Professional practice Flashcards
Name the four ethical principles
- Justice
- Autonomy
- Beneficence
- Non-malfeasance
How do you resolve an ethical issue
Identify the problem and relevant laws/principles
Consider the impact on stakeholders
Find potential course of action and choose
Assess the outcome and decide if more input is needed
What is PT scope of practice identified by
- Education and training
- Governing body (national standards)
- Institution (facility that you work at)
What is not in the PT scope of practice
Diagnosing medical conditions and diseases
Giving advice about medications
Medical treatments not in PT scope (can you predict and deal with potential complications of the tx and is there another profession more equipped to carry out this tx?)
What are the PT restricted activities and which can be delegated?
- Tracheal suctioning *
- spinal manipulation
- acupuncture or dry needling
- Treating a wound beneath the dermis *
- Ax or Tx of pelvic musculature
- Administering medication through inhalation *
When do you need to get consent and when are you exempt
Need: Prior to Ax, Tx, involving others in care, sharing health records
Exempt: in emergency (CPR) or if trumped by “duty to warn” and only if imminent
What is the minimum age for consent in Canada
No minimum age for consent
What is informed consent
the pt or SDM has received info about the tx, nature of the tx, benefits, risks, side-effects, consequences of not receiving the tx and alternative options.
Then the pt or SDM can make an informed decision and allows them to be involved in the decision making process.
Name the components of consent
- capacity
- voluntariness
- understanding
- disclosure
What are the consequences of not gaining consent?
Legal (assault and battery)
Professional misconduct (from complaint, board and college decides)
What are the 6 ways to effectively communicate
- Courtesy
- Clarity
- Listening
- Consider culture
- Get on same page
- Body language
How do you prevent poor communication?
-Clearly explain risks/benefits
-Using plain language
-Showing empathy
What can effective communication do?
-Support history taking, diagnoses, and clinical decisions
-Increase client’s adherence
-Help self-management
-Influence preventative health behaviours
-Improve client satisfaction and experience in care
What are alternative methods to communication?
Interpreters
Handwriting
Visual-gestural
Diagrams
Online platforms / technology
Educational materials
What does documentation about communication need to include?
Clear
Accurate
Professional
Timely
Explain what the 4 ethical principles mean
-Justice - everyone has fair and equal treatment
-Autonomy - Patient makes own informed decision
-Beneficence - Do good - act in patient’s best interested
-Non-maleficence - Do no harm
Which restricted acts cannot be delegated?
Acupuncture
Spinal manipulations
Communicating a diagnosis
Internal assessment or rehabilitation of pelvic musculature
What do you need to ensure before you delegate?
Written instructions of what to do if there is an adverse event
Person must understand circumstances
Person must be competent - with knowledge, skills, judgment
What do the components of consent mean?
-Capacity - able to understand and appreciate consequences, no age limit, determined by physio, situational based, given by substitute decision maker if not able
-Voluntariness - patient not coerced into making decision, PTs can give objective reasons and explain professional opinion in unbiased fashion but final decision is up to the patient
-Disclosure - disclose information in order to make informed decision, treatment, what it entails, risks and benefits, consequences if don’t do treatment and other alternative, can withdrawal consent at any time
-Understanding - making sure patient understand what you said, allow questions, check understanding
What must a SDM be?
Willing, available, capable, 16 years old or parent, act in wishes stated when patient was capable and PTs can take to consent and capacity board if think SDM not acting in patient’s wishes
What are the two privacy legislations?
-Federal - PIPEDA
-Provincial - HIC and HIC agents
What would you do if privacy breach occurred at your clinic?
- Contain the breach
- Notify patient - and tell them to report to the information and privacy commissioner
- Notify employerif agent of HIC
- HIC notifies regulatory college
- Notify information and privacy commissioner
What is the duty to warn?
If danger imminent, going to cause serious bodily harm and danger to themselves or someone else then the duty of harm outweigh the duty of patient confidentiality
A young patient tells you not to tell their mom but they are going to try to harm themselves this evening. The patient begs you not to tell and states that they will lose trust in you if their mom finds out. What do you do?
Report to services that can help the child
A patient tell you not to tell their son that they have terminal cancer. Do you tell their son and what principle is this under?
-Lock - box
-No you cannot tell the son.
-You can record the information but not use it.
-Duty to warn precedes this
A patient doesn’t want the doctor to know that they have bloody poops. What to you do?
-Advise the patient that this is important information for the doctor to know and that there are health risks associated from withholding this information
-Ultimately it is the patient’s decision to tell this information or not