Lab 1 Flashcards
What is the most common procedure a clinician will use?
Talking/ educating & listening (communication)
What are the benefits of effective clinician-patient communication?
- Support better history-taking, diagnosis and clinical decisions
– Increase a patient’s adherence to recommendations and follow up
– Help patients self-manage
– Influence the adoption of preventative health behaviours
– Improve patient satisfaction & experience of care
What are some tips to follow to ensure good communication?
- First Impressions
– Greet professionally
– Introduce self
– Eye contact - Be aware of body language
– Non verbal communication: facial expressions, gestures - Listen (Active and Reflective)
– Paraphrase what a patient tells you (reflective listening) - it shows they have been
heard and provides a checkpoint to ensure you have received the intended information. - Ensure understanding
– Use plain language to ask questions / explain Provide multiple chances to ask questions
– Ask patients to TEACH BACK to you what you have done / discussed in their own words so you can be sure you expressed yourself in a manner that was understood
Consent is the law. True or False?
True
There are no exceptions to obtaining consent before rending services (including assessment or treatment). True or False?
False.
ONLY exception is an emergency.
What are the principles of obtaining consent?
Principle 1: Obtain BEFORE rendering services.
Principle 2: Heath practitioner who proposes treatment is responsible for formulating opinion about patient capacity to provide informed consent.
Principle 3: Must relate to proposed treatment, be informed & given voluntarily and not
through misrepresentation / fraud
Principle 4: Must be informed
Principle 5: Only a health practitioner who has the knowledge to obtain informed consent, including the ability to answer questions is able to obtain consent for treatment that they are intending to deliver.
Principle 6: If a Physiotherapist (PT) is proposing a treatment, then they are responsible for ensuring informed consent obtained;
Principle 7: A prudent PT should not begin an individual treatment / procedure without prior discussion with the patient (i.e. what would the PT like to do)
Principle 8: If in doubt if consent was obtained or the patient refuses/does not appear to be aware of the treatment the PT should not proceed (exception = emergency)
Principle 9: A substitute decision maker(SDM) is called when a health care practitioner does not believe that the patient is capable of consenting to a proposed treatment. Because the health care practitioner cannot perform the treatment without consent, he/she must turn to the substitute for a decision. SDM must rely on following wishes received when the individual was capable/ was at least 16 years of age when expressed wishes
Principle 10: There is no age of consent- rely on capacity (16 years of age for wishes to be taken into consideration if becomes incapable)
How can consent be obtained?
- Expressly (verbally, in writing)
- implied (words, behaviours/ actions)
If a patient signs a consent form, this means informed consent has been obtained. True or False?
False.
You must have a discussion with patients, provide information required to make a decision and answer any questions.
Patients can refuse care/ change their mind and withdraw consent at any time. True or False?
True.
Matters included in “informed” consent are… (6)
1.The nature of the treatment.
2.The expected benefits of the treatment
3.The material risks of the treatment
4.The material side effects of the treatment
5. Alternative courses of action
6. The likely consequences of not having the treatment.
What should be included when documenting consent?
– Verbal / review of written document
– Date consent obtained
– Who was involved in the discussion
– Information relayed to the patient / substitute decision maker
– The questions asked by the patient and answers provided
– Who provided consent (i.e. patient / substitute decision maker)
– Provider information
Give an example of how you would obtain informed consent for a subjective interview.
Hi, my name is Elizabeth Finkelzon and I’m a physiotherapy student at McMaster. Before I begin, may I ask how you’d like to be addressed?
Interview, current history, past history, writing down for patient record, opportunity to ask questions, opportunity to withdraw or disengage if they chose to do so. At end need to overtly obtain consent to proceed.
What is the general purpose of a subjective interview?
Gathers information to identify and understand changes from the patient’s normal
status (i.e. chief complaint, impact on function)
+ determines patient’s goals for treatment
+ Provides a foundation to guide the physical examination / objective exam
Subjective history gathering starts _______, then progresses to _____ ______ information.
Generally, more specific
During subjective history gathering, PTs should ask _____ questions, structured in a way that does not lead patient to a specific answer.
Neutral
