Professional Aspects Exam Flashcards
In 2016, the Council on Accreditation of Nurse Anesthesia Educational Programs established the Programs’ Transition to the_______
Doctoral Level policy.
In 2016, the Council on Accreditation of Nurse Anesthesia Educational Programs established the Programs’ Transition to the Doctoral Level policy. This policy mandates that all accredited programs offer a doctoral degree for students entering programs as of
January 1 of: 2022
A principle of tort law assigning responsibility to the hospital for damages caused an employee of the hospital is
the doctrine of “Respondeat Superior”
Explain the principle of TORT LAW
One of the principles of tort law was the doctrine of “respondeat superior”: let the master answer. When damage is caused by a servant (employee), the master (employer) should be held responsible for it.
The anesthesia-care provider establishes a duty to the patient when?
the provider-patient relationship is established
As a care-provider, duty is established when
the provider-patient relationship exists
There are certain general duties that all providers have to their patients such as
obtaining informed consent, and discussion of risks and alternatives.
During a study of the effects of low-dose dopamine versus placebo on renal perfusion, data was collected and the χ2 test was used for data analysis. The χ2 test helped to determine:
if the null hypothesis was valid
The χ2 test is appropriate for deciding what?
if proportions of data falling into categories are different at a given level of significance.
What information does X2 tells us?
the decision to reject or accept the null hypothesis can be made.
Under US Law, cases supporting anesthesia as a practice of both medicine and nursing include: (Select 2)
- Chalmers-Francis v. Nelson,
2. Frank v. South
What are regulations? .
Regulations: are specific written policies adopted by an administrative agency
Regulations are also frequently referred to as
“rules.”
State administrative agencies derive their rulemaking authority from what?
from an enabling law.
A z score represents what?
how many standard deviations a given raw score is above or below the mean.
4 Reasons that a null result may be obtained include:
- There really is not the trend or difference that the researcher believes exists.
- The sample of cases and observations included in the analysis is biased.
- There are insufficient cases in the sample to detect the trend.
- The measurements chosen have very high or inherent random variability.
What standard is this: There shall be complete, accurate, and timely documentation of pertinent information on the patient’s medical record.
Standard VI
What standard is this: Obtain informed consent for the planned anesthetic intervention from the patient or legal guardian.
Standard II
What standard is this: Transfer the responsibility for care of the patient to other qualified providers in a manner that assures continuity of care and patient safety.
Standard VII
What standard is this: Formulate a patient-specific plan for anesthesia care
Standard III
Prion diseases are responsible for:
spongiform encephalopathies
Prions are highly resistant to denaturation with chemical agents What is the significance of that?
disinfection and sterilization of reusable medical instruments a unique challenge because effective prion decontamination relies upon protein hydrolysis or destruction of protein tertiary structure
Prions are composed of
misfolded protein without nucleic acid
They are responsible for the transmissible spongiform encephalopathies
Prions
Bovine spongiform encephalopathy aka or “nd
mad cow disease” in cattle a
Like mad cow disease in humans is
Creutzfeldt–Jakob disease (CJD) in humans.
What happens when prions enters the human body?
When a prion enters a healthy organism, it provides a template to guide the misfolding of normal protein into the extremely stable prion form, highly resistant to denaturation by chemical and physical agents.
Mechanisms of maintaining coverage when changing professional liability carriers include the: 2
- use of a retroactive policy date
2. use of tail coverage
There are ways to change professional liability insurance carriers while still
maintaining continuous coverage.
Methods to maintain coverage include the placement of a retroactive start date on the new policy and the acquisition of tail coverage, which provides what?
insurance coverage for events that may have occurred during the time of coverage of the previous policy.
The doctrine known as “Captain of the Ship” holds that:
the surgeon assumes control of the operating room and staff and may be held liable for any negligence occurring in the operating room
The doctrine known as “Captain of the Ship” holds that once the surgeon assumes control of the operating room, the surgeon is responsible for everything, including
negligence, that occurs.
Punitive damages: result from
wanton, reckless or fraudulent negligence
The law allows for 3 different types of damages. What are they?
General Damages
Special Damages
Punitive Damages
The Law allows for how many damages?
3
What are general damages?
those such as pain and suffering that directly result from the injury.
What are special damages are those
actual damages that are a consequence of the injury, such as medical or funeral expenses.
Punitive damages are intended to punish the care-provider for
negligence that was reckless, wanton, fraudulent or willfu
Punitive damages are intended to punish the care-provider for
negligence that was reckless, wanton, fraudulent or willful
After abdominal surgery, the patient arrived to the PACU with a stridor, which was found to be the result of laryngeal edema with vocal cord laceration, secondary to difficulty with intubation. Damages may be awarded to this patient due to:
res ipsa loquitor “ The thing speaks for itself”
Re
Res ipsa loquitor means
“the thing speaks for itself”.
What does RES IPSA LOQUITOR states?
This holds that under certain circumstances the mere fact that the damage occurred (e.g. a corneal abrasion) is sufficient proof of negligence without requiring the plaintiff to have to prove a specific act of negligence.
Interpretations of the law by the attorney general are:
not binding on the courts. However, they are important because they tell how the executive branch will act.
Research studies focused on the changes noted in a sample over the course of time are known as:
longitudinal studies
Longitudinal studies deal with changes in a study group over the course of time.
prospective (A.K.A. cohort) studies
retrospective (A.K.A. case-control) studies.
Cross-sectional studies deal with a
phenomenon at a particular point in time.
The null hypothesis asserts that: there is
no difference between groups or relationship between variables
The null hypothesis claims that any
differences in the data are due to chance, or that any difference among groups is due to random effects.
Within the AANA bylaws, there are provisions allowing for the establishment of 3 separate and autonomous councils including the: (Select 3)
The councils do not report to the association president or executive director, with the exception of evaluation oversight.
- The National Board on Certification and Recertification of Nurse Anesthetists (NBCRNA)
- Council on Accreditation of Educational Programs in Nurse Anesthesia
- Council for Public Interest in Anesthesia
Within the AANA bylaws, there are provisions allowing for the establishment of 3 separate and autonomous councils including the: (Select 3)
- The National Board on Certification and Recertification of Nurse Anesthetists (NBCRNA)
- Council on Accreditation of Educational Programs in Nurse Anesthesia
- Council for Public Interest in Anesthesia
These 3 autonomous councils are solely responsible for their
own internal affairs, including the election of officers and the direction of financial activities.
According to Standard V of the Scope and Standards for Nurse Anesthesia Practice: (Select 2)
- continuous end-tidal carbon dioxide monitoring is required on all patients during controlled or assisted ventilation
- continuous electrocardiography and monitoring of heart sounds are required on all patients
Standard V concerns the
monitoring of the patient’s physiologic condition as appropriate for the type of anesthesia and patient needs.
State all the provision of standard V:
- Monitor ventilation continuously with auscultation, chest excursion and ETCO2 during controlled or assisted ventilation. Use spirometry and ventilatory pressure monitors as indicated.
- Monitor oxygenation continuously with clinical observation and pulse oximetry.
- Monitor cardiovascular status continuously via electrocardiogram and heart sounds. Record blood pressure and heart rate at least every five minutes.
- Monitor body temperature continuously on all pediatric patients receiving general anesthesia and when indicated on other patients.
- Monitor neuromuscular function and status when neuromuscular blocking agents are administered
- Monitor and assess patient positioning.
An administrative agency, such as the Food and Drug Administration: combines what
combines all of elements of the three branches of government
An administrative agency is part of the
Regulations issued must be consistent with enabling acts and other legislation..
executive branch.
Administrative agency such as the FDA, As an entity, it combines all 3 branches of the government,
has a legislative function, an executive function as well as a judicial function in that the agency can conduct hearing s on charges and determines guilt or innocence.
The limits of your professional liability coverage are $1,000,000/$3,000,000, this means that: (Select 2)
- $1,000,000 of coverage is available for any one event in a policy year
- $3,000,000 of coverage is available for the sum of events in a policy year
Limits of professional liability coverage have two components. The limits are indicated with a
slash mark between two numbers
Damages based on the value of the injury caused are called
compensatory damages
Damages based on the value of the injury caused, even if it is difficult to value, are called compensatory damages. If the wrongdoing has been intentional or gives a sense of outrage
courts may aware punitive or exemplary damages.
An important aspect of punitive damages is the
lack of insurance coverage.
The most commonly considered evidence of whether an appropriate standard of care was upheld comes from:
expert witnesses
Generally, depositions: are done where?
conducted outside the courthouse by agreement of the parties.
The witness swears to
tell the truth and a certified court reporter takes down every word spoken during the deposition.
What is The doctrine of “Sovereign Immunity” ?
protects the government from being sued without its consent
The doctrine of “sovereign immunity” protects the government from being sued without its consent. The federal government permits lawsuits to be brought against it under most circumstances, but these suits must be
brought in federal courts.
The most restrictive type of state-granted credential is:
licensure
Persons who do not possess the requisite license may neither
use the title of the profession nor practice the profession as it is defined.
Normal distribution is ____Curve
Bell-shaped
As a result of the negative skew, most data points are
high and spread out toward the lower end of the distribution.
What is the Rosenthal effect?
At times, the expectations of the researchers in a study influence the outcome.
According to Standard II of the Scope and Standards for Nurse Anesthesia Practice:
documentation of informed consent for the anesthetic should be acquired and/or documented in the medical record by the CRNA.
The CRNA shall obtain or verify that an informed consent has been obtained by a qualified provider. standard ____
II
Discuss anesthetic options and risks with the patient and/or legal guardian in a language the patient and/or legal guardian can understand–> Standard
II
Document in the patient’s medical record that the informed consent was obtained –> Standard
II
Determination of the facts of the case as well as the applicable law is the responsibility of the:
trial court
Courts are either
Courts are either trial courts or appellate courts.
Trial courts are where
cases are brought and facts presented.
What are appellate courts?
Decisions of the trial courts can be appealed to the appellate courts.
Specificity refers to: the
proportion of patients who do not have abnormal pseudocholinesterase out of all of the negative tests
Specificity refers to the proportion of individuals who test as
negative who really do not have the disease, out of all of the negative test results.