Risk Assessment, Palliative Care, Legal & Ethical Issues and Care Planning (Week 3)

Question 1

What are 5 Victorian Government Principles of Person-Centred Supportive Practices?

Answer 1

• Get to know the person
• Share the power and responsibility
• Have flexible and accessible service
• Coordination and integration
• Environment – physical, cultural, social and attitudinal

Question 2

TRUE/FALSE:
Assessment tools are less likely to be mechanical or electronic, but rather paper-based + requiring knowledge + critical thinking by the nurse.

Answer 2

TRUE

Question 3

List 3 criteria for assessment tools:

Answer 3

1) Reflective of the culture and language of the person being assessed
2) Validated
3) Best one for your purpose – i.e., asks the right questions

Question 4

TRUE/FALSE:

Collecting data is not doing an assessment

Answer 4

TRUE

The collected data needs analysing, and conclusions acted upon.

Question 5

List 3 examples of where assessment tools can be found in:

Answer 5

1) Nursing textbooks/journals
2) Models of care e.g., chronic care model
3) Websites - e.g., NARI, government websites

Question 6

Define: sexual health

Answer 6

“A state of physical, mental and social well-being in relation to sexuality. It requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence” - WHO.

Question 7

TRUE/FALSE: Palliative care attempts to lengthen or shorten one’s life

Answer 7

FALSE

Question 8

List 5 roles of a palliative care nurse:

Answer 8

» Assess client + family → offer support, education and/or referral
» Incorporate a palliative care approach with primary and curative care
» Communicate, collaborate and mediate for client to other services that tailor their needs
» Sensitively discuss end of life options and assist client/family to plan in advance for living and dying
» Respond quickly to crisis situations

Question 9

What is the difference between competency & capacity?

Answer 9

Competency: describes decision-making abilities – a nurse alone cannot decide this. Need evidence over time.

Capacity: describes specific decisional abilities – task/event specific and needs to be established for each context that it may be used in.

Question 10

List 4 domains for legally determining capacity:

Answer 10

1) The ability to communicate consistently or stable choices
2) The ability to understand basic information about choices
3) The ability to evaluate reasonable implications of choices
4) The ability to use a reasoned process to rationally weigh risks and benefits of choices.

Question 11

What is the main responsibility of the Office of the Public Advocate (OPA)?

Answer 11

The OPA facilitates competent persons to appoint others to make decisions and manage their affairs in the event that they are unable to make decisions for themselves.

Question 12

What factors must be considered when assessing risk?

Answer 12

• The nature of the actual or potential activity
• What factors contribute to the risk – environmental, cultural, health, etc.
• Risk of serious harm if the activity is performed – low, medium or high
• Risk of harm if the activity is prevented – low, medium or high
• Positive/negative outcomes of the activity
• Positive/negative outcomes for others
• Can factors be controlled? – By whom, when, where and how
• A risk reduction action plan – that is regularly reviewed

Question 13

What 5 things are required in Advanced Care Planning?

Answer 13

1) An Advance (Health or Care) Directive.
2) An enduring power of medical attorney.
3) A letter to the person who will be responsible for making decisions on your behalf.
4) An entry in your medical record stating what level of treatment or resuscitation you are comfortable to accept – or a Refusal of Treatment Certificate.
5) Written instructions which clearly voice your view

Question 14

List 4 things required when assessing capacity:

Answer 14

1) A cognitive assessment – e.g., PAS or MM.
2) Observation and interviews to assess awareness, judgement/insight.
3) A relative functional assessment – e.g., gait/balance, falls risk, etc.
4) Depression scales.

Question 15

TRUE/FALSE:

Administrators make financial and legal decisions

Answer 15

TRUE

Question 16

What 4 elements must a care plan include?

Answer 16

1) A statement of the problem based on assessment info or case progress notes.
2) A statement of the desirable goal for the client.
3) The actions or interventions that you, your client, your staff or your team will use to achieve the goal.
4) An evaluation of the success, partial success or failure of the plan.

Question 17

What does S.M.A.R.T when referring to care plan goals?

Answer 17

S - specific
M - measurable
A - achievable
R - realistic
T - timely