Ethics Flashcards
What is the AANA code of ethics?
Dictates principles of conduct and integrity for CRNAs and holds them accountable regardless of institutional policy or a physician order
What are practice guidelines? Should or must be followed?
Guidelines that assist providers that are commonly accepted in the anesthesia community
“Should” be adhered to
What are practice standards?
Describe the minimum rules and responsibilities of anesthetists.
“Must” be adhered to
What are position statements?
Express the AANA official positions or beliefs
Define autonomy
The patient’s ability to choose without controlling interference by others
Define nonmaleficence
The provider has an obligation to not inflict harm (Hippocratic oath)
Define beneficence
Providers should take action for the benefit of others. Prevent harm by actively helping
What are 6 elements of consent?
Competence
Able to make decisions
Disclosure of information
Understanding of said information
Voluntary consent
Documentation
What is informed refusal? Example?
The patient has the right to refuse treatment
Ex: Jehovah’s witness
What is an advanced directive?
Legally binding document that outlines patients wishes
What 4 things must be proven during a lawsuit asserting malpractice ?
Duty
Breach of duty
Causation
Damages
What is res Ipsa loquitur?
The thing speaks for itself. Can shift the burden of proof from the plaintiff to the defendant
What 4 things must be proven in res Ipsa loquitur?
- Injury would not have occurred in the absence of negligence
- Injury was caused by something under complete control of the defendant (provider)
- The patient did not contribute to the injury
- The evidence for the explanation of events is solely under the control of the provider
Libel vs slander?
Libel - written defamation
Slander - verbal defamation
Assault vs battery.
Assault - is the attempt to touch another person
Battery - touching a person without expressed or implied consent
What is vicarious liability? Another name?
One person may be liable for another’s actions.
Respondeat superior
Ex: MD is responsible for PAs actions
What is the Affordable care act?
-All individuals must carry health insurance
-Standards and requirements for health insurance
-Can no longer charge more for pre-existing conditions
What is EMTALA?
Emergency Medical Treatment and Labor act
Must treat the patient regardless of their ability to pay
What is Health Insurance Portability and accountability act?
HIPPA
Federal law that you can’t disclose information
What is the controlled substance act?
The government defines and controls-controlled substances
What schedule 1 drugs are used in anesthesia?
NONE
Schedule 1 drugs have no acceptable medical use
What schedule 2 drugs are used in anesthesia?
High potential for abuse
- Opioid agonists (fent)
- Cocaine
- Meth
- Phencyclidine
What is the health information technology for economic and clinical health act?
An amendment to HIPAA
Intended to create a healthcare information technology infrastructure to improve quality of care
Lawsuit steps
First step in a lawsuit?
Notify insurance immediately
What is an emancipated minor?
Patients younger than 18 who were given rights of an adult by the state
Some criteria
1. Married
2. Veteran
3. A parent or pregnant
4. Economically independent
If a Jehovah’s Witness patient is having surgery with high likelihood of transfusion, what steps should be taken?
Seek a court order prior to surgery
If a Jehovah’s Witness patient is having life threatening hemorrhage, can blood be given before obtaining a court order?
Yes but must seek a court order after
Should a Jehovah’s Witness patient under the age of 18 be included on medical decisions regarding blood products?
Yes if close to 18
What is anesthesia crisis resource management ?
?? in a crisis, people can respond without proper training?
What are 5 complications of fatigue?
Diminished reaction time
Impaired decision making
Decreased situational awareness
Impaired memory or focus
Periods of microsleep
What is microsleep?
Sleep that lasts seconds to minutes
What does being awake for 24 hours equal in alcohol BAC?
24 hours of wakefulness is equal to a BAC of 0.1%
When is sleep related behavior most common?
16 or more hours of work
Night shift
6 counter measures for fatigue?
Napping
Caffeine
Exercise
Consistent sleep wake pattern
Medications
Recovery between shifts
What is the OSHA limit for exposure to ionizing radiation for annual and lifetime
Annual = 5 rem
Lifetime = (n-18) x 5 rem
n= age
Is there a limit to MRI exposure? S&S?
No limit but may cause dizziness, vertigo, or light flashes
OSHA noise exposure limits?
8-hour span 90dB
single noise level of 115dB
What is addiction?
A need for a substance - loss of self-control
What is impairment?
Inability to safely participate in life
What is tolerance?
More drug is needed to achieve desired effect
What is withdrawal?
A characteristic syndrome that is the direct result of stopping a drug
How many years of recovery is recommended before reentry to the workplace? How long should “probation” be?
1 year
5 years of monitoring
What are the steps if you suspect a coworker is abusing or impaired?
- Do not let them out of your site or drive
- Have a treatment facility available
- Do not let them decide their treatment
- Threaten to call the police
What are 6 elements of high-quality care?
- Patient centered care
- Safe
- Effective
- Timely
- Efficient
- Equitable
What is cultural competence
Give the same care to every human
