Orders, sexual abuse, and the HCCA Flashcards
What two pre-requisites (other than being an MRT) are needed for you to preform an authorized act?
- You need to have an order
- You need to be competent
What legislation mandates who can prescribe an x ray procedure in ontario?
The H.A.R.P act
What are the 2 types of orders?
- Direct order
- Medical directive or protocool
What catagory would verbal orders fall under?
Direct order
Who are direct orders for?
- A specific patient
- A specific treatment
What needs to be included in a direct order?
- Dated
- Authenticated by order health professional
- In writting
What is a verbal order?
A direct order communicated over the phone or electronically transmitted.
What must a verbal order contain?
- Name of health professional ordering it
- Date and time it was ordered
- Be signed by the individual accepting it
Who is a medical directive order for?
A specific treatment for a range of patients that meets that range of criteria
True or false?
A medical directive is always written.
True
What is another name for a medical directive?
A standing order
Name 3 different things that must be included in a medical directive:
There is over 3, but for test purposes, only name 3
- A standardized reference number
- What the treatment or range of treatments are
- Who may preform this proceedure
How are concerns about orders resolved?
- Discussing the concern directly with the responsible health professional
- Identifiying outcomes desired for resolution
- Providing a rationale and best practice evidence in support of the concern
- Documenting the concern and steps taken to resolve it in the appropriate record
How many controlled acts are MRTs authorized to perform?
5
Can you preform a controlled act that you are not authorized to perform?
No, but if you are delegated, you can do it
What is delegation?
The transfer of authority to perform a controlled act
MRTs may accept delegation of acts provided what?
The delegator:
1. Is authorized
2. Not been restricted from performing this act
3. Has knowlege, skill, judgment to perform and delegate task
4. MRT member has competency
5. A written record of transfer of authority
6. MRT complies with any conditions
True or false?
CMRITO members can accept the delegation of a controlled act.
True
True or false?
CMRITO members cannot delegate authorized acts to others.
True
To complete any type of order, a CMRITO member must be what 3 things?
- Competent
- Accountable
- Collaborative
How can we prevent sexual abuse as a profession?
- Ask for consent
- Communication and explain the reason you are doing things
What are the 2 courses of action for discipline for sexual abuse?
- Reprimand the member
- Revoke the members registration if any sexual abuse has occured
How much can the commitee find the member for sexual abuse?
- Up to $35000
- Legal costs incurred by the college
- Require the member to reimburse the college for any funding provided for victim
What are 3 communication principles developed for CMRITO members?
More than 3, just name 3
- Talk before you touch
- Treat each patient as an individual
- Maintain confidentiality
List 3 communication tips set out by the CMRITO sexual abuse prevention program:
(more than 3 just name 3 for testing purposes)
- Use diagrams or charts
- Legitimize the patients feelings
- Be tact and considerate
What are 3 touching principles developed for CMRITO members?
(more than 3, only name 3)
- Touch only when nessesary
- Respect cultural diversity
- Get patients consent
True or false?
The RHPA advises that CMRITO members file a written report to the college if the member has reasonable grounds, obtained in the course of their practice to beleive that a patient has been sexually abused by a CMRITO member or any other health professional.
False; they REQUIRE
True or false?
Failure to report cases of sexual abuse committed by health professionals can lead to penalties.
True
What information must be included on a report about sexual abuse committed by a health care professional?
- Name of person filling report
- Name of professional alleged to have committed the abuse
True or false?
In cases of any suspected child abuse, regardless of a members professional practice, a report must be done immediately.
True
What are some x ray signs that can indicate child abuse?
- Posterior rib fractures
- Metaphyseal corner fractures (bucket handle fractures)
- Diaphyseal fractures in children under 3
- Skull fractures
- Multiple injuries at different healing stages
What are some phyical signs that indicate a child may be being abused?
- Cigarette burns
- Bruises
- Behaviour
- Improbable explanations
What is the act governing consent to treatment in ontario?
The health care consent act (HCCA)
What is a course of treatment?
A series or sequence of similar tratments administered to a person over a period of time for a particular health problem
What are exceptions to getting consent for treatment?
- Taking a person’s health history
- The communication of an assessment or diagnossis
- The assesment or examination of a person to determine the general nature of the persons condition
Is the use fo ionizing radiation by an MRT considered treatment?
Yes. Done for diagnostic purposes
Do MRTs need written consent from a patient to preform an x ray?
No
What are the 2 elements of consent?
- Consent
- Capacity
What are 3 requirements of consent for the patient recieving treament?
The patient must:
1. Be informed
2. Be voluntary
3. Not be obtained through misinterpretation or fraud
When must consent be given?
Always BEFORE the proceedure
When can patients withdraw consent?
Any time before or during the procedure
When are patients considered capable to give consent?
- If they understand the information that is relevant to making a decision about the proposed treatment and;
- Appriciate the reasonably forseeable consequences of accepting or refusing the treatment or of making no decsion
What are charecteristics that can cause concerns about a persons capacity?
-The person appears to be impaired by alcohol or drugs
-The person appears to be severely depressed
-The person is experiencing pain, acute fear or anxiety
True or false?
The existence of a phychiatric, neurological diagnosis, or disability are indicators that a person is uncapable to give consent.
False; should not be used as grounds for incapacity on thier own
True or false?
Capacity is fluid.
True
What do you do if the patient is incapable of consenting?
Provide a substitute decision maker
Who are the people that should be contacted to be the substitute decision make if a patient is incapable?
(in order from who should be contact first)
- Gardian or person appointed by court
- An attourney for personal care under power of attorny
- Representitive appointed by the consent and capacity board
- Spouse/partner
- Child of patient, parent or patient, or CAS
- Parent with only right of access
- Sibling
- Any other relative
- The public guardian and trustee
What are the exceptions to gaining consent prior to providing treatment for an incapable patient
If it is considered an emergency (patient severly suffering/at risk of sustaining serous bodily harm)
What circumstances must the patient meet in order for the emergency exeption to apply?
- The patient must be incapable
- The delay will prolong suffering or risk serious harm
- Communication with a capable patient is not possible due to barriers such as language/disability
What are the steps for obtaining consent?
- Determine the patients capacity
- If patient is incapable and its not an emergency, follow the guidelines of your college
True or false?
If the patient/someone else intends to apply to the board of consent to make a decision, you must give them time to do so.
True, providing not an emergency situation
Who gets consent for x ray procedures?
Doctors
What is our role concerning consent for x ray proceedures?
To verify consent
What does PHIPA stand for?
Personal health information protection act
What does PIPEDA stand for?
Personal information protection and electronic documents act
True or false?
Patient information can be shared within the circle of care if required for practicing.
True
True or false?
Members can share patient inormation and discuss patient care in a public setting, provided that no names are used.
FALSE
What is the PHIP act for?
For protecting the collection, use and disclosure of personal health information
