test #1 Flashcards
Who is the RDH accountable to?
The public
3 fundamental aspects of a professional practitioner
honesty, fairness, competence
which framework must be used when conducting DH therapy?
ADPIE
PHIPA stands for:
Personal health information protection act (2004)
Controlled act self-initiated RDH authorized to do?
scalling and root planning
can RDH of CPR without consent (when needed)
yes
who develops guidelines and regulations for DH practice in Ontario
CDHO
Can RDH delegate a controlled act in educational setting to student
yes
How many years must DH records be kept legally
10 years
who determines the clients capacity for decision making?
the clinician providing care
The purpose of a professional association is to:
support the professional development of its members and lobby the government for legislative changes
What are ethics?
discipline of dealing with what is good or bad and with moral duty and obligation
what is the code of ethics
moral guidelines, outline or moral principles of health care based on goals, values, and ideals
what are principles or values
they guid the conduct of health care providers by helping to identify, clarify and justify moral choices
General health care principles (6)
nonmaleficence, beneficence, autonomy, justice, veracity, confidentiality
Nonmaleficence
do no harm, keeping knowledge and skills current, know own limitation
preventing and removing harm
beneficence
obligation to act in best interest of the client
autonomy
right to self determination, self govern, make one own decisions
foundation of informed consent
justice
provide individuals with what they are owed, due or deserved (equality) regardless of age, gender, religion etc
veracity
being honest and telling the truth, basis of trust is essential
confidentiality
related to respect for persons, trust is important for the exchange of personal information
CDHA code of ethics (5 principles)
beneficence, autonomy, integrity, accountability, confidentiality
Ethical violations
when DH fails to meet of neglect their specific ethical responsibilities as expressed in the code
ethical dilemmas
when one or more ethical principles are in conflict
ethical distress
when Dh experience constraints or limitations to which they are or feel powerless and which compromise their ability to practice according to the professional principles
Steps in decision making (8)
1) describe issue and identify nature of problem
2) gather info
3) clarify problem
4) identify options
5) address pros and cons
6) decide on course of action
7) implement your decision
8) assess the consequences
signed consent
piece of paper
informed consent
requires the client to be given sufficient information about the procedures, its benefits, and risks to make good decision
4 elements of valid consent
1) it relates to the treatment
2) it is informed
3) it is voluntary
4) there is no misrepresentation or fraud
informed consent must address: (6)
nature of consent, expected benefits, possible risks, possible side effects, alternate sources of action, likely consequences of not having treatment
is signed consent required?
no, but prudent in complex cases or w questionable outcomes
patients must sign refusal of treatment
protects against legal issues
what is the health care consent act (HCCA)
- system for obtaining treatment decisions on behalf of incapable patients
- if patient is incapable, substitute decision maker has given consent
- DH determines patients capability
- consent to treatment can be withdrawn at any time
- Dh must inform incapable patient of plan
When was the HCCA implemented
1996
Age of consent (by HCCA)
16
importance of record keeping
Good records are best legal defences, no record - didn’t happen
client record principles (8)
- good writting, non erasable ink, date all entries, sign all entries, no subjective comments, use uniform terms, correct errors w stroke and initial, no blank spaces
purpose of records (4)
accurate dental records, provide history of care and treatment, provide creditable defence, dental records are legal document
CDHO record regulation: (8 components)
1) general client info
2) medical history
3) dental history
4) dental and peri charts
5) treatment records of every examination findings
6) treatment record of procedures preformed
7) non-written client records (x-rays, photographs)
8) other required records (finical record, sterilization)
Retention of records
must be kept for 10 years following:
1) last vist, last conversation
2) after child turns 18 - 10 years following 18th b day
Supreme Court of Canada rules:
whoever owns office owns client records, client is able to have a copy upon request
destruction of client records
shredded or hard drive destroyed - mark date destroyed
boundary crossing overview
1) relationship of trust
2) power imbalance
3) RDH responsibility to maintain boundaries
categories of professional boundaries (3)
1) confiding something personal to a client that you would only tell friend
2) giving or receiving gifts
3) dual relationships
risk of crossing boundaries (3)
1) professional risk
2) risk of client
3) observers of the relationship (interferes with prof judgment, clients ability to respect out judgment)
risk factors in DH (3)
1) seeing client over a ling period of time (life story)
2) client audience
3) our responsibility to maintain the boundary
CDHO zero tolerance
under no circumstance will sexual abuse be tolerated
who mandated that the CDHO develop a sexual abuse prevention program?
RHPA 1991 sexual abuse
Bill 97 protecting patients act
Sexual abuse prevention program
What constitutes as sexual abuse under the RHPA?
Very broad, includes sexual intercourse or other forms of sexual relations, touching, behaviour or remarks (laughing at sexually inappropriate joke at the office with clients)
-apply to all sexual relations before, after and during treatments
what is the mandatory penalty for findings of sexual abuse?
1) revocation of RDH certificate for 5 years
2) reprimand
3) RDH pay fine up to 35,000 to minister of finance of ON
4) pay all or part of legal costs
5) RDH pay for therapy of client
Who enforces sexual abuse penalty
CDHO
What constitutes as spouse according to CDHO spousal exemption regulation?
according to RPHA and family law act: person married for minimum of 3 years, or common law for 3 years
what to do if inter to date a client?
wait a year after last treatment, transfer care to peer, never treat again
difference between professional boundaries and sexual abuse
- boundaries is grey area, sexual abuse is 0 tolerance
info on how we store documents and how to keep records:
PHIPA, PIPEDA and CDHO record regulations
Legislative timeline for sexual abuse regulation:
feb 5, 2015 - CDHO proposed regulation
Oct 8, 2020 - legislating was passed
DH obligations
1) client dignity
2) show rescpet
3) respect cultural diversity
4) obtain consent
5) clients can change their mind
6) never place instruments on client
PHIPA (provincial regulation)
Ontario’s personal health information protection act (2004)
- rules for collection, use and disclosure of person health info (Ontario only)
PIPEDA (federal regulaiton)
Personal information protection and electronic documents act
- rules for collection, use and disclosure of person health and other info (Canada)
Where would a DH find info on record keeping?
PHIPA - health info Ontario
PIPEDA - privacy legislation (all types)
CDHO - specific info needed in charts
