Professional Issues Flashcards
Just Culture
-blame free reporting to increase reporting to uncover the source of the error
End of Life Issues
Corneal Donation
- elevate head 20-30 degrees
- instill artificial tears
- tape eyelids shut with paper tape
- apply ice over eyes
advance directives
written guide detailing a patient’s wishes prepared when a patient is *competent
*enacted (to put into place) when the patient loses decision making capacity
living will
-allows an individual to declare what treatments an individual does and does not want
-can only be applied once they have a terminal illness or in vegetative state
durable power of attorney
-designates a surrogate decision maker
DNR
may limit CPR or intubation but does not withhold comfort measures such as pain relief or O2
family presence
-gives closure
-reduces questioning- of events
-decrease shock and anger
death notifications
- md & nurse deliver together (not real life)
- ascertain family’s knowledge
- *use the words died & dead
- encourage them to touch the patient
- leave tubes in for coroner cases
- circle unsuccessful iv stick sites (not real life)
forensic evidence
(not real life)
- use quotation marks in documenting
-facts only no judgement - do no cut through clothing
double fold bag with tape no staples - place paper bags over patient’s hand if - -suspecting firing arm for gsw residue
- do not label wounds entrance or exit (wound 1 & wound 2)
Who is responsible for determining the best mode of transport, equipment needed in route, and qualified personal based on patient’s needs?
the transferring facility
considerations before air transportation
> ground: takes longer but more room
rotor-wing helicopter: rapid point to point transfer but cabin no pressurized
fixed wing: pressured and can fly in inclement weather
- gastric tube to decompress abd
- 2 IVs
- foley
- no air splints
- may place chest tube for small pneumo for rotor
professional negligence:
duty
the nurse has a duty to perform care
professional negligence: breach of duty
the person failed to complete the duty
professional negligence: proximate causation
the breach caused damage either physical, emotional, psychological, or social
professional negligence: damages
damage actually exists
patient consent: implied
allows appropriate treatment in an emergency, as in unrepsoinve patient
patient consent: express
agreement to treatment by signing paperwork
patient consent: informed
- patient understand risks and benefits of the treatment and in not under the influence
- has legal capacity to make the decision
patient consent: involuntary
ensuring needed treatment when an individusal refuses care
ie: suicidal, dleusional, dementia
COBRA & EMTALA are meant to protect patients from what?
“dumping” practices in which hospitals transferred patients based on their lack of ability to pay
EMTALA applies to any patient who comes to ED requesting
an exam or treatment
these patients must be provided with a medical screen exam performed by a qualified medical provider
check list of transferring a patient
- patient must be stabilized
- receiving hospital must be secured with an accepting physician
- patient must be notified of transfer
- patient must sign certification they understand the benefits outweigh the risks
- transferring hospital must send appropriate medical records
- transferring facility just arrange transportation with adequate life support
COBRA
applies to any patient who comes to the ED requesting an exam or treatment.
a medical exam must be performed by a qualified medical provider
Implied consent
allows appropriate treatment in an emergency for an *unresponsive * patient
Express consent
agreement to treatment, signs paperwork
Informed consent
patient understands risks and benefits of the proposed treatment, is not under the influence, and has legal capacity to make the decision
Involuntary consent
ensuring needed treatment when an individual refuse care
i.e. suicidal, delusional, dementia
mitigation
to prevent or minimize potentially adverse effects
preparedness
emergency traning, mutual aid agreements, stokcplie supplies
Response
evacuation, shelter, disaster triage
Recovery
restoring systems, replenish supplies, dispose of waste
