourage initiation of small steps
