PCM 2 Unit 1 Flashcards
Regulations encoutntered in Acute and Post-Acute Care Setting
What are some fall risk a patient may have?
- Prior level of function, prior falls
- Cognition, behavior, CLOF
- Polypharmacy
- Bowel and Bladder function
- Diagnosis associated with falls
- Vision
- Lines and equipment
Regulations encoutntered in Acute and Post-Acute Care Setting
What are some things us PT can be cautious of to assist patients to prevent falls?
- Alarm systems
- Proper footwear
- Medications
- Toileting schedule
- Good lightling
- Mobilization
Regulations encoutntered in Acute and Post-Acute Care Setting
How are Restraints defined?
Any manual method, physical or mechanical device, material or equipment that immobilizes or reduces ability of a patient to move his or hers arms, legs, body, or head freely; a drug or medication when it is used as a restriction to manage the patient’s behavior or restrict the patients freedom of movement and it is not the standard treatment or dosage for the patients condition
Regulations encoutntered in Acute and Post-Acute Care Setting
When is it indicated to use restraints on a patient?
- Patient who poses a risk to themselves or others
- Patient that requires it in order to provide treatment (surgical)
Regulations encoutntered in Acute and Post-Acute Care Setting
What are the requirements need in order to restrain a patient?
- MD that must be updated every 24 hours
- Depending on the type of restraints and facility policy -> Patient must be monitored continuously, hourly, every 4 to 6 hours
Regulations encoutntered in Acute and Post-Acute Care Setting
What are different types of restraints?
- Wrist restraints
- Ankle restraints
- Mitt restraints
- Vest restraints
- Bed rails (all 4)
- Wheelchair seatbelts
- Medications
Regulations encoutntered in Acute and Post-Acute Care Setting
What are some risk associated with the use of Restraints?
- Strangulation/Asphyxiation
- Mobility limitations
–Pressure ulcer formation
–Urinary incontinence
–Constipation
–Pneumonia
–Deconditioning
Regulations encoutntered in Acute and Post-Acute Care Setting
Should the use of restraints be a first resort or last resort option for a patient?
Use of restraints should be a last-resort option after all alternatives have been explored
Regulations encoutntered in Acute and Post-Acute Care Setting
What are some Alternatives that can be used instead of restraints?
- Schedule toileting
- Food and fluids
- Sleep
- Walking
- Diversions (reading/activites)
- The recriutment of familty memebers
- Alarms (bed and w/c) to alert staff when a patient has moved from a bed or chair unassisted
- Adequate pain management
- Sitters (alternative methods of camouflaging or securing medical devices, lines, or wires)
Regulations encoutntered in Acute and Post-Acute Care Setting
What are the General Guidelines for Restraint use?
- Use Slip knots instead of square knots
- Secure to stable / Removeable objects
- Avoid attaching it to where the patient is lying or sitting
- Avoid attaching to where the patient can easily remove it
- Make sure its secutre but not tight (2 finger test)
- Relace after therapy session
- Take into consideration the effects of a chemical restraint on treatment session
Regulations encoutntered in Acute and Post-Acute Care Setting
Why are Hospital Emergency Codes important?
Facilities use codes to convey crucial information quickly with mininum misunderstanding by staff while avoiding panic and stress to the patients and those who are visiting the hospital
Regulations encoutntered in Acute and Post-Acute Care Setting
What is Code Red?
Fire
Regulations encoutntered in Acute and Post-Acute Care Setting
What is Code Blue?
Adult heart or respiratory emergency
Regulations encoutntered in Acute and Post-Acute Care Setting
What is Code Orange?
Hazardous material spill or release
Regulations encoutntered in Acute and Post-Acute Care Setting
What is Code Yellow?
Bomb threat
Regulations encoutntered in Acute and Post-Acute Care Setting
What is Code Grey?
Combative person
Regulations encoutntered in Acute and Post-Acute Care Setting
What is Code Silver?
Person with a weapon/Hostage situation/Active Shooter situation
Regulations encoutntered in Acute and Post-Acute Care Setting
What is Code White?
Pediatric medical emergency
Regulations encoutntered in Acute and Post-Acute Care Setting
What is Code Purple?
Child abduction
Regulations encoutntered in Acute and Post-Acute Care Setting
What is Code Pink?
Infant abduction
Regulations encoutntered in Acute and Post-Acute Care Setting
What is Code Green?
Missing High-Risk Patient
Regulations encoutntered in Acute and Post-Acute Care Setting
What is Code External Triage?
External Distaster
Regulations encoutntered in Acute and Post-Acute Care Setting
What is Code Internal Triage?
Internal Emergency
Regulations encoutntered in Acute and Post-Acute Care Setting
What is Code Code Clear?
To clear a code
Regulations encoutntered in Acute and Post-Acute Care Setting
What is HIPAA?
Health Insurance Portibility and Accountability Act
- A federal law enacted to protect health care-related information
Regulations encoutntered in Acute and Post-Acute Care Setting
What is the HIPAA privacy rule?
- Protects all “individually identifiable health information” aka “protected health information (PHI)” of any kind (oral, papter, electric)
- Allows patients to access their health records and control use of it by other professions
- Sets standards for the maintaining and transmitting the PHI
Regulations encoutntered in Acute and Post-Acute Care Setting
With HIPAA, what are individually identifiable information?
- Data that relates to patients physical and mental health
- Health care provided to the patient
- Payment for healthcare services
- Common identifiers:
–Name
–Address
–DOB
–Social security number
Regulations encoutntered in Acute and Post-Acute Care Setting
With HIPPA, what are Violations of the Privacy rule?
- Providing PHI to other health care professionals that are not involved with the patients care
- Accessing a patients record taht you are not treating
- Not being compliant with a patients request for their medical record within 30 days
Communication
What are the Foundations of Communication?
- Building rapport
- Active Listening
- Empowerment
- Empathy
Communication
What is Verbal Communication? How can it be presented to the listener or patient? How is raport built?
Verbal communication should be represented in a language that the listener understands
- Brief and concise
- Your tone, volume, and inflection of your voice can detract or add to the message
–Can stimulate or calm a patient based on your voice and behavior
Build rapport by showing:
–Active listening
–Empowerment
–Empathy
Communication
What is Attentive/Active Listening?
This is essential for effective communication
- You evaluate the patients tone of voice
- Observe non-verbal cues
- Listen for the main theme of the message then reflect that information back to the patient/colleague
- Focus on the content of the message instead of the way its being communicated
- Clarify the message to ensure understanding
Miscommunication can attribute to medical errors
Communication
What is Empowerment? What are the General Principles?
The ability to engage your patient as an active participant in their care
Communication
What is Empathy?
The ability to understand and share the feelings of others
- This greatly strengthens the relationship
- This is displayed verbally and non-verbally
Communication
How is Non-verbal communication demonstrated?
Through facial expression, posture, gestures, body movements and changes in body responses
This is demonstrated through therapeutic touch
This makes up the majority of human connection
Communication
With Written Communication, what should be included in documentation?
- The patients primary and treatment Dx
- Physician’s orders
- The patient barriers to treatment and their resolution
- The patient’s consent to treatment
- The POC, which includes goals, interventions
- Proposed frequency and duration, and discharge
- Short-term and Long-term goals
- Risk or benefit of treatment
Communication
With Written Communication, how can you enhace patient education?
- Brief, concise, and specific use of language that is understood by the patient
- Diagrams, drawings, photographs or videos can enhance communication of concepts
- Pay attention to the patients and their caregivers non-verbal communication as an indicator for how the information is being received
Typed or printed instructions are easier to read
What can poor communication in the Acute Care Setting lead to?
- Patient harm
- Increased LOS
- Poor resource use
- More intense caregiver dissatisfaction
- Rapid turnover
Communication Problems tend to be classified into four categories, what are they?
- Late delivery of communication thus not being effective
- Not communicating with all the relevant individuals on the team
- Content not consistently complete or accurate
- Communications whose purpose were not achieved, thus leaving issues unresolved
What is SBAR?
This stands for:
Situation: what is going on with the patient?
Background: What is the clinical background or contex?
Assessment: What do I think the problem is?
Recommendation: What do I think needs to be done for the patient?
How can SBAR be effective for Communication?
- SBAR provides a standardized means for communicating in patient care situations
- SBAR provides a common and predictable structure for communication, can be used in any clinical domain, and has been applied in obstetrics, rapid response teams, ambulatory care, ICUs and other teams
- SBAR also present guidelines for organizing relevant information when preparing to contact another team member, as well as the framework for presenting the information, appropriate assessment, and recommendations
What is Cultural Competence in Health Care?
This refers to meeting the needs of people from distinctive ethic and racial groups as well as those with disabilities, diverse socioeconomic status, and LGBT communities
- This can:
–Improve patient outcomes
–Decrease health disparties
–Secondary benefits are improved patient satisfaction, increased adherence to medical advice
What are the 3 dimensions of Cultural Competence?
- Self awareness and reflection:
–Biases, prejudices and values - Respectful communication
–Lern about cultural norms and traditions of diferent ethnic and religious groups - Collaborative partnerships
–Mutural respect, expectations and acceptance of plans
What is the LEARN model for culturally effective commuication?
Listen
Elicit
Assess
Recommend
Negotiate
What are barriers to delivering culturally competent care?
- Inadequate knowledge
- Decreased self-awareness
- Impaired organizatinal systems and structure
- Limited resources
What are the solutions to reducing barriers of culturally competent care?
- Recognizing differences between yourself and your patients
- Language accessibility
- Building diverse representative teams
- Educate the organization and community
What are some resoures to promote cultural competence?
- Expand patient education literacy materials
- Cultural competence training
- Interpreters
- Diversify staffing
