Professional issues Flashcards
A nurse anesthetist in middle management submits written complaints to a state board about several other CRNAs that is false and defamatory. Which AANA document could be applied to this situation?
A. Code of ethics
B. Practice guidelines
C. Practice standards
D. Position statements.
A. Code of ethics
________ dictates the principles of conduct and professional integrity that guide the decision-making & behavior of nurse anesthetists.
AANA code of ethics
_______ are authoritative statements that describe minimum rules and responsibilities for which anesthetists are held accountable.
Practice standards
________ are systematically developed statements to assist providers in clinical decision making that are commonly accepted within the anesthesia community.
Practice guidelines
__________express the AANA’s official positions or beliefs on practice-related topics. They may also define the knowledge, skills and abilities considered necessary for a nurse anesthetist.
Position statements
The AANA code of ethics also
Speaks to the CRNA’s responsibility to society, endorsement of products or services, research integrity, and responsibility to patients and competence
The use of unnecessary invasive pre operative testing is most likely to put the provider in violation of the principle of:
Nonmaleficence
Commonly accepted principles of healthcare ethics include
justice
beneficence
respect for autonomy
nonmaleficence
Healthcare ethics comprise the set of ______________ that guide how decisions are made in healthcare.
moral principles, beliefs, and values
Define respect for autonomy.
means that providers must respect and abide by decisions made by competent patients
Define nonmaleficence.
A provider has an obligation not to inflict hurt or harm.
Define beneficence.
The provider should act for the benefit of others
Define justice.
People under similar circumstances and conditions should be treated alike
Informed consent for anesthesia should include:
a. description of the recommended type of anesthetic
b. agreement to undergo the scheduled surgery/procedure
c. risks and benefits of each type of appropriate anesthetic
d. patient preferences, questions, and fears
C & D
What are the six elements of informed consent?
competence
decision-making capacity
disclosure of information
understanding of disclosed information
voluntary consent
documentation
When can the anesthesia provider recognize “implied consent”
In an emergency, when immediate treatment is required, and the patient is unconscious or unable to consent
In an emergency, informed consent
should be sought from family members or legal decision makers as soon as possible even with implied consent recognized
Describe four examples of persons who require special assistance
hearing impaired
cognitive impairment
visual impairment
limited English proficiency
_________ may be allowed to translate only in an emergency
Family members
A patient has a right to refuse
medical treatment or therapy
In an elective case, a provider has no ethical obligation to provide
inappropriate care or care associated with unreasonably high risks
______ is when minor children are included in the informed consent discussion, and their agreement should be sought.
Assent
What element of informed consent is “the patient must demonstrate understanding”?
understanding of disclosed information
What element of informed consent is “the patient consents in the absence of coercion or distress”?
voluntary consent
What element of informed consent is “the medical record must contain documentation of the informed consent”?
documentation
What element of informed consent is “the patient has the legal authority to consent”?
competence
What element of informed consent is “the patient has the ability to decide about specific anesthesia care”?
decision making capacity
What must an anesthesia provider do to obtain informed consent for epidural placement in a parturient who recently received 50 mg of meperidine?
a. review the efficacy of current pain management
b. document the patient’s dilation, effacement, and station
c. Determine that the patient has sufficient capacity
d. perform detailed obstetrical history and physical exam
C. determine that the patient has sufficient capacity
Obstetric patients receiving regional anesthesia should always be
consented for a general anesthetic
State law and facility policies should be consulted when a __________ is receiving obstetrical services.
Minor
In a case of maternal-fetal conflict, the provider’s respect for
maternal autonomy may oppose the principle of beneficence in promoting the well-being of the mother and the fetus
Parturients and their families need to be informed that the timing of labor analgesia is variable and dependent upon
labor progress, fetal status, consultation with the obstetrician, and anesthesia service availability
Parturients should be reassured that if regional analgesia is delayed due to an emergency, ______________________ will be available until the anesthesia provider can attend to the patient.
alternative pain management
What should occur if there is a maternal-fetal conflict?
The anesthesia provider should keep communication with the mother open and non-coercive while procuring an ethics consultation, referencing hospital policy, and reviewing state law
What should occur if there is a maternal-fetal conflict?
The anesthesia provider should keep communication with the mother open and non-coercive while procuring an ethics consultation, referencing hospital policy, and reviewing state law
A terminal cancer patient with a “do not resuscitate” order presents for a port-a-cath placement. Which standard of nurse anesthesia practice has the most immediate relevance to the anesthetist’s preoperative activities?
a. standard 2 on thorough preoperative assessment and evaluation
b. standard 3 on plan for anesthetic care
c. standard 4 on informed consent and related anesthesia services
d. standard 13 on wellness
c. standard 4 on informed consent and related anesthesia services
An advanced directive is a
legally binding document that delineates the patient’s wishes regarding healthcare interventions in the case of incapacity and/or delegates the authority to make healthcare decisions to another party
____________- should be reconsidered before anesthesia is administered.
Advanced directives
this can lead to full suspension, partial suspension, or no suspension
Just as informed consent must be documented, the __________________________ discussion must also be documented
the reconsideration of advance directives discussion
Who does the AANA recommend to be present when discussing changes in advance directives during the informed consent process?
the patient, family, and health care team
Identify the standards of care that have been published by the American Association of Nurse Anesthetists. (select 3).
a. wellness
b. infection control and prevention
c. chronic pain management
d. latex allergy management
e. transfer of care
f. mass casualty incident preparedness
a. wellness
b. infection control and prevention
e. transfer of care
The term ____________ refers to any sort of professional misconduct.
malpractice
The term ____________ refers to any sort of professional misconduct.
malpractice a
The term ____________ refers to any sort of professional misconduct.
malpractice a
The term ____________ refers to any sort of professional misconduct.
malpractice
In a negligence or malpractice claim, the patient (plaintiff) must proof four things:
duty
breach of duty
causation
damages
Duty means that
the anesthesia provider had a duty to the patient
Breach of duty means that
the provider failed to fulfill their duty
Causation means
a close causal relationship existed between the provider’s acts and the patient’s injury
Damages means
that actual damage was the result of a breach in the standard of care
___________ is defamation in the verbal form.
Slander
__________ is defamation in the written form.
Libel
If you publicly disclose private facts about a patient (even if those facts are true), then you may have
defamed the patient’s character and violated the HIPPA
Res ipsa loquitur means that
“the thing speaks for itself” and can shift the burden of proof from the plaintiff to the defendant
