lecture material - term test 2 Flashcards
Aaron antonvskys model of salutogenesis
- the creation of health and not simply the absence of disease
- operationalized with the SOC scale
SOC scale
sense of coherence scale
5 assumptions for pathogenesis
- the starting point is a disease or problem
- about avoiding problems
- reactive (Rx/Tx)
- humans are inherently healthy
- about not getting worse
5 assumptions for salutogensis
- starting point is a healthy potential
- about approaching potential
- proactive (causes health)
- humans are inherently flawed
- develops capacity
when confronted with a stressor a person with a strong SOC will do what 3 things
- be motivated to cope = meaningfulness and motivation
- have an understanding of the challenges in front of them + comprehensive and cognitive
- believe they have the necessary skills and resources to manage and control one’s life = manageability
Jon Kabat Zinn idea of mindfulness
paying attention in a particular way
- on purpose
- in the present moment
- non judgementally
James Baraz idea of mindfulness
Mindfulness is simply being aware of what is happening right now without wishing it were different. Enjoying the pleasant without holding on when it changes (which it will). Being with the unpleasant without fearing it will always be this way (which it won’t)
7 benefits of mindfulness
- improved cognition skills
- enhanced creativity
- enhanced relationships
- increased compassion
- enhanced morality and intuition
- health benefits
- reduced stress and anxiety
4 stages of mindfulness development
- none
- mindfulness after the fact
- mindfulness of the impulse
- dissolution of the impulse and habit
4 foundations of mindfulness
- body/sense
- emotions
- thoughts
- meaning making
body sense
- breathe work
- present to both your internal and external world
emotions
- noticing our reactions to out experiences
- getting to know what we find
1. pleasent
2. unpleasant
3. neutral - avoid, seek or ignore
thoughts
- we believe our own thoughts as objective truth
- when challenged we become defensive
- damages leadership credibility
meaning making
- how we interpret our experiences and attach meaning to them
- we often don’t question our own assumptions or are even aware of them
3 levels contributing to the neuroscience of mindfulness
- cellular
- structural
- functional
cellular
neurotransmitters, hormones and immunity
structural
no less than 8 brain regions
functional
requires the patterns of synapses in the brain
9 typical types of paramedic documents
- ACR
- incident report
- exposure
- injury report
- paramedic referrals
- personal notes
- collision and accident reports
- equipment malfunction report
- daily documentation
which 2 documents can be filled out by a supervisor
- exposure
- injury report
what is paramedic referrals or CREMS used for
referral for social support
what happens if something is not documented
it’s not considered done
NOT DOCUMENTED = NOT DONE
how long must an ACR be kept for at a minimum
10 years
ACR
ambulance call report
when must all ACRS be completed by
the end of shift (you cannot leave or go home with anACR) and documentation must be complete before your go
when is a ACR needed
- whenever a request for an ambulance is initiated
- if you participated or were part of an event you must too sign the report
- cancelled calls must still get an ACR
- every call needs a ACR unless dispatch indicated one isn’t needed
- minimum # of assessments must be met, as soon as you come into contact with a patient a ACR is needed
if there are 25 patients how many ACRS will need to be completed
25 (EVERY PATIENT MUST BE DOCUMENTED)
pertinent negatives
are used when the clinician documents why they DID NOT perform a procedure
example of pertinent negatives
if Aspirin is part of the agency protocol for Chest Pain but was not administered, the reason should be documented. This is done using PN values.
do pertinent negatives point away from associated complications
YES
“He denied shortness of breath”) and rule out other diagnoses (“He denied headache, neck stiffness, nausea, vomiting, diarrhea, dysuria, and rash”)
pertinent oral statements
can be made by patients or others on scene and is anything said on scene that is pertinent to the patient interaction
5 things to make sure for when completing documentation
- accurate
- unaltered
- legible
- free from non-professional and extraneous information
- consider your audience
accurate
- never lie about what you saw or did
- never elaborate and try to male things seem more exciting than they actually were
unaltered
- you have to document on the form in such a way that no one else can go back and alter what was documented
- no one changes the ACR or your way of documentation
- you never want it to be out into question that you left blanks on purpose so that you could go back later and change the documentation
legible
- you have to be able to read what is written
- has to be legible by anyone who could read it
- easier for electronic ACR as its a typed document
free from non-professional and extraneous information
- no personal and opinionated statements
- things that can easily be put into question
consider your audience
- who will read it
- other
1. paramedics
2. health care professionals
3. your service or supervisor
4. police
5. lawyers - its a reflection of you and your service
3 consequences of errors
- implications to medical care
- legal implications
- statistical errors
implications to medical care
- errors written on the form causes issues for ongoing patient care
example of implications to medical care
if you didn’t actually administer a medication but indicated you did on the ACR another HCW in the hospital may draw a general impression as to what was done and make a plan based on what was written down
- wrong vitals or general impressions can even impact patient care
legal implications
- the form can come into question if brought into court
- legal liability or negligence if it was falsified on the ACR
statistical errors
- BH and services take the forms to check patient safety and care it being met
- error itself could result in errors in the statistics of the patients we are seeing and planning of paramedic service going forward
what are ACRs used to determine
- what kind of patients are we seeing
- where are we most frequently receiving calls from
- who does what
- which paramedics are doing certain things in the field
**can skew results interpreted by BH or paramedic services
7 ACR guidelines
- report essential data
- protect confidentiality
- ensure the security of patient information, records and documents
- collect current and historical patient information
- document in a non-judgmental and objective manner
- ensure appropriate distribution
- students cannot complete an ACR standard rule
when is an incident report needed
- any time there is something to do with responding to a call or something happens and there is a delay
example: snow storm might delay us getting to a call
6 possibilities for a needed incident report
- delay or delay of transport
- excessive scene time
- any suspicious or unexpected death
- any suspected or actual crime scenes
- equipment failures affecting patient care outcome or response
- any harm or risk of harm to the patient, crew or any other person in the care of or transported by the ambulance crew
