Section A Flashcards
Health Care Consent Act a patient has the right to:
- Receive safe and proper care.
- Give or refuse consent for any procedure, and for any reason.
- Have a medical professional clearly explain health problems and treatments.
- Participate in health care decisions.
- Ask questions and express concerns.
- Request a second opinion; within reason.
- Be assured that personal information is confidential.
- Request to access their health information records.
- Request the transfer of their health records to another medical professional; A fee may be charged
Consent:
Permission for something to happen or agreement to do something
Informed consent
is a voluntary permission given by a patient to allow touching, examination or treatment by health care providers. Basic patient right. Patient can provide consent to one specific treatment or a plan of treatment
Informed consent involves the patient’s understanding of the following:
- What the doctor or health care worker is proposing to do
- Whether the doctor’s proposal is a minor procedure or major surgery
- The nature and purpose of the treatment
- Intended effects versus possible side effects
- The risks and anticipated benefits involved
- All reasonable alternatives including risks and possible benefits.
- Explanation of the tests
Implied Consent:
When a patient non-verbal behavior indicates agreement.
• After asking a patient’s permission to draw blood , patient sticks out their arm
• Patient sticks out arm without you asking
Regulated Health Professions Act 1991 (RHPA):
a common framework for regulating health professions in Ontario. Under the Act, the Health Professional Regulatory Advisory Council (HPRAC) was established and the purpose is to advise the Minister of Health and Long-Term Care on regulatory matters for health professions in Ontario. The Minister relies on HPRAC as a source of evidence and advice in the formulation of policies relating to health professionals
Regulates 28 health professions in Ontario and the main objectives of RHPA are
- to protect the public from harm
- to promote high quality care
- to ensure regulated health professions are accountable to the public
- to give patients access to health professionals of their choice
- to treat all patients and health professionals in an equitable manner
Main Purpose of RHPA :
- to protect the public from harm
- to prevent the public from receiving health care services from healthcare providers who are incompetent, unfit or unqualified
RHPA - Controlled Acts:
- A controlled act is any one of the following total 14 controlled acts:
- Communicating a diagnosis or identifying a disease or disorder
- Performing a procedure on tissue below the dermis or the mucosa membrane or below the surface of the cornea or teeth Exemption of venipuncture and phlebotomy delegated to Lab Technicians (we are not regulated)
- Setting or casting a fracture of a bone or a dislocation of a joint
- Administrating a substance by injection or inhalation
- Putting an instrument or finger into any openings of the body
- Prescribing or dispensing or selling drugs
- Prescribing for eye or hearing problems
Laboratory Specimen Collection Centre Licensing Act regulation 682/3
describe the qualifications that a Lab Technician must possess in order to work in a licensed medical laboratory. Currently, Lab Technicians work under the supervision of the Lab Technologist when performing test procedures. Should the Lab Technicians become regulated, this supervision will no longer be required. Also dictates who needs to be in a lab Director-Supervisor- Technologist- Technician , what types of specimen can be examined and processed (ONLY HUMAN), who can order tests (midwives (only pregnancy related tests), dentists, doctors, clinical nurse practitioners).
At request of an insurer
medical physician orders the tests under the Insurance Act
a laboratory is defined as:
means an institution, building or place where examinations as are prescribed by the regulations, of specimens taken from the human body are performed to obtain information for medical diagnosis, prophylaxis or treatment
Specimen collection centre is defined in the act as
a place where specimens are taken or collected from the human body for examination to obtain information. Does not include where an HPC is doing surgery
Ontario’s Personal Health Information Protection Act (PHIPA):
Can only use information in the course of providing services , Cannot disclose any information, Provider must ensure that all employees and agents comply with the regulations.
Scope of PHIPA
- Health information custodians (HICs) that collect, use and disclose personal health information (PHI). Must ensure that reasonable steps are taken to protect the information against theft, loss or unauthorized use.
- HIC are defined as HPC, Pharmacies, labs, hospitals, nursing homes – where people give you treatment
- Non-health information custodians where they receive personal health information from a health information custodian (use and disclosure provisions)
Health information is:
- Highly sensitive and personal in nature
- Must be shared among health care providers for the benefit of the individual
- Disclosed for secondary purposes if it is viewed to be in the best public interest (e.g. research, public health, fraud investigation, quality assurance)
Right of Access and Correction to PHI Record:
- An individual has a right of access to his/her records
- right to correct their records of personal health information
- Custodian must respond to a patient’s request to access his/her health record within 30 days, with a possible 30 day extension
- Custodian must offer assistance if a patient’s request lacks sufficient detail of what the patient wants
Corrections to records must be made by
striking out information in a manner that does not obliterate it, labelling the information and removing it from the record, while maintaining a link to the record or informing the person accessing the information that it is incorrect and how to get the updated information. Custodian must give written notice to all persons who access the records of the correction/s made on PHI record.
Privacy
is the right of an individual to keep personal information from being disclosed
Confidentiality
is how we as health care providers/employees treat private information once we and others receive it
Canada Health Act (CHA):
- Canada’s federal health insurance legislation.
- Federal government gives the province and territories money and they decide how it will be allocated based on the criteria provided by the federal government
- aim to ensure people are provided services without being charged directly
- universal healthcare founded by tommy douglas
Canada’s national health insurance is often referred to as “Medicare”
Ensures all residents have access to hospital and physician services on a prepaid basis
National program is composed of 13 provincial and territorial health plans
universal health insurance be guided by 4 criteria
a) Public Administration - applies to provinces and territories not the hospital. Must be operated by a non profit basis
b) Comprehensiveness - must cover all insured health services
c) Universality -services provided on equitable terms and conditions.
d) Portability -minimum waiting period, not to exceed three months, imposed by the new province of residence.
e) Accessibility -reasonable access to insured health care services and access must not be impeded, directly or indirectly by charges or location
Occupational Health and Safety Act
gives a worker the right to refuse work that he or she believes is unsafe.
- The Right to Know
- The Right to Participate
- The Right to Refuse Dangerous Work
Government’s Responsibilities of OHSA
- to enforce occupational health and safety legislation
- to conduct workplace inspections
- to make information available
- to promote training, education and research
Employer’s Responsibilities of OHSA
- to establish and maintain a Health and Safety Committee (HSC), or select at least one health and safety (H&S) representative
- to take every reasonable precaution to ensure safe workplaces
- to train employees about any potential hazards
- to supply personal protective equipment and ensure workers know how to use the equipment safely and properly
- to immediately report all critical injuries
- to the government department responsible for occupational health and safety or compensation
- to train all employees on how to safely use, handle, store and dispose of hazardous substances and handle emergencies
What is chain of custody?
An unbroken documented chain of events from the time of sample collection until it is processed and completed.
Chain of custody documents
The forms (documents) should include:
• name or initials of the individual collecting the specimen
• each person or entity subsequently having custody of it
• the length of time the person handled the specimen
• the date the specimen was collected or transferred
• employer or agency information
• specimen number
• patient’s name
• employee’s name (collected by)
• a brief description of the specimen/container.
• lock box seal number
Transportation of the specimen on Chain of Custody
transported in a sealed box
A law enforcement agency legal seal to the Legal Sample
The official legal seal must be initialed and dated by the individual who has affixed the legal seal.
sample must be placed in an appropriate tamper evident container.
TRANSPORTATION OF DANGEROUS GOOD ACT
Study symbols
Required in Canada when a person is involved in shipping, receiving and transporting dangerous goods by air, water, road or rail
UN Number:
N numbers or UN IDs are four-digit numbers that identify hazardous substances
Category A is identified by 2 UN numbers
UN 2914- Infectious substance affecting humans
UN 2900- Infectious substance affecting animals
highly infectious - dangerous goods
Category B is identified by one shipping number
UN 3373-Biological substance, category B
diagnostic IATA packging 650
The specific requirements for packing any clinical sample under TDG include:
-identifying and classifying the material- label specimen
proper packaging –water tight primary , secondary leak proof containers with absorbent material between primary and secondary,TERTIARY OUTER CONTAINER WITH BIOHAZARD SYMBOL.
-shipping documents –requisition
-container labels and marks
-operator training & certification
-Emergency Response Plan
-Accidental Release Reporting
Layers of packaging for TDGA
A large zip-lock plastic bag, plastic lined container or foam tube holder provides the secondary liner.
The outer packaging is a durable plastic toolbox.
Must be sent as priority - infectious samples cannot be mailed
Employees are responsible for under WHMIS
Report hazards Report accidents Follow rules Undergo training Participate in program development and implementation
Under the WHMIS 2015 Management is responsible to:
Have health and safety policies in place
Orient and train workers to ensure awareness and competence in safe work practice-right to know
Keep records, evaluate the program and take corrective actions
Demonstrate of enforcement of rules
Accountability
Conduct accident investigations
Identify hazards and advice employee accordingly
Participate in program development and implementation
When is the SDS updated?
An SDS will be required to be updated when the supplier becomes aware of any “significant new data”. (New data regarding the hazard)
SDSs will be required to be updated within 90 days of the supplier being aware of the new information
Every SDS must provide a date of last revision in Section 16
SUPPLIERS LABEL
- Product Identifier
- Signal Word
- Hazard statement
- Precautionary Statement
- Supplier Identification
- Pictograms
Workplace labels are used when
hazardous materials are produced in the workplace
the suppliers label is missing or illegible
when hazardous materials are poured from one container to the next
Workplace labels must have the following information:
Product name (matching the SDS product name).
Safe handling precautions may include pictograms or other supplier label information.
A reference to the SDS (if available).
Lab labels must have the following Information
Product name Safe handling precautions Reference to SDS when available Date of preparation Date of Expiration(optional) Storage conditions.(optional) Employee initial (optional- depends on work place protocol) May have pictograms or personal protective equipment (PPE) information (optional -depends on work place protocol)
Lab Director
qualified medical practitioner, certified by Royal College of Physicians and Surgeons, with at least 2 years of lab training
Responsible for the administration of the scientific and technical operation of a lab
Lab Supervisor
Qualified practitioner with post-graduate/doctorate degree and has one year experience in laboratories or with under-graduate degree with three years lab experience
Under supervision of the director and supervises lab personnel
Lab Technologist
Completed relevant course experience or has 6 years of experience and is acceptable to the Director or is recognized as a Lab Technologist
Performs tests that require independent judgement
Lab Technician
Obtained School Graduation Diploma and has completed the relevant courses and together with experience is acceptable to the Director or Diploma and two years of experience as a technical trainee
under direct supervision does tests that require limited technical skills and responsibilities
Ethics
principles of conduct governing an individual or a group
Bio/medical ethics revolve around four principles:
1) Autonomy - Respect for the patient and his/her rights
2) Beneficence - Act in best interest of patients
3) Non-maleficence - Do no harm, maximize benefits, minimize harm
4) Justice - Giving every person his/her fair share of medical services
autonomy
respects that each person is capable of making decisions/judgments on personal goals, lifestyles and actions.
individual’s freedom/rights to participate
Policies and Practices That Enshrine Autonomy
Informed Consent by Patient
Privacy/Confidentiality
Ethics Consults
Ethics Committee
Competent Patient:
one who authorizes medical treatment and understands the effects of the treatment in terms of health, lifestyle, values, religious beliefs.
Incompetence Patient:
one who is inability to understand one’s situation, risks and benefits of treatment and consequences of making or not making decision
Situations that override a Patient’s Autonomy
Child endangerment
Principle of beneficence:
To do good or to act in the best interest of the patient.
Principle of Non-maleficence:
Avoid harm to the patient or what would be against the patient’s interest
Medical needs are based on the following criteria
1) Likely to benefit the patient
2) Urgency of need
3) Change in the quality of Life
4) Duration of benefit
Ethics Committee in hospital
Acts primarily as a guardian of the patient’s rights and may be legally liable for recommendations
Bill is
a proposed legilation
Insured act
for HIV antibody
Employee responsibilites for OHSA
- to work in compliance with the OH&S Act and regulations
- to use personal protective equipment and clothing as directed by the employer
- to report workplace hazards and dangers
