QUIZ- vulnerability Flashcards
what is vulnerability?
the quality or state of being exposed to the possibility of being attacked or harmed, either physically or emotionally
CNA code of ethics and vulnerability?
recognize the potential of vulnerability of persons receiving care and do not exploit their trust and dependency in a way that might compromise the therapeutic relationship
dimensions of vulnerability?
-social, psychological, physical
social: demographic data in relation to potential for illness
psychological: actual/potential harm to identify of self/emotional effects
physical: physiological state and susceptibility to morbidity/mortality
vulnerability in perioperative patients?
- increased risk of harm
- needing surgery can create feeling of loss of power
- anxiety can effect health outcomes: predominately prolongs recovery time
key findings in the semi-structured interviews of 10 nurses in perioperative environment?
- vulnerability exists! needs to be managed appropriately!
- the importance of holistic approach
- value of integrity, advocacy, empathy, and presence
QSEN?
quality safety education for nurses
-six QSEN competencies
6 QSEN competencies?
- patient centered care
- teamwork and collaboration
- evidence based practice
- quality improvement
- safety
- informatics
why are the QSEN competencies important?
-you must understand them so you are aware when practicing and reduce harm of the patient, increase safety for your self too
history of informed consent…?
- modern informed consent came from the nuremberg trials (1947) in germany… conducted on patients without their consent and without letting them know the the risks of those trials
- concluded that all experiments and all trials involving humans should be coded and informed consent taken
informed consent is for:
any invasive or minimally invasive procedure
consent=
voluntary agreement to some act or purpose made by a capable invdividual
a client or substitute decision maker must be: (to give consent)
- adequately informed
- capable of giving/refusing consent
- free from coercion, fraud, or mirepresentation
ethical considerations of consent?
- support clients with reduced capacity to make decisions that they are capable of
- obligated to take action if any concerns about consent
physicians role for informed consent?
- inform of the procedure and risks
- inform of the benefits and alternatives
- provide an opportunity to ask questions
- inform of their ability to withdraw consent
- inform if the protocol differs from the actual procedure
consent is valid if:
- it is freely given without coercion
- patient is competent
- it is provided in writing
- pt is able to understand
nurses role for informed consent?
- may ask the patient to sign
- may witness the patient signing
- clarifies the patients understanding
- ensure the patient is not impaired prior to signing
what is informed consent required for?
- invasive procedures
- radiation
- non-surgical procedure with more than slight risk
- procedure involving sedation or anesthesia
who can provide informed consent?
- individual (pt)
- surrogate (pt not of age or competent)
- emancipated minor
- physician in an emergency
informed consent process (4)
- assess any barriers to communication and understanding
- obtain decision and consent
- re-establish consent
- assess for coercion
infants act?
- legislation related to persons under the age of 19
- provides rules for qualification as a “mature” minor… we assess who is a mature minor
- mature minor can make own health care decisions independent of parents
when can a mature minor consent to healthcare and treatment in their best interest (if HCP believes they understand…?)
- what the treatment involves
- risks/benefits
- need for treatment
implications of the infants act
-no set age for when someone can give consent
informed consent is a legal mandate, but it also helps…
to psychologically prepare the patient by ensuring that the patient understands the surgery
is consent valid if the pt was under meds that can affect judgement and decision making?
NOPE!
if legal age and mentally capable, pt personally signs form… if not…
- surrogate
- emancipated minor (married or independently living)
- in an emergency: surgeon
ways to improve consent process?
- audiovisual material or discussion
- ensure content is understandable
- braille—> sign language
- multiple languages or interpreter for diff cultures
voluntary consent=
freely given without coercion
-18 y/0 unless emancipated
incompetent pt=
individual who is not autonomous and cannot give or without consent
informed subject=
should be in writing
-should contain: explanation of procedure and risks, description of benefits and alternatives, an offer to answer questions, instructions
patient must be able to comprehend so…
- if non-english: in a language that is understandable
- trained medical interpreter
- alternative formats
- questions answered
what is a fundamental principle of the health care consent and care facility admission act?
presumption of capability
-assume pt can give consent unless there is a reason to believe otherwise
advanced directive=
a consent or a refusal in advance of the need for health care
substitute decision maker=
authorized under a representation agreement to make particular health care decisions
three main themes of vulnerability?
- labels
- recognition
- management
labels as a theme of vulnerability?
Classification into groups heightened awareness of existing vulnerability within specific groups prior to surgical intervention & alerted practioners to utilize effective management strategies
recognition as a theme of vulnerability?
- Physical & behavioral signs were identified along with awareness of the patient’s state of mind & the anxietal state caused by the environment, surgery & perception
- Patients appearance, vital signs, trembling, rigidity
Manifests differently in each patient
management as a theme of vulnerability?
- Professional qualities & strategies
- Professional, communication and personal alongside the value of presence
- Knowledge & experience was imperative knowledge and experience was imperative knowledge of their role, being confident and competent
- Observation skills facilitated assessment & subsequent planning and implementation of care designed to meet the patient needs
Dignity & respect
aim of the qualitative study of perioperative patients and vulnerability?
-reduce preoperative anxiety, therefore minimizing postop complications, promoting patient outcomes
etic perceptions=
anaesthetic, surgery, environment with equipment and unknown surroundings
emic perceptions=
previous and current life experiences, individual responses to these
actual vs. potential vulnerability?
Actual vulnerability: known circumstances rending an individual susceptible while potential vulnerability is defined as circumstances which may or may not cause vulnerability
precedents to vulnerability?
o Surgical intervention
o Admittance to hospital for surgery
o Undergo general anesthesia or regional
o Preparation for surgery
Exposure to a stressor causing an anxiety response
aggravating factors to vulnerability?
-fear, anxiety, anticipated pain and discomfort, fear of unknown, fear for ones life
