Objectives 20-36

Question 1

Abandonment*

Answer 1

Act of leaving a patient who is dependent on the caregiver’s presence; applies to all surgical patients
Leave patient alone in operating room or at any time during transport
Leave patient with transport stretcher side rails down and walk away

Question 2

Assault*

Answer 2

Act that causes a person to fear that he/she will be touched in an offensive, insulting, or physically injurious manner; A simpler definition: assault is a threat (or perceived threat)
Surgeon threatens to harm you

Question 3

Battery*

Answer 3

Actual act of harmful or unwarranted contact

Operate on patient without consent

Question 4

Doctrine of corporate negligence*

Answer 4

An organization fails to ensure that acceptable level of patient care is provided

Question 5

Doctrine of reasonably prudent person*

Answer 5

Act is measured by determining what a reasonably prudent person would do in the same situation; we should perform an action as any reasonably prudent person would

Question 6

Iatrogenic injury*

Answer 6

An injury resulting from the action of health care professionals
Amputate wrong leg
Take out the wrong kidney

Question 7

Invasion of privacy*

Answer 7

Disclosure of private information without consent

Question 8

Liability*

Answer 8

an obligation to do or not do something; being held legally accountable for our actions

Question 9

Malpractice*

Answer 9

A negligent act that results in patient harm; a person’s wrongful conduct
Lack of attention to surgical counting results in item left in patient
Medications not labeled, wrong med given

Question 10

Negligence*

Answer 10

A breach of duty; doing something a reasonable person would NOT do or failing to do something that a reasonable person WOULD do; does not necessarily cause harm to patient
Lack of conscientiousness in aseptic technique
Lack of attention to surgical counting procedures
Not labeling medications on back table

Question 11

Res ipsa loquitur*

Answer 11

Latin for “The Thing Speaks for Itself”; a legal concept indicating that the harm caused was obvious
Sponge/instrument left in
Wrong leg amputated; wrong kidney removed

Question 12

Respondeat superior*

Answer 12

“Let the Master Answer”; your employer is responsible for your actions (as long as you are functioning under your job description limits); borrowed servant doctrine sometimes overrides this.

Question 13

Tort*

Answer 13

A civil wrong; intentional or unintentional

Question 14

EXAMPLES OF UNINTENTIONAL TORTS THAT COULD OCCUR IN SURGERY

Answer 14

Patient misidentification (wrong patient)
Performing wrong procedure (wrong site)
Retained foreign objects
Patient burned
Improper specimen handling or loss
Injury due to equipment malfunction
Loss or damage to patient property
Harm due to break in sterile technique
Abandonment
Medication error

Question 15

General consent

Answer 15

The patient’s agreement to be admitted to hospital for routine services

Question 16

Special informed consent

Answer 16

Additional permission that is required for any procedure with more than normal risk
Must be acquired for any procedures that demands risk, such as implants or any surgical procedures.

Question 17

EXAMPLES OF PROCEDURES THAT REQUIRE SPECIAL INFORMED CONSENT.

Answer 17

Any surgical procedure
Administration of anesthesia
Any surgical procedure that will affect one’s ability to reproduce
     Vasectomy
     Hysterectomy
     Tubal ligation
Chemotherapy

Question 18

ITEMS THAT MUST BE CONTAINED ON A PROPERLY WRITTEN INFORMED CONSENT FOR SURGERY.*

Answer 18

Patient’s legal name
Surgeon’s name, not the signature
Name of surgical procedure
Patient’s signature
Witness signatures
Date and time of signatures

Question 19

IDENTIFY CONDITIONS UNDER WHICH A PATIENT IS ABLE TO GIVE INFORMED CONSENT.*

Answer 19

Patient has capability and authority
Patient is of legal age (includes an emancipated minor)
Patient is mentally alert
Patient is legally competent

Question 20

options for obtaining consent for surgery in emergency situations.

Answer 20

Telephone
Electronic
Administrative consent

Question 21

rules for legally proper surgical documentation.*

Answer 21

Correct spelling and eligible handwriting
Must be written using standard terminology and approved abbreviation.
Factual in nature and not subjective
Written records corrected with single line drawn through and initialed
Legal signature used; in ink

Question 22

Expectations of THE AHA’S PATIENT CARE PARTNERSHIP’S

Answer 22

High quality Hospital care
Clean and safe Environment
Protection of patient privacy

Question 23

High quality Hospital care

Answer 23

Qualified providers
Educated and certified or licensed
Up to date, properly functioning equipment
Following established Standards of Practice (evidence-based)

Question 24

Clean and safe Environment

Answer 24

Proper cleaning of operating room between patients
Protection from equipment hazards
E.g.; grounding pad with ESU
No cross-contamination
Health care workers free of communicable disease

Question 25

Protection of patient privacy

Answer 25

HIPAA requirements | The only information that is shared is that which is necessary to provide care

Question 26

State the purpose of a hospital’s risk management program.

Answer 26

The main purpose of the risk management program in the healthcare setting is ensure patient safety and reduce medical errors that jeopardizes the hospital’s ability to achieve its mission and protect against financial liability.

Question 27

examples of sentinel events reported within a hospital’s risk management program.*

Answer 27

``` Falls (from wet floors or objects) Wrong patient, wrong site, wrong procedure Medication errors Intraoperative burns (surgical fires) Loss of specimen Violence in the workplace (harassment, threats, bullying) Retained foreign bodies Malfunctioning equipment ```

Question 28

IDENTIFY ORGANIZATIONS USED AS RESOURCES FOR CURRENT INFORMATION ON REDUCING MEDICAL ERRORS IN SURGERY.*

Answer 28

Nationally: Association of Surgical Technologist (AST) The joint commission The council on surgical and perioperative safety (CSPS) No thing left behind

Question 29

OBLIGATIONS REQUIRED BY THE SAFE MEDICAL DEVICE ACT.

Answer 29

Device tracking Report all incidents in which a medical device or user error may have caused or contributed to the death or serious injury to the patient

Question 30

EXPLAIN THE IMPACT OF THE CONFIDENTIALITY STANDARD OF HIPAA ON SURGICAL TECHNOLOGY PRACTICE.*

Answer 30

The only information we are allowed to share is what is necessary to continue a patient’s care. Everything else is confidential. The confidentiality standard of HIPAA means that we can’t share patient information unless it is needed to care for a patient. It applies to everyone in the operating room. I cannot discuss what I observed in surgery with anyone outside of my closed classroom in a learning environment. I can’t talk about what I saw that day with my friends or in the student lounge. If I do, then I am not demonstrating ethical conduct and failure to keep information confidential may result in immediate removal from the clinical site setting and dismissal from the program.

Question 31

MORAL PRINCIPLES USED TO GUIDE ETHICAL DECISIONS.

Answer 31

``` Benevolence (for good) Trustworthiness Honesty Justice (fair and equitable treatment for all patients) Prevention of harm (do no harm) Refusal to take unfair advantage ```

Question 32

FACTORS TO CONSIDER IN MAKING AN ETHICAL DECISION.

Answer 32

``` Accountability/responsibility Corporate integrity Cultural beliefs Religious beliefs Personal (moral) values ```

Question 33

Accountability/responsibility

Answer 33

Are you willing to be accountable/responsible for your decisions/actions

Question 34

Corporate integrity

Answer 34

The facility administration guards integrity of facility; corporate values

Question 35

Cultural beliefs

Answer 35

Your personal decisions; respect others’ for their decisions | Don’t have to agree with their decision, but respect their right to make it based on their cultural norms

Question 36

Religious Beliefs

Answer 36

We can’t force ours on others

Question 37

Personal (moral) values

Answer 37

we can’t force our morals on the patient. We must respect a patient’s right to make their own decisions based on their moral values, but we don’t have to agree with their decision.