Legal Aspect of IV CM and Medication Administration Flashcards
It is dictated by the conscience (inner guide) of the individual.
Morals
A set of standards that establish what is right/ good
Moral principles
It is based on the morals of an individual and is dictated by the individual
Ethics
A set of moral principles that govern one’s course of action.
Ethics
It is a mandate and therefore could be changed and could differ from one place to another.
Law
Ex. double checking a medication although it is not your job, but because you are obliged
Morals
Ex. The patient has the right to know what drug will be administered within his body, and what the effects of the drug are
Ethics
Law concerning the RT profession
RA 7431 Radiologic Technology Act of 1992
2 major classifications of the law
- Civil law
- Criminal law
Broken if another person’s private legal rights have been violated. This injury is to one person and not to the entire society.
Civil law
How to prevent civil cases
- Make sure to explain the entire procedure
- Before making an examination, check patient’s identity
- Restrain only a patient to prevent hurting themselves or another person. (For infants, inform the parents first)
Ex CR
Covers a system of laws enacted to punish or reform those who have committed a criminal act against a state or nation
Criminal Law
Pertains to the claim of an individual supported by the law.
Rights
involves personal injury or damage resulting in civil action or litigation to obtain reparation for damages incurred; may be committed intentionally or unintentionally
Torts
Several situations can occur in which a tort can be brought against the health professional because of some action that was deliberately taken.
Intenrional misconduct
It can be filed if the patient is reasonably fearful of being injured by the imprudent conduct of the RT.
Civil Assault
Could be charged if there is an actual bodily harm that has been inflicted on a patient as a result of intentional physical contact between the healthcare provider and a patient.
Civil battery
A tort that protects individuals from unwarranted interference with their personal life or private affairs.
Invasion of privacy
It is an act of giving false statements about a person that destroys the reputation of that person.
Defamation
Defamation two types
- Slander (spoken)
- Libel (written)
Occurs when a person intentionally restricts another person’s movement within any area without legal authority, justification, or the restrained person’s permission.
False Imprisonment
Breach or a failure to fulfil an expected standard of care.
Unintentional Misconduct (Negligence)
Different cases for intentional misconduct
- Civil assault
- Civil battery
- Invasion of privacy
- Defamation
- False imprisonment
False DIBA?
IVP test results in death for only — people
1 in 100,000
The Radiologic technologist owes a duty to the patient based on the standard of care that a reasonable Radiologic Technologist is expected to provide under a similar circumstance.
Unintentional Misconduct (Negligence)
Different cases for negligence
- Contributory negligence
- Comparative negligence
- Assumption of Risks
This happens when the patient is injured due to his own negligence.
Contributory negligence
The injury occurred due to both parties (the patient and radiologic technologist)
Comparative negligence
The patient is informed of the possible risks that he/she may encounter during the examination. It is very important to take an informed consent before any procedure.
Assumption of Risks
A contract wherein the patient voluntarily gives permission to someone (in this case, the imaging staff) to perform a procedure or service.
Informed consent
It protects the patient and healthcare professional legally. This provides the agreement of the patient in conducting the procedure despite the risks of the examination.
Informed consent
5 steps to obtain informed consent
- Disclosure of information
- Comprehension
- Voluntariness
- Competence of Health care professional
- Permission giving by the patient (Authorization)
Disclosure of information is where the RT explains everything to the pt. This includes the (1), (2), (3), and (4)
- examination
- preparation
- possible risks
- contraindication
This involves the patient’s understanding on the information that you gave.
Comprehension
The best way to check whether the patient understood everything is to —
let them — what you have discussed.
The patient should be willingly to undergo the procedure. The patient has the right to refuse if he/she does not want to proceed with the examination.
Voluntariness
Patients who refuse treatmen should sign a —
“refusal or consent” form
it is very important to reassure the patient of your skills as a professional. The medical professional should be competent enough at all times when performing a procedure.
Competence of Health care professional
After receiving adequate information, the patient must explicitly agree to the proposed intervention (may be done verbally or in writing)
Permission giving by the patient (Authorization)
Permission for less invasive or routine procedures.
Verbally
Permission for major interventions or surgeries, usually documented through a consent form.
In writing
For an informed consent to be valid, the patient:
- must be of legal age and mentally competent.
- Tmust offer consent voluntarily (no coercion).
- should be adequately informed about the medical care being recommended.
Different types of consent
- Implied consent
- Expressed consent
- Written consent
- Spouse consent
- Surrogate consent
This consent involves granting permission for healthcare worker without a formal agreement between the patient and the healthcare provider.
Implied consent
The consent was given verbally by the patient to the healthcare provider.
Expressed consent
This is the safest form of informed consent that involves the signature/agreement of the patient written in a form.
Written consent
This type of consent depends on the law of a certain land.
Spouse consent
An authorized person makes medical decisions on behalf of a patient who is unable to do so due to incapacity.
Surrogate consent
It is very important for a Radiology department to set a policy and procedure on the following topics:
- Contrast reaction protocol
- Basic CPR training
- History taking of patient
- Resuscitation equipment
- Oxygen tank
- Intravenous access
- Patient observations
- Placement of contrast material
- Emergency drug box/ medicine cabinet
- Informed consent
(IM TOP CHIRP)
It is very important to know the possible flow of reaction of contrast media to know the standard of care for these situations.
Contrast reaction protocol
A lifesaving technique used during emergencies.
Cardiopulmonary resuscitation (CPR)
(1): This indicates if the patient has an allergy to certain drugs that may affect the procedure. A (2) should be evident in the department in order to have uniformity among all staffs during an interview.
- History taking of patient
- standard and detailed history taking
Resuscitation equipment: A — should be available nearby the department or imaging area for emergency purposes.
crash cart
(1) should be present in every room that performs contrast examinations. The amount of oxygen to be introduced should be found in the (2).
- Oxygen tank
- protocol
The department should develop its own protocol with guidelines regarding —. Orientation of staff is also important and critical in performing contrast studies.
IV access
This includes observing for signs and symptoms that may occur during any radiographic examination, most especially to contrast studies.
Patient observations
Contrast media should be stored properly in order to last longer. It is very important to be organized and cautious to where you store these contrast agents.
Placement of contrast material
Located in a visible and easily accessible area, typically near imaging rooms where contrast agents are used.
Emergency drug box/ medicine cabinet
There should be a protocol and a policy on how — is taken from the patient.
informed consent
Best form of allergic reaction prevention
Patient observation
Responsibility and Accountability: Medico-Legal Aspects of CM
- Check the date and type of CM
- Check the quantity
- Check for the lot number
- Check the route of administration
- Check the temperateure
- Check the glass of the CM
(G! DQ LRT)
Always note it down on the patient’s chart.
date and type of CM
Check for the date of (1) and date of (2).
- manufacturing
- expiration
The dosage is computed according to the(1) and (2) to be examined.
- body mass
- body part
In case an adverse effect happens, look for the —to see if there is a problem with the manufacturing. This should be done especially if the color is okay and the agent is not expired.
lot number
Commonly they use the vein unless in case of (1). If the venous entry fails, it can be done (2) but it is not the duty of the radiologic technology to perform this.
- catheterization
- arterially
The temperature affects the (1) of the CM. If the temperature is colder, the CM tends to be (2).
- viscosity
- more viscous
Check for a — in the glass that can cause problem upon administration of contrast agent. If a — is visible, do not use the CM anymore.
chip
This is to ascertain that the patient has no allergy to CM or any other substances.
Check the patient’s detail
To know who introduced the CM during the procedure or to know the entire procedure.
Check the details of radiologist or injecting radiographer
Never do the procedure if the attending physician or radiologist did not sign the request of the patient.
Make sure that the request form has been signed
This is to prevent contamination and the risk of having infection.
Obseve aseptic technique
An injury to a patient or any error made by personnel in the diagnostic imaging department must be documented in a/n — as soon as it is safe to do so.
incident report
When filing an incident report, write in simple terms (1), (2), (3), (4), (5), (6), and what was done to alleviate the situation at the time.
- what occurred
- at what time
- on what date
- in which room or department
- to whom
- who was present
An injury to a patient or any error made by personnel in the diagnostic imaging department must be documented in an incident report —
as soon as it is safe to do so
