Legal And Ethical obligations OT Flashcards
Professional Duty of Candour
- Every healthcare professional must be open and honest with patients when something goes wrong with their treatment or care which causes or has potential cause, harm or distress.
Statutory Duty of Candour - 2014
- Applies to organisations not individual
- Organisation which provide healthcare have statutory duty of Candour
- Organisation have duty to support their staff to be open and honest with patients when something goes wrong .
Statutory duty of Candour introduced when ?
-2014 applied in 2015 by NHS bodies
- Applies duty on organisation
GDC 9 standards
1- Put patient interest first
2- Communicate effectively with patient.
3- Obtain valid consent
4- Maintain and protect pt informatio
5- have clear and effective complaint procedure
6- work with colleagues in way for pt best interest
7- Maintain, develope and work within professional knowledge and skills
8- Raise concern if patient at risk
9- Make sure our personal behaviour maintain confidence in us and dental profession
Which GDC standards for dental team already require?
1- Put patient interest first
1.3- be honest and act with integrity
5.3.8 - Offer apology and practical solution if patient makes a complaint
Candour mean?
However Candour means being open and honest with all patients whether they made complaint or not.
Duty of Candour ?
- Being open and honest with patient Before tx
- An important part of being open and honest with patients is having a thorough discussion before tx starts
- it is important that patients understand their options for tx including benefits and risks.
- you must give information in a way they can understand that they understand decision they are being made
- Make sure you give enough time to make decision
Delivering Apology
- as soon as Tell the patient and and we question fully and honestly.
- Apologise in meaningful way rather than being general expression.
- Offer an appropriate remedy or support to put matter right if possible.
- Explain fully short and long term effects of what has happened.
What if patient does not want to know details?
- Respect their decision
- let them know if they change their mind in future , can provide further information
- Record you discussion with patient including their decision not to have further information.
Is apologising to the pt is not the same as admitting legal liability for what happened?
NO
Notifiable Patient Safety Incident
- It applies to incident where something unintended or unexpected has occurred in the care of patient.
Notifiable safety incident is a specific term defined in the duty of Candour regulation.
Do not get confuse with other legislation
Example of Notifiable patient safety incident
- child with UNKNOWN allergy to latex went for dental check up. Dentist wore latex gloves and child had anaphylactic attack. Child made full recovery
Checklist of Notifiable safety Incident.
1- Did something unintended or unexpected happen during care or tx
2- Did it occur during provision of regulated activity
3- has it resulted in death or severe or moderate harm?
Never Event in dentistry
Serious incidents that are wholly preventable because of guidance or safety recommendations that provide strong systemic protective barriers are available at national level and should be implemented by all healthcare providers
Never event in dentistry
The extraction of wrong tooth had been classified as one of the Never events in dentistry but removed from list of never event and classified as PATIENT SAFETY INCIDENT
General Dental Council
Standards for Dental Professionals
- Standards for Dental Professionals
- Principle of Dental Team working
- Principle of Patient Confidentiality
- Principle of Patient consent
- Principle of Complaints Handling
- Principle of Raising Concerns
Putting patient interest first and acting to protect them
- Put patient interest before anyone
- Work within your knowledge and competence. ( Refer for second opinion or further tx when necessary
- Keep full and accurate records including MH
- Deal appropriately with patient complaint
- Do not put patient at risk because of your health or behaviour or of colleague . Seek advice when necessary.
- Do not accept any gift or payment which may appear to affect your personal judgment.
- Do not make misleading claims
Work within your knowledge and competence
-Only work under your scope of practice
- Update CPD/ life long learning
- Post grads courses
- Journal and articles
- Professional meeting
- Research/ awareness of current best , Practice / law and guidelines
- Refresher/ back to work courses
Keep Full and accurate records
- Dated
- Contemporaneous
- Medical history updated
- Nothing option given / pt choices decisions
- Any treatment provided and advice given
- Material used e.g type of anaesthetic
- Any problem encountered
- Further treatment discussed, appt recommended, referral
Respect patient dignity and choices
- Treat patient with respect and dignity
- Always seek patient consent
- Treat all patients fairly - do not discriminate
- Listen to patients and provide them with the information they need to make an informed decision
-Maintain appropriate relationships with patient
Protect confidential of patient information
- All patient information is confidential and only to be used for purpose it’s given
- Keep patients information secure
- In certain cases it is justifiable to disclose pt information without consent. You should get advice before doing this.
Co -Operate with other members of the dental team
- Treat all team members and colleagues fairly - do not discriminate
- Communicate effectively, share your knowledge and skills with other team members.
Maintain your Professional knowledge and competence
- Life long learning
- Identify your limits as well as your strengths
- Find out about current best practice and evidence based guidance
- Follow the law and regulations which affect your work equipement and business
Be trust worthy
- Justify the trust that your pt, public, your colleagues have in you by always acting honestly and fairly
- Apply these principles to professional business and educational activities
- Maintain appropriate standards of personal and professional behaviour
If patient come in emergency you don’t have orthodontist . You can do this
Removal of wire causing trauma
Consent forms
- Implied
-verbal
-written - informed
Best of consent would be ?
Informed and Written
Principle of consent
- Voluntary - they making decision
- Valid
- Informed consent - understand full information
- Capacity - pt has ability to make an informed decision.
Consent
- Is a process not always a one off event
- Discussions should continue through out treatment
- Decision may change or second opinion may be requested at any time
Confidentiality Breach
-If confidentiality breached , dentist/ therapist/ hygienist faces investigation by GDC
- Possible erasure from registration.
- legal action by patient for damages for breach of 1988 data protection act.
When disclosure is in public interest
- Where Expressly the patient has given consent to the disclosure
- Where disclosure is necessary for purposes of enabling someone else to provide health care to pt and patient consented to this sharing information
- where disclosure is required by Statute or ordered by court of law
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