Lesson 1

Question 1

What is effective informed consent?

Answer 1

Gives individual right to make educated decisions regarding their own health.

Question 2

Which patients do we get informed consent from?

Answer 2

Obtained from a patient prior to a medical intervention that has the potential for harm.

Question 3

Adult competence?

Answer 3

Presumed competent unless legally declared incompetent.

Question 4

Minors competence?

Answer 4

Presumed incompetent based on emotional maturity and cognitive age.

Question 5

Rationale for parents/guardians giving consent for minors?

Answer 5

Parents would want “best interest”.

Question 6

Exceptions to minor incompetence rule?

Answer 6

Emancipated minor, minor who is marries, has children, pregnant, military or financially independent. Some states allow exceptions for minors with STDs, reproductive related, mental health, and substance abuse history.

Question 7

What is considered competent?

Answer 7

1. Patient can understand the nature of their condition.
2. Capable of making a rationale decisions: pt must be able to understand treatment available and outcomes of each case.
3. Must be able to effectively communicate their understanding and decision.

Question 8

Three steps to be effective informed consent?

Answer 8

1. Pt has full capacity and competence.
2. Pt must be provided w/ clear and adequate information.
3. Pt must give consent to treatment voluntarily w/o manipulation/coercion.

Question 9

What must we provide the pt for effective informed consent?

Answer 9

P- recommended medical Procedure
A- reasonable Alternatives to the recommended procedure
R- Risks of the procedure
Q- asking the pt any Questions

Question 10

How do you determine if the information you are giving the pt is “adequate disclosure” of info?

Answer 10

Reasonable Person Standard: Information you give to the pt is what a reasonable person would consider significant to making a decision about intervention.

Question 11

Implied consent?

Answer 11

During emergent situations.

Question 12

General consent?

Answer 12

Certain conditions, verbal or written consent sufficient.

Question 13

What do you do if consent is verbal?

Answer 13

Document in chart! Must be written for specific high risk procedures and signed by a witness.

Question 14

How to ensure pt comprehension?

Answer 14

“Teach Back” method.

Question 15

Exceptions to informed consent?

Answer 15

Public health requirement, prevent death/harm, or therapeutic privilege which is hard to justify but it implies the indications/complications/ treatment options could actually cause harm and therefore not done.

Question 16

Who developed universal precautions and in what year?

Answer 16

CDC in 1987.

Question 17

Why were universal precautions designed?

Answer 17

To protect against blood borne pathogens such as HIV, Hep B & C.

Question 18

When were universal precautions revised and what was the revision and what did the recommendations become and what does it include?

Answer 18

In 1996 and it was revised to include all body fluids, secretion, and excretions.
Recommendations became known as Recommendations for Isolation Precautions in Hospitals and it includes standard precautions.

Question 19

What are standard precautions?

Answer 19

Set of guidelines designed to minimize the spread of infectious diseases transmitted by exposure of infectious body fluids. Use in all pts. Treat each pt as they are infectious.

Question 20

Standard precautions for handwashing?

Answer 20

Wash hands after touching blood, body fluids, other contaminated items.
Wash hands immediately after gloves removed.
Wash hands in between pt contacts ( before AND after you see pt).
May need to wash hands even between tasks on the same pt.

Question 21

5 steps to hand washing according to the CDC?

Answer 21

1. Wet your hands w. clean running water (warm or cold), turn off the tap, and apply soap.
2. Lather your hands by rubbing them together with the soap. Lather the backs of your hands, between your fingers, and under your nails.
3. Scrub your hands for at least 20 secs. Hum “happy birthday” from beginning to end twice.
4. Rinse your hands well under clean, running water.
5. Dry your hands using a clean towel or air dry them.

Question 22

Alternative to hand washing?

Answer 22

Alcohol based hand sanitizer (at least 60% alcohol content), rub for 20 seconds until hands dry.

Question 23

Standard precautions for gloves?

Answer 23

1. Wear gloves when touching blood, body fluids, or contaminated items.
2. Gloves should be clean, non sterile gloves adequate.
3. Put on gloves before touching MM and non intact skin.
4. Change between tasks on same pt/procedure if needed.
5. Remove gloves promptly after use, before touching any surfaces, other non-contaminated items, and before your next pt.

Question 24

What should you do immediately after removing gloves?

Answer 24

Wash hands.

Question 25

Standard precautions for mask, eye protection, face shield?

Answer 25

1. Wear during pt activities that are likely to generate splashes/sprays of blood or other body fluids.
2. When performing sterile procedures.

Question 26

Standard precautions for gown?

Answer 26

1. Wear clean, non sterile gown during pt activities that are likely to generate splashes/sprays of blood or other body fluids.
2. Remove soiled gown as promptly as possible in biohazard waste (red bag).

Question 27

Additional/Isolation precautions?

Answer 27

1. Contact
2. Droplet
3. Airborne

Question 28

Standard precautions + Contact Precautions?

Answer 28

A patient infected/colonized w/ microorganisms that can be transmitted by direct contact w/ pt, or indirect pt w/ environment (something pt touches).
Wear gloves even when entering room.

Question 29

Standard precautions + Contact/Droplet Precautions Room?

Answer 29

Private if available or share room w/ someone infected w/ same organism.

Question 30

Examples of contact?

Answer 30

MRSA, VRE, Varicella, enteric infections such Clostridioides difficile, E. coli O157:H7.

Question 31

Standard precautions + Droplet Precautions?

Answer 31

A pt infect w/ microorganism that can be transmitted by droplets (large particle droplets > or = to 5 microns) when coughing, talking, sneezing, or performing procedures. Droplets remained suspended in air for limited periods, transmission is associated with exposure within 3 to 6 feet of the source. Wear mask within three feet of the pt. Mask pt during transport.

Question 32

Cough etiquette?

Answer 32

Pts and visitors should cover nose and mouth when coughing. Promptly dispose used tissues and practice hand hygiene after contact w/ respiratory secretions.

Question 33

Examples of droplet?

Answer 33

Influenza, Haemophilus influenza type B, Mycoplasma PNA, Bordetella pertussis, rhinovirus, adenovirus.

Question 34

Standard precautions + Airborne Precautions?

Answer 34

Pt infected w/ microorganism that can be transmitted by airborne droplet nuclei (small particle residue 5 microns or less) or evaporated droplets containing microorganisms that remain suspended in the air and that can be dispersed widely in room or over a long distance.

Question 35

Standard precautions + Airborne Precautions room?

Answer 35

Private if available or can share room with someone infected with same organism. Room must be negative air pressure in relation to surrounding area, 6-12 exchanges per hour. Room exhaust must be appropriately discharged outdoors or passed through a HEPA filter before recirculation within the hospital. Certified respirator worn when entering room. (OSHA: Occupational Safety and Health Administration)
Mask the patient during transport.
Cough etiquette.

Question 36

Example of airborne?

Answer 36

Tuberculosis, measles, Covid-19, Ebola virus.

Question 37

Sharps safety and needlestick prevention?

Answer 37

Use of the special sharps container permits quick disposal of a needle without recapping and safe disposal of other sharp devices that may be contaminated with blood.
Do not recap, bend, break, or otherwise manipulate any sharp needle or lancet device by hand.

Question 38

Transport and handling of diagnostic specimens?

Answer 38

Specimens should be transported to the laboratory in plastic leakproof bags. Protective gloves should always be worn for handling any type of biological specimen.
If a needlestick should occur – you should report it to supervisor/occupational health.