Healthcare Trends Flashcards
Telemedicine
Use of audio, video, & other telecommunications and electronic information processing technologies to monitor the health status of a patient from a distance.
Telemedicine Benefits
Support long-distance clinical health care
Promote patient and professional health-related education
Support public health and health administration
Reduce healthcare costs
Patient counseling
Case management
Supervision/preceptorship
Telemedicine Conflicts
**HIPPA, confedientiality, and informed consent
additional licenses
ANA scope
Future (reimbursements, legal, resources
Types of tellemedicine
Teletriage
Teletrauma
Telestroke/ Telecardiology
TelementalHealth
Telehomecare
Forensic Telenursing
What is the number 1 thing telemedicine can not do for nursing?
Assessments
Healthcare Payment
public insurance
private insurance
private pay
diagnoses-related groups
performance pay
Accreditation for hospitals
The Joint Commission (JCAHO)
Centers for Medicare and Medicaid (CMS)
Magnet designation
Other- Trauma/NICU/Stroke/
Nursing Education Program Accreditation
Beneficence
doing good or acting in the best interest of the patient
Autonomy
patients to make decisions about their medical care without their health care provider trying to influence the decision
Justice
all persons (patients) will be treated fairly and equitably
Fidelity
loyalty and trust from both parties
Nonmaleficence
the obligation of a physician not to harm the patient
Veracity
requires that healthcare providers be honest in their interactions with patients
Confidentiality
prohibits the health care provider from disclosing information about the patient’s case to others without permission
-HIPPA
Ethical dilemma
All solutions/options pose ethical problems
May be equally unpleasant
involve pt’s right to self-determination
Examples of ethical dilemmas
Informed consent
Do not resuscitate directives
Pain control
Withdrawal of fluids and nutrition
Genetic testing/reproductive technology
Experimental therapies
Inability to afford treatment
Organ/tissue donation
Decision making for ethics
Advance directives
Living wills
Patient care partnership/Patient bill of rights
Power of attorney
Medical
Legal
Advance directives
opportunity to express their values, goals for care, and treatment preferences to guide future decisions about health care.
- autonomy
Living wills
legal document that tells doctors how you want to be treated if you cannot make your own decisions about emergency treatment.
Power of attorney
gives someone else the right to make decisions about their medical care on their behalf.
Ethics committees
Create policies to assist with decision making
Education
Case Review
Policy Development
The ethics committee needs to have no
direct relationship to the pt
Nurses are obligated to report
Communicable diseases
criminal acivity (abuse and domestic violence)
animal bites (bed bugs)
gunshot
stab wounds
assaults
homicides
suicides
HIPPA breaches
Incidents Reporting
Goals
Avoiding a similar event at any stage in the future
Improve patient care
Specific Details and Descriptions are factual only
Facts Only/Objective Tone
Witness Statements
What should you never chart in thir file regarding incident reports?
Only objective data - ONLY WHAT IS OBSERVED
Never chart and incident report was filed
Internal Report
fall
External Report
organizations outside the hospital
CPS
T/F: Incident Reports substitute for documentation in the client’s chart.
False; no substitution, all documentation needs to be completed on both ends
Obligation to Report
Violates rule and contributed to the death or serious injury of a patient
Suspect nurse’s practice is impaired by chemical dependency or drug or alcohol abuse
Abuse, exploitation, fraud, violation of professional boundaries
Lacks knowledge, skill, judgement, or conscientiousness and pose a risk of harm
-TPAPN
Notify the physician if
Change in LOC, VS, respirations, symptomatic vs no symptomatic, wrong medication, incidental needlestick,
Chain of command
TPAPN
Nurses with drug and alcohol problems
The board of nursing prefers the employing organizations to be a part of this process
Ultimately, it may not protect the nurse’s license
T/F: If I am a licensee and see another nurse or a student nurse do something wrong, I can only report it to the Board of Nursing.
FALSE
If I receive disciplinary action against my license, why does it have to be published in the Board’s Newsletter?
PUBLIC KNOWLEDGE
What happens after reporting?
Disciplinary Hearing
Peer assitance program (TPAPN)
Whistleblowing
A person may not suspend or terminate the employment of or otherwise discipline or discriminate against a person who reports in good faith
no backlash
Whistleblowing concerns
firing or lay off
blacklisting
demoting
deny overtime or promotion
disciplining
denial of benefits
failure to hire
intimidation
threats
reassignments
reducing pay
The Safe Harbor Rule (SHPR) – RNs or LVNs
Instances
when the nurse feels accepting the assignment puts the pt and nurse at risk
When do you need to call Safe Harbor?
Before taking the assignment
still get it then protected by safe harbor
Civility
Having good manners and being polite
Respecting others
Based on recognizing that all human beings are important
Protection from discrimination
Incivility
Any type of speech or behavior that disrupts the harmony of the home, work, or educational environment
Other names in health care
Nurses eating their young
The doctor-nurse game
Aggressive communication
Civility in Nursing
The basis for caring
Promotes emotional health
Creates a positive environment for learning and the promotion of healing
Develops emotional intelligence in nurses
Transforms negative attitudes
Incivility increases when people are under
stress
Incivility includes
Cyber-harassment
Vicious anonymous e-mails
Hate text messaging
Acts of rudeness
Social rejection
Bullying
Defined as any behavior that could reasonably be considered humiliating, intimidating, threatening, or demeaning to an individual or group of individuals
Can occur anywhere
Can become habitual, being repeated over and over
A complex concept that includes Physical/Emotional/Verbal abuse
Hazing and initiation rites are forms of
bullying
Bullying ultimately effects the
patient
Peer abuse or lateral violence
one to one bullying from peers
have helpers that contribute to or prolong the bullying activities.
Lateral or Horizontal Violence
Has many of the same characteristics as bullying except that it takes place almost exclusively in the work setting among peers
Can be either covert or overt
Overt Lateral Violence
Name calling
Threatening body language
Physical hazing
Bickering
Fault finding
Negative criticism
Intimidation
Gossip or divulging confidential information
Shouting
Blaming
Put-downs
Raised eye brows and rolling of the eyes
Verbally abusive sarcasm with rude tones
Physical acts such as
Pounding on a table
Throwing objects
Shoving a chair against a wall
Covert Lateral Violence
More difficult to identify
Includes
Unfair assignments
Marginalizing a person
Refusing to help someone
Ignoring
Making faces behind someone’s back
Refusing to work with certain people
Whining, sabotage, exclusion, and fabrication
Results of Lateral Violence
decreased communication
poor quality of care
reduced saety of clients
poor morale
excessive “sick days”
High turnover
leave profession
What re the physical symptoms of lateral violence
HTN
Insomnia
Depression
GI upset
Incivility consequences in clinical settings
jeopardizes client safety
increase errors
low quality
hostile, toxic work environment
high turnover
