Study Guide Q's: Healthcare System Flashcards
Patient informed consent
Informed consent is a process of communication between you and your health care provider that often leads to agreement or permission for care, treatment, or services. Evey patient has the right to get information and ask questions before procedures and treatments. [from Google]
Patient self-determination act
The purpose of the Patient Self-Determination Act was/is to inform patients of their rights regarding decisions toward their own medical care, and ensure that these rights are communicated by the health care provider. [from Google]
HIPAA
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that required the creation of national standards to protect sensitive patient health information from being disclosed without the patient’s consent or knowledge. [from Google]
Direct Access
Direct access is exactly what it sounds like: patients having direct access to physical therapy services. This means that they do not need a physician referral or prescription in order to receive the services of physical therapists. [from Google]
ADA, FLMA, Age discrimination in employment act
ADA
ADA: The ADA prohibits discrimination on the basis of disability in employment, State and local government, public accommodations, commercial facilities, transportation, and telecommunications. It also applies to the United States Congress. To be protected by the ADA, one must have a disability or have a relationship or association with an individual with a disability. An individual with a disability is defined by the ADA as a person who has a physical or mental impairment that substantially limits one or more major life activities, a person who has a history or record of such an impairment, or a person who is perceived by others as having such an impairment. The ADA does not specifically name all of the impairments that are covered. [from Google]
ADA, FLMA, Age discrimination in employment act
FLMA
: The FMLA entitles eligible employees of covered employers to take unpaid, job-protected leave for specified family and medical reasons with continuation of group health insurance coverage under the same terms and conditions as if the employee had not taken leave. [from Google]
Age discrimination in employment act:
: The Age Discrimination in Employment Act (ADEA) forbids age discrimination against people who are age 40 or older. It does not protect workers under the age of 40, although some states have laws that protect younger workers from age discrimination. It is not illegal for an employer or other covered entity to favor an older worker over a younger one, even if both workers are age 40 or older.
Describe the purpose and utility of the Power of Attorney
- Purpose: legal document that gives one person (the “agent”) power to take action on behalf of another person (the “principal”)
- Durable POA: continues after the principal becomes incapacitated
- Springing POA: gives the agent power only when the principal becomes incapacitated
- Incapacitated: the inability of an individual to manage property or business affairs because the individual has any of the following statuses: an impairment in the ability to receive and evaluate information or make or communicate decisions even with the use of technological assistance; is missing, detained (including incarceration in a penal system) or outside the US and unable to return
Types of elder abuse
- Caregiver and self neglect
- Emotional and psychological abuse
- Deception
- Intimidation
- Threats
- Fiduciary/financial exploitation
- Typically includes psychological abuse
- Physical abuse
elder abuse is carried out by
- Family members
- Paid caregivers
- Nursing homes
- Scam artists
S&S of elder abuse
- Signs in the patient
- Unexplained or untreated injuries
- Poor hygiene
- Malnutrition and dehydration
- Dirty or inappropriate dress
- Signs in the abuser
- Aggression toward or verbal abuse of the patient
- Speaking for the patient during an examination or treatment
- Disagreeable to instructions or suggestions in the patient’s best interest
Identify ways to identify elder abuse
- Screening tests for elder abuse
- Elder Assessment Instrument
- Indicators of Abuse Screen
- Brief Abuse Screen for the Elderly
- Laws regarding reporting
- Geriatric rehab professionals have a legal duty to act reasonably to identify elder abuse or neglect involving their patients, and to take appropriate action to prevent further abuse
- North Carolina N.C. Gen. Stat. § 108A–102(a) – (b) (a) Any person having reasonable cause to believe that a disabled adult is in need of protective services shall report such information to the director (of Adult Protective Services). (b) The report may be made orally or in writing. The report shall include the name and address of the disabled adult; the name and address of the disabled adult’s caretaker; the age of the disabled adult; the nature and extent of the disabled adult’s injury or condition resulting from abuse or neglect; and other pertinent information.
How to report elder abuse
- Who to contact
- For a community-dwelling older adult:
- Local adult protective services agency
- For an older adult in a long-term care facility:
- Local long-term care ombudsman
- Other groups:
- Citizen advocacy groups
- Office on Aging
- Protection and Advocacy System
- For a community-dwelling older adult:
Describe various types of restraints, compare the benefits vs. the risks, and the requirements to use restraints
-
Restraints: devices (physical) or substances (chemical) that restrict freedom of movement
- Purpose: increase patient safety and prevent injury
- Evidence shows that restraints often increase the incidence of falls
- Laws: “patient has the right to be free from any physical or chemical restraints imposed for purposes of discipline or convenience, and not required to treat the resident’s medical symptoms.”
- Requirements
- MD order
- Must be discontinued after 24 hours unless well documented for necessity
- Additionally: elaborate process to show failure of “less restrictive devices” prior to restraint implementation
- Use of restraints:
- Prohibited in prone position
- May be used if necessary to prevent imminent danger or injury
- May not be used as a discipline or for convenience
- Must be ended at the earliest possible time
- May only be used when less restrictive interventions have been determined to be ineffective
- Must be ordered by a physician or other authorized, licensed practitioner
types of restraints
- Chair or bed alarm
- Bed rail
- Lap buddy, lap tray
- Seat belt
- Reclining WC or gerichair
- Wedge cushion
- Hand mitts
- Extremity tie-on devices
- Waist and pelvic ties
- Posey vest
- *If the person can’t remove the device, it is considered a restraint
Describe the general advocacy process.
- Healthcare advocacy
- Key role in building strong health systems
- Self-advocacy and patient-focused advocacy
- APTA Code of Ethics: PTs shall participate in efforts to meet the health needs of people locally, nationally, or globally
- Legal, legislative, and regulatory advocacy
