Intro to Acute Care (Role, Legal, & Ethics)

Question 1

Integrated approach in which members of a clinical team actively coordinate care and services across disciplines

Answer 1

Interprofessional Patient Care

Question 2

area of clinical knowledge and related research that is pertinent to patient care

Answer 2

health care discipline

Question 3

physicians, surgeons, physicians-in-training, medical students, physical assistants

Answer 3

Discipline of medicine

Question 4

Advanced practice registered nurses–nurse practitioners, nurse anesthetists, clinical nurse specialists; staff nurses and nursing student

Answer 4

Discipline of nursing

Question 5

Pharmacists, respiratory care practitioners, dietitians, therapists (occupational, physical, speech), social workers, chaplains, child life specialists, case managers, paramedics, emergency personnel

Answer 5

Discipline of allied health professionals

Question 6

Medical directors, nurse managers, supervisors, health unit coordinators

Answer 6

Discipline of administration

Question 7

Counsel patients on diet, hygiene, and preventive health care and who diagnose illnesses and prescribe and administer treatment for patients suffering from disease/injury

Answer 7

Attending physicians

Question 8

makes clinical decisions and provides a broad range of diagnostic, therapeutic, preventive, and health maintenance services

Answer 8

Physician assistant

Question 9

4 types–nurse practitioners, certified nurse-midwives, clinical nurse specialists, and certified registered nurse anesthetists (CRNA)

Deliver primary and/or acute care in variety of settings; diagnose and treat common acute illnesses and injuries, perform physical examination, and manage chronic health conditions

Answer 9

Advanced practice registered nurses

Question 10

Pharmacists; Respiratory therapists; Dietitians; Occupational therapists; Physical therapists; Speech therapists; Social workers; Child life specialists; Case-managers; Emergency medical technicians (EMT) and paramedics

Answer 10

Allied health professionals

Question 11

distribute medications prescribed by other providers, inform patients about medications, and advise practitioner on selection, dosages, interactions, and side effects

Answer 11

Pharmacists

Question 12

Respiratory therapists

treat patients of all ages with respiratory illnesses and other cardiopulmonary conditions

Answer 12

Respiratory therapists

Question 13

applies sciences of foot, nutrition, biochemistry, physiology, food management, and behavior to maintain health status of patients

Answer 13

Dietitians

Question 14

promote health and wellness to those person who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitations, or participation restrictions

Answer 14

Occupational therapists

Question 15

help improve patient’s strength and mobility, relieve pain, and prevent/limit physical disabilities

Answer 15

Physical therapists

Question 16

evaluate, diagnose, and treat speech, language and swallowing disorders in all ages

Answer 16

Speech therapists

Question 17

assist individuals, groups, or communities to restore, enhance their capacity for social functioning; help prevent and mitigate crisis, and counsel individuals and families to cope with stress

Answer 17

Social workers

Question 18

promote effective coping through play, preparation, education and self expression activities; provide emotional support for families, encourage optimal development of children

Answer 18

Child life specialists

Question 19

help patients understand their current health status, what they can do about it, and why those treatments are important

Answer 19

Case managers

Question 20

provide emergency care to people who have suffered from illness/ injury outside hospital setting, work under protocols

Answer 20

Emergency medical technicians (EMT) and paramedics

Question 21

Shared mission, purpose, or goal

Answer 21

Essential for interprofessional teams

Question 22

integrated scheduling, physical proximity of team members, strong interpersonal communication skills; regular opportunities for communication; shared language of communication lack of therapeutic territorialism, and commitment to interprofessional process

Answer 22

Goals for success for interprofessional team

Question 23

Communication
Cooperation (empowerment of team members)
Cohesiveness (team sticks together)
Commitment (investing in team process)
Collaboration (equality in team)
Confronts problems directly
Coordination of efforts (actions support common plan)
Conflict management
Consensus decision making
Caring (patient-centered outcomes)
Consistency (with one another and environment)
Contribution

Answer 23

12 C’s of Teamwork

Question 24

allows team members to share concerns about safety or quality of patient care and to ask questions in attempt to improve understanding of patient care

Answer 24

Open Communication

Question 25

can provide opportunity for open communication and collaboration between team members

Answer 25

Interprofessional rounds

Question 26

allows team members to review team performance, identify errors and evaluate them in relation to team function, and provide and receive constructive feedback to improve team performance

Answer 26

Team debriefing

Question 27

recognizes as a matter of civil liberty, the parent's right to make decision regarding a child's education, health care, lifestyle, regiment, religious observation, and discipline

Answer 27

Parental liberty doctrine

Question 28

The state may intervene against a child's natural parent/legal guardian and act as parent of any child who is need for protection State will have the burden of proving that it has not unjustifiably interfered with the parental liberty doctrine

Answer 28

Parent patriae

Question 29

Minor who has been made free of parental control--usually automatically emancipated when they become pregnant or have children of their own, regardless of age

Answer 29

Emancipated minor

Question 30

allows minor to demonstrate requisite capacity and maturity to make independent decisions with regard to health care Takes into consideration age of minor, nature of situation, ability of minor to understand medical procedure in question and laws of state in which minor resides

Answer 30

Mature minor

Question 31

presumption under US law that a minor is someone younger than 18 is immature and may not make their own decisions regarding healthcare

Answer 31

Immature minor

Question 32

Allows parents and children 14 years or older to refuse medical treatment for a life-threatening condition; preventing parents from being charged with medical neglect if decision to refuse such treatment is made jointly, in good faith, by parents and child who is older than 14 Virginia legislature

Answer 32

Abraham's Law

Question 33

Allow parents and children to have autonomy regarding decision related to medical treatment, even if it contradicts conventional wisdom If parents can demonstrate that they are advocating for their position based on reasonable information and a plan of treatment that they truly feel is in the best interest of the child, courts will often side with parents Courts will often side with children even if their decisions conflict with those of the parent under the mature minor doctrine if court finds the child is sufficiently informed about diagnosis and treatment alternatives and reasonably understands consequences of decision

Answer 33

Parker Jensen Cancer Case

Question 34

Decision making for oneself, not commonly applied to children

Answer 34

Consent

Question 35

Parent is fully informed of purpose, benefits, and risk for child and is asked for permission to perform procedures or enroll child in study

Answer 35

Permission

Question 36

Self-determination by which child having been fully informed or informed to extent of their ability to understand participates in decision making May be simple expression of opinion or may be involved discussion of all aspects of tissue

Answer 36

Assent

Question 37

If child can write a their own name, can be as young as 6 or 7 years

Answer 37

Youngest age a child can assent

Question 38

Holds that HCPs must not share confidences between themselves and a patient/parent with others without patient's or parent's express permission If HCP believes that the patient in danger of self-harm or harm to another, then information must be shared appropriately to prevent such injuries Must report disclosures of illegal activity

Answer 38

Confidentiality

Question 39

Obtaining informed parental consent or permission without undue influence/coercion

Answer 39

Responsibility of research study investigator

Question 40

Verify that consent is legitimately obtained and that consent protocols are followed May not advise or direct decision to participate

Answer 40

HCP's responsibility in research study

Question 41

If parent is not present, but available by telephone, then obtain permission with third-party "auditory witness"

Answer 41

Emergency Procedures with parent available on the phone

Question 42

Determine if child is mature enough and able to understand condition and make decision as a mature minor

Answer 42

Emergency procedures without parent available, but minor is awake

Question 43

two licensed medical professionals may make a declaration that life-saving car is needed should be committed to writing in a patient's medical record

Answer 43

Emergency procedures without parent available and unconscious minor

Question 44

Matched by height, weight, ABO, and serology status; less problematic ethical issues

Answer 44

Cadaver donors

Question 45

Sibling has 1:4 chance of being a perfect match with identical twin being best match; there is emotional cost

Answer 45

Live donor transplantation

Question 46

Some states require parental permission to provide any kind of education related to sexuality or birth control Other states have laws that allow children of a particular age (14 or 16 years) to consent to their own health care

Answer 46

Reproductive decision making

Question 47

male fertility preservation minors must provide consent for procedures and storage of reproductive tissue

Answer 47

Cryopreservation of spermatoza

Question 48

female fertility preservation before treatment with radiation therapy minors must provide consent for procedures and storage of reproductive tissue

Answer 48

cryopreservation of oocytes &/ embryos, ovarian transposition

Question 49

1. helping pediatric patient achieve developmental appropriate awareness of condition 2. telling pediatric patient what to expect with clinical management 3. assessing understanding and factors influencing response 4. soliciting expression of pediatric patient's willingness to accept proposed

Answer 49

Four components of assent

Question 50

Allows patients and/or surrogates to designate desired medical interventions under applicable circumstances

Answer 50

advanced directives

Question 51

If unresolved, ethics consult should be obtained--> then legal counsel is next step Court system may be required to determine patient's next best therapeutic plan

Answer 51

Refusal of Care

Question 52

Medical interventions that are unlikely to produce any significant benefit to patient HCPS have moral duty to refuse to provide therapeutic option that may harm a patient and social duty to conserve resources

Answer 52

Futile/Inappropriate Care

Question 53

Deliberate intervention undertaken with intention of ending a life to relive intractable suffer Fear of "slipper slope" AAP does not support idea

Answer 53

Euthanasia

Question 54

Set of ethical criteria for evaluating the permissibility of acting when one's otherwise legitimate act will cause negative effect that one would normally be obliged to avoid Action having foreseen harmful effects partially inseparable from goof effect is justifiable upon satisfaction of following (nature of act is itself good or at least morally neutral)

Answer 54

Doctrine of Double Effect (DDE)

Question 55

Judgment made on behalf of a non-competent patient based on what the person would have decided had he/she been competent

Answer 55

Substituted judgement

Question 56

Has origins in family law; surrogate decision maker must determine the highest net balance among available options; weighing positive against negatives Can be difficult to apply

Answer 56

Best interest

Question 57

provide care that benefits the patient

Answer 57

Beneficence

Question 58

avoid harming the patient

Answer 58

Nonmaleficence

Question 59

individuals should decide what constitutes their own best interest

Answer 59

Autonomy

Question 60

provides services fairly without bias from factors irrelevant to medical situation

Answer 60

Justice

Question 61

provide direct patient care by collecting and analyzing data to appropriately manage care

Answer 61

Clinician

Question 62

engages in shared planning and intervention with other health care professionals to attain desired patient goals

Answer 62

Consultant/Collaborator

Question 63

teaches patients, families, peers, and communities about a variety of health care issues

Answer 63

Educator

Question 64

Uses research process to provide evidence-based patient care--research/scholarships--you need to be able apply research to your patient population

Answer 64

Researcher

Question 65

State board of nursing | Certificate vs MSN vs DNP

Answer 65

Licensure

Question 66

Non-governmental agency that validates an individual has met certain predetermined standards set by individual's profession Determines if you are safe to practice as an NP; required for licensure

Answer 66

Certification

Question 67

Process of validation of required education, license, and certification Usually carried out by hospital or clinical practice site Admitting privileges are determined by hospital

Answer 67

Credentialing

Question 68

Authorizing a HCP scope and content of patient care services

Answer 68

Privileging

Question 69

legal provisions set up by individual state nurse practice acts i.e. what would be considered appropriate for HCP to do?

Answer 69

Scope of practice

Question 70

evolve out of scope of practice establish minimal levels of acceptable performance *important for malpractice claims *would another NP at your same level do the same things you did?

Answer 70

Standards of practice

Question 71

ability of NP to prescribe medications to clients is dependent on state nurse practice acts state practice dictates the level of prescriptive authority allowed DEA has ruled that NP's may obtain registration numbers

Answer 71

Prescriptive authority

Question 72

Legal responsibility that a NP has for actions that fail to meet the standard of care, resulting in actual or potential harm to a patient

Answer 72

Liability

Question 73

damaging one's reputation as a result of information being shared without patient's permission

Answer 73

Invasion of privacy

Question 74

failure of a NP to render services with the degree of care, diligence, and precaution that another member of same progression under similar circumstances would render to prevent injury to someone else *asked to perform a task outside of their job description

Answer 74

Malpractice

Question 75

MInor who has been determined by certain set of circumstances or by a court to be given status as an adult--don't require parental consent Being in military service, being financially independent of parent and living on their own, being married

Answer 75

Emancipated minor

Question 76

Minor can consent for medical decision regardless of parental consent, in regards to sexual health, STIs, mental health services, perinatal/prenatal services, immunizations, substance use disorders, care after rape/assault

Answer 76

Minor legal exception

Question 77

respect for persons; self-reliance or self-determination

Answer 77

Autonomy

Question 78

clinician decides what is best for the patient | i.e. futile care--meaning if there are contraindications for medical intervention that may prolong their suffering

Answer 78

Paternalism

Question 79

following through, faithlessness, commitment to keep promises

Answer 79

Fidelity

Question 80

Doing no harm or as LITTLE harm as possible I.e. putting a PICC line, but trying to limit the blood loss as much as possible

Answer 80

Non-maleficence

Question 81

Telling the truth

Answer 81

Veracity

Question 82

Equal distribution of goods, services, benefits, and burden | Impartiality

Answer 82

Justice

Question 83

Exists an ethically "right" and ethically "wrong" choice Taking controlled substances that are not legally prescribed to you is an ethically wrong choice

Answer 83

Ethical problem

Question 84

Exists two ethically "right" choices Usually develop when values among parties are discrepant i. e. offering a particular treatment modalities that may or may not have good outcomes, may be an ethical problem i. e. offering ECHO in patient that might be progressing to brain death while another clinician thinks it is worth a shot

Answer 84

Ethical Dilemma

Question 85

Obtain relevant facts Identify ethical issues from facts Determine who is affected Identify the alternatives available to person who must resolve dilemma Identify likely consequences of each alternative (con/pon) Decide appropriate action then evaluate effectiveness of decision

Answer 85

Resolving Dilemmas