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PA Profession > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

What is bioethics?

A

Truth-telling and advocating for patients, even when you disagree with the choices the patient has made

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2
Q

What are the important factors of truth-telling as a PA?

A

Critical to relationship building with patients
Need self-evaluation of our own values
Issues occur when our values collide with patient’s values

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3
Q

What are the four famous medical ethics topics?

A

Roe v Wade
Karen Ann Quinlan
Terri Shiavo
Tuskegee Syphilis Study

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4
Q

What is the importance of the Karen Ann Quinlan case?

A

Doctors didnt want to disconnect patient from life support even though the parents did
Brought about the “right to die”

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5
Q

What is the importance of the Terri Shiavo case?

A

Husband wanted to take wife off life support when in vegetative state, parent’s didn’t
Brought about advanced directive

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6
Q

What is the importance of the Tuskegee Syphilis Study?

A

Informed consent and actual treatment was never actually given to the patients participating

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7
Q

What is the importance of Roe v Wade?

A

Expanded privacy

Gave the right to abortion

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8
Q

What are the fundamentals of PAs professional growth?

A

Continued improvement of technical skills and medical knowledge
Self-directed reflective advancements

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9
Q

What are the goals of PAs as professional moral agents?

A

Work within acceptable boundaries
Exercise responsibility with significant level of dependent autonomy and personal judgement
Develop appropriate PA - patient judgement
Strong knowledge base and technical skills

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10
Q

What is morality?

A

Practices and conduct that arise from customs

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11
Q

What is eithics?

A

Choices arising from reasonable examination of morality

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12
Q

What are the different character and virtue aspects of professional moral agents?

A 
Empathy
Respect
Honesty
Kindness
Fairness
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13
Q

What are the four fields of bioethics?

A

Theoretical bioethics
Clinical bioethics
Regulatory and policy bioethics
Cultural bioethics

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14
Q

What are the four principles of biomedical ethics?

A

Autonomy
Nonmaleficence
Beneficence
Justice

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15
Q

What is autonomy regarding biomedical ethics?

A

Privacy, freedom of choice, self determination
Patient is self governing
Patient allowed to act freely

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16
Q

What is nonmaleficence regarding biomedical ethics?

A

Concept in Hippocratic Oath
Inflict no harm or evil
Maximize benefits while minimizing possible harms

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17
Q

What is beneficence regarding biomedical ethics?

A

Keep patient safe and keep from harm
Act in the interest of the patient (PA’s major responsibility)
Altruistic (unselfish)

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18
Q

What is the georgetown mantra?

A

Mainstay of ethical principles in the healthcare setting

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19
Q

What is liability?

A

An obligation or a debt

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20
Q

What is liability insurance?

A

Insurance against loss due to claims for damages alleging malpractice

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21
Q

What is malpractice?

A

Alleged professional misconduct or lack of ordinary skill in the performance of a professional act

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22
Q

What is ocurrence form policy?

A

Protects future
More expensive
Covers for an incident that occurred during the coverage time

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23
Q

What is claims-made policy?

A

Protects for term of specific employment

Covers when the lawsuit is filed regardless of when the incident actually happened

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24
Q

What do the majority of lawsuits come from?

A

Come from incidents that do not raise red

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25
Q

What are the six main reasons that PAs are sued?

A 
Lack of adequate supervision
Untimely referral
Failure to diagnose
Inadequate examination
Lack of documentation
Lack of communication
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26
Q

How can the pitfalls of lack of adequate supervision be avoided?

A

Know your state laws
Communicate with your supervising physician regularly
Document “in consult with Dr.” in chart for assessment and plans sections

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27
Q

How can the pitfalls of untimely referral be avoided?

A

Discuss plans with supervising physicians

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28
Q

How can the pitfalls of failure to diagnose be avoided?

A

Discuss case with supervising physician and document

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29
Q

How can the pitfalls of inadequate examination be avoided?

A

Confirm and expand on history of CC
Focues on PE and any abnormal findings
Be sure to complete exam yourself and document
Include inspection, ausculatation, palpation, and percussion in PE

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30
Q

How can the pitfalls of lack of documentation be avoided?

A

If it wasn’t written, it wasn’t done

Document!!!!!

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31
Q

How can the pitfalls of lack of communication be avoided?

A

Communicate with patient and with the supervising physician

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32
Q

What are the strategies for avoiding lawsuits?

A 
Documentation
Strengthen the Medical Record
Confidentiality and professionalism
Dictation
Legibility
Alterations of medical record
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33
Q

What is the function of the medical record as a legal document?

A

Serves as a record of what you have done to and for the patient
Lets other know what has been done to and for the patient

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34
Q

What can be done to strengthen the medical record documentation?

A

Initial and date all documents you review
Address all body systems pertinent to the CC
Write full notes
Limit use of abbreviations
Use a consistent method of charting and organizing medical records

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35
Q

How can confidentiality and professionalism help prevent lawsuits?

A

Do not discuss patient matters where you can be overheard
Don’t speak about details regarding patients
Only give information to authorized people

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36
Q

How can dictation help prevent lawsuits?

A

One of the best modes to document cases
Encourages complete entries
Be sure to have patient chart in front of you as you dictate

37
Q

What is the proper way to handle errors?

A 
SLIDE method
SL - single line through the mistake
I - initial the error
D - date the error and new entry
E - note "error" in the area
38
Q

What are the different ways that communication can be used to decrease likelihood of being sued?

A

Spend more than 15 minutes with patient
Use humor and laugh with patients
Explain things before doing them
Encourage your patient to talk and then listen

39
Q

What are the different forms of prevention that can be used to stop patients from being upset?

A

Patient-centered office
The receptionist makes first impression
Make the waiting rooms comfortable
Adhere to appointment times
Maintain privacy, comfort and compassion
Document and follow up missed appointments
Don’t assume compliance with testing and treatment

40
Q

What is the discovery rule?

A

Statue of limitations does not begin until the occurrence of the event puts the plaintiff on notice

41
Q

What is the discovery rule period?

A

The patient has two years to notice the wrong doing

From here the patient has one year from the discovery in order to file a lawsuit

42
Q

What are the four elements of medical malpractice?

A

Duty
Breach
Causation
Injury-damages

43
Q

What does the national practioner databank do?

A

Prevents incompetent providers from moving freely from hospital to hospital
All medical malpractice payments are reportable to the databank
Allows employers and insurance companies to look to see if you have any claims filed against you

44
Q

What is informed consent?

A

Comprehensive discussion and documentation indicating that patient was informed and fully understands procedures, risks, benefits, and alternative options

45
Q

What must be in front of you in order to make it okay to refill Rx?

A

Patient chart

46
Q

What is a system of health care?

A

Corporate body that may own or manage health care provider facilities

47
Q

What is a network of health care?

A

Group of physicians, hospitals, insurers, or community agencies that deliver broad spectrum health services

48
Q

What are hospitals?

A

Liscensed institutions that provide diagnostic and therapeutic patient services

49
Q

How are hospitals classified?

A

Based length of stay
Ownership
Primary focus of care

50
Q

What is considered a short stay at a hospital?

A

Less than 30 days

51
Q

What are the four different categories for length of stay regarding hospital visits?

A

Subacute
Acute
Tertiary - specialized
Quaternary - most specialized

52
Q

What is a community hospital?

A

Non-federal short stay hospitals
Open to the public
ACH

53
Q

What is a voluntary hospital?

A

Established by community rather than federal gov
Non-profit
Operated by churches, fraternal groups, etc

54
Q

What is a proprietary hospital?

A

Operated to make a profit

55
Q

What is a government hospital?

A

Includes VA hospitals and military hospitals

May be federally, state, city, or county funded

56
Q

What is JCAHO?

A

Joint Commission on Accreditation of Healthcare Organizations
Commission established to improve quality of public health care
Performs hospitals visits every 3 years

57
Q

What is the role of the board of trustees in a hospital?

A

Oversees with hospital administration, finance, planing, fundraising, and quality improvement

58
Q

What is the role of the CEO in a hospital?

A

Develops hospital’s management organization

59
Q

What is the definition of guidelines?

A

Evidence based recommendations for practice

60
Q

What is the definition of policies?

A

Methods of communicating about roles, responsibilities, and functions

61
Q

What is the definition of quality indicators?

A

Screening tools to identify potential problems in the quality of care delivered by a hospital department

62
Q

What are the four categories of health policies outcomes?

A

Health status
Health-related knowledge
Health-related behavior
Patient satisfaction

63
Q

What is HIPAA?

A

Health Insurance Portability and Accountability Act
Started in 1996
Ensures security and privacy of individual health information

64
Q

What effects did HIPPA have?

A

Improved communication
Standardized security procedures
Streamlined more efficient systems
Basic privacy expectations are now standard

65
Q

Who are the covered entities that HIPAA applies to?

A

Health plans
Health care clearinghouses
Health care providers

66
Q

What are some examples of entities that are not covered by HIPPA?

A

Workers compensation
Government programs
Government oversight

67
Q

What are examples of protected health information?

A 
Hospital bill
Job application
Pharmacy prescription
Drivers' licenses
Employee ID badge
Any list of patient names and their respective health insurance provider
68
Q

How is the US healthcare system ranked worldwide?

A

Ranked 37th out of 191

69
Q

What is the majority of money spent on in the US healthcare system?

A

Last 30 days of life

70
Q

The use of Evidence-Based research places attention into what?

A

Public health measures
Health promotion
Disease prevention

71
Q

What is HPDP?

A

Health promotion and disease prevention

PA is primary player is establishing

72
Q

What factors influence health?

A 
Age, sex and hereditary factors
Individual lifestyle factors
Social and community influences
Living and working conditions
General socioeconomic, cultural and environmental conditions
73
Q

What is the definition of health promotion?

A

Any combination of educational, organizational, economic and environmental supports for healthy living

74
Q

What is primary prevention?

A

Attempts to remove or modify risk factors or causes of disease in patients
Use of helmets, safety belts, and condoms

75
Q

What is secondary prevention?

A

Detects condition in earliest stage
Provides an opportunity to intervene to cure or stop disease
Use of pap smears

76
Q

What is tertiary prevention?

A

Aimed at treatment of an existing symptomatic disease or condition to prevent complications
Goal is to limit disability, morbidity, premature death, or rehabilitation

77
Q

What is the USPSTF?

A

US Preventative Services Task Force

Develops recommendations for clinical preventative services

78
Q

What are the barriers to health prevention and promotion?

A

Time
Money
Language

79
Q

What are the strategies PAs use to cause behavioral changes in patients?

A

Use empathy
Be respectful and genuine
Develop trust

80
Q

What is motivational interviewing?

A

Interview aimed at getting the patient to make the choice about behavior changes

81
Q

What is the Prochaska’s Transtheorectical Model?

A

PA facilitates the patient’s self change

82
Q

What are the stages of the Prochaska Transtheoretical model?

A 
Pre-contemplation
Contemplation
Preparation
Action
Maintenance
Termination
83
Q

What occurs in the precontemplation stage?

A

Clinician’s role is to get the patient to start thinking about the problem and possible solutions
Ask patient to think about issue between visits

84
Q

What happens in the contemplation stage?

A

Patient thinks about problem on their own
Patient dabbles in action
Clinician should identify pros and cons of change
Ask what would promote commitment

85
Q

What occurs in the preparation stage?

A

Patient understands change is needed
Patient begins to form a commitment to goals
Clinician should negotiate a start date
Reassure patient that action is the right thing to do

86
Q

What occurs in the action stage?

A

Patient follows care plan of regular activity to change problem
Patient shows commitment to plan
Clinician should help patient modify plan if needed
Show interest in improvement
Discuss slips and relapses

87
Q

What occurs in the maintenance stage?

A

Behavior change is now part of normal life
Intensity of effort may taper off
Clinician should ask how patient is doing, discuss slips, and be alert for signs of waning enthusiasm

88
Q

What occurs in the relapse stage?

A

Patient reverts to old problem behavior
Patient talks and acts like one in earlier stages
Patient may be resistant to discuss problem
Clinician needs to remind reasons for change
Say when not if for next attempt
Normalize relapse

89
Q

What are the major roles of the clinician in counseling change of behaviors?

A

Recognize change is a process
Promote patient to move through stages
Allow patient to remain in control
Apply thoughtful influence as opportunities present

PA Profession (2 decks)

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