Test 2 Flashcards
State of physical, mental and social well-being
Health
Proper body mechanics should be implemented when moving and caring for patients to maintain good health
Study of the human body in the working environment
Ergonomics
Sensitivity to the needs of others
Empathy
3 reasons why it is a radiographers professional and ethical responsibility to keep consumption of supplies to a minimum (large quantities of supplies are consumed in healthcare facilities)
Environmentally advantageous
Department costs
Keeps department moving more effectively
Contains district groups which hold conferences for radiographers
One in each state and four more
Provide opportunities to advance the profession and help members stay current
ASRT
Describes how individuals learn morality:
First behave according to obedience and punishment
Then behave morally to gain acceptance and approval
Eventually behave according to conscience that recognizes morality to society and the human condition
Kohlberg’s Theory
Branch of philosophy that is a systematic reflection on morality
Considering the proper response to any situation
Professionals are responsible for knowing and honoring the principles of ethics that govern their profession
Ethics
Provide remedies when patients have been caused harmed or treated harm or treated wrongly
Laws
Establishes broad principles of professional cants
Put aside personal prejudice and emotional bias when rendering professional services
Radiology protection for self and others
Patient confidentiality
Code of ethics
Mandatory, specific standards of minimally acceptable professional conduct
Rules of ethics
Method of evaluating situations in which the correct action is in question
Ethical analysis
4 basic steps of ethical analysis
Identify the problem
Develop alternative solutions
Select the best solution
Defend your selection
6 moral/ethical principles that are guides to correct action
Beneficence Nonmaleficence Veracity Fidelity Justice Autonomy
Goodness, actions that bring about good are considered right
Beneficence
No evil, an obligation not to inflict harm
Nonmaleficence
Truth, obligation to tell the truth
Veracity
Faithfulness, obligation to be logical or faithful
Fidelity
Fairness
Justice
Self-determination, respecting the independence of others and acting with self-reliance
Autonomy
Hospitals required to provide protection for patients concerning the release of individual financial and medical information without written consent
No information given to employer, financial institutions or other medical facilities
Each facility will have a written procedure for compliance with these standards
Health Insurance Portability and Accountability Act (HIPAA)
Most consent is given on admission and is implied for routine procedures
Certain procedures such as myelograms and arteriograms require the patient receive full explanation of the procedure and potential risks, patient and witness then sign a consent form
Informed consent
Patients can refuse treatment or examination at any time
The healthcare worker should communicate with the patient and explain the situation
If the patient still refuses, notify the physician
Right to refuse treatment
Do not resuscitate; when a patient agrees to not be revived if they code
DNR
Outline of specific wishes about medical care if patient loses the ability to make communicative decisions
Some states also have physician assisted deaths
Advance directive
Deals with offenses against the state or society
Criminal law
Thefts and drug related crimes
Felonies
Violation of laws that regulate practices
Misdemeanors
2 types of criminal law
Felonies
Misdemeanors
Deals with rights and duties of individuals with respect to one another
Civil law
Civil wrong by one individual against another person or their property
Tort
The suing party
Plaintiff
The party being sued
Defendent
Threat of harm
Assault
Unlawful touching
Battery
Unjustifiable detention on one against their will; the least restrictive immobilization device possible should be used, hand or leg restraints must be ordered by the physician. Ex: a patient wishes to leave and is not allowed
False imprisonment
Confidentiality is not maintained or when a patient’s body has been exposed
Invasion of privacy
Malicious spread of information, written information
Libel
Defamation of character in verbal form
Slander
Neglect or omission of reasonable care or caution
Negligence
2 torts
Intentional misconducts
Negligence
6 intentional misconducts (torts)
Assault Battery False imprisonment Invasion of privacy Libel Slander
Res ipsa loquitur
“The thing speaks for itself”
Resondeat superior
“Let the master respond” (the employer is responsible for the employee’s negligent acts)
Body language says a lot; ex: leaning forward while a patient talks shows interest
Nonverbal communication
A way we show how we feel about our career and patients
Uniforms present a simple, neat this and are easily cleaned
Clean exam rooms show respect for the patient
Appearance
Good listeners wait their turn to provide input
Listening skills
Clear, distinct speech that uses language and content appropriately
Verbal skills
Revealed by nonverbal behaviors, voice tone and word choice
Attitude
Validate that you have understood
Sometimes you may find yourself in a new procedure or with another healthcare worker with an accent
Validation of communication
The healthcare professional consciously influences a client or helps to better understand through verbal or nonverbal communication
Therapeutic communication
First contact is usually the introduction; patients should be addressed as a person, not as an exam
Addressing the patient
Patients like to share making choices involving their healthcare
Valid choices
Idea that elderly are ill, worthless and unattractive
Ageism
4 most important opportunities for patient education
During the explanation of procedures
Responding to patient concerns
Part of patient prep procedures
During instruction for follow up procedure
2 situations that may arise when the radiographer deals with a deceased patient
Radiographs for placement of lines needed to support organs for donation
Homicide (ex: person shot, find bullets)
Service for patients when they are likely not to live more than six months
Hospice
Provide relief but not intended for a cure
Palliative
5 stages of grieving (Dr. Elizabeth Kubler-Ross)
Denial Anger Bargaining Depression Acceptance
Grieving person refuses to accept the truth
Denial
Person experiences frustration of helplessness and a feeling of outrage
Anger
Person seems to be attempting to earn forgiveness or mitigation of the loss by being “very good”
Bargaining
Person accepts loss or impending death and deals with life relationships on a more realistic basis
Acceptance
Federal agency governing safety in the workplace, provides guidelines to ensure a high level of safety for hospital workers; required part of safety procedures in hospitals
Occupational Safety and Health Administration (OSHA)
3 components of a fire
Fuel
Oxygen
Heat
2 ways fire can be avoided
Add water (lowers temperature) Smother it (remove oxygen)
4 causes most hospital fires are traced to
Spontaneous combustion
Open flames
Cigarette smoke
Electricity
Chemical reaction in or near flammable material causes enough heat to start a fire (rare due to safety measures but may occur during renovations or new construction)
Spontaneous combustion
4 infractions of fire safety
Blocking fire doors to prevent them from closing
Storing equipment in corridors, hindering evacuation
Improperly storing flammable items
Using unapproved extension cords
R.A.C.E
Rescue
Alarm
Contain
Extinguish/evacuate
Remove patients from danger by moving at least two fire doors away
Rescue
Active alarm system or use hospital call code for fire
Alarm
Close open doors to limit oxygen supply and prevent spread of smoke and heat, make sure oxygen valves and electrical circuits are turned off and close doors to patient rooms
Contain
Use fire extinguisher for small fires and leave the area for larger fires
Extinguish/evacuate
P.A.S.S. (using a fire extinguisher)
Pull the pin
Aim the nozzle at fire base
Squeeze the handle
Sweep side to side to prevent spread of the fire
Should be on file for all hazardous materials and easily acceptable
Material Safety Data Sheets (MSDS)
Developer and fixer are classified by MSDS as hazardous
OSHA requires one wear protective aprons, goggles and nutrile gloves when pouring or cleaning up film processing solutions
Darkroom chemicals
Regulates safe disposal of hazardous waste
EPA
Flood the eye with running water for five minutes
Eye spashes
Reports injury rates for hospital workers that are similar to that of industrial workers
Bureau of Labor Statistics
Principles of proper alignment, movement and balance; proper this prevents work injury
Body mechanics
3 concepts for understanding principles of body mechanics
Base of support
Center of gravity
Line of gravity
Portion of the body in contact with the floor; if this is broad it provides stability for body position and movement
Base of support
Point where body weight is balanced
Usually located in pelvis or lower abdomen
Body is most stable when this is nearest the center of the base of support
Center of gravity
Imaginary line passing vertically through the center of gravity; body is most stable when this bisects the base of support
Line of gravity
Too small to be seen by the naked eye; include bacteria, viruses, protozoa, prions and fungi
Microorganisms
Microorganisms that live on or in the body without causing infection or disease
Normal flora
Microorganisms that cause disease
Pathogens
Small, single-celled organisms with a cell wall and an atypical nucleus that lacks a membrane, can grow independently and replicate without a host cell
Significant diseases this causes: tuberculosis, streptococcal pharyngitis (strep throat)
Bacteria
3 shapes bacteria are classified by
Cocci
Bacilli
Spirilla/spirochetes
Cocci
Spherical
Bacilli
Rod-shaped
Spirilla/spirochetes
Spiral-shaped
2 staining processes bacteria are classified by
Gram positive
Gram negative
Retain dye when washed with alcohol
Gram postive
Dye is removed after washed with alcohol
Gram negative
3 oxygen requirements bacteria are classified by
Obligate aerobes
Anaerobes
Facultative organisms
Require oxygen to grow
Obligate aerobes
Will not grow in the presence of oxygen
Anaerobes
Can adapt to grow with or without oxygen
Facultative organisms
Atypical bacteria, grows inside animal cells
Transmitted by vector bites (ticks, lice, fleas, mites)
Cause of Rocky Mountain spotted fever and typhus fever
Ricketttsiae
Subcellular organisms, cannot survive independently
Include Hepatitis, Epstein Barr
Viruses
Single-celled yeasts or long branched filament structured like mold
Produce alcoholic beverages, cheese, bread
Cause infections such as athlete’s foot and ringworm
Fungi
May be infectious proteins, do not have DNA or RNA
Can transform healthy nerve proteins to more of these
Resistant to natural body defenses
Thought to cause mad cow disease
Prions
Complex single-celled animals that exist as free-living organisms, some are parasitic
Live in the human body, classified as motile (moving) vs nonmotile
Diseases caused include malaria and toxoplasmosis
Protozoa
6 factors that must be present for the cycle of infection to occur
Infectious organism Reservoir of infection Portal of exit Susceptible host Portal of entry Means of transporting the organism
Characteristics of certain microorganisms that cause them to be pathogenic and distinguish them from normal flora, enable bacteria to destroy or damage the host cell and resist destruction by the host’s cellular defenses
Virulence factors
Can be any place where pathogens can thrive in sufficient numbers to pose a threat, must provide moisture, nutrients and suitable temperatures
Reservoir
Individuals which are a reservoir of infection, without realizing it due to lack of symptoms
Can also include: animals, soil, food and water
Carriers
Any route through which blood, bodily fluids, excretions or secretions exit the body
Portal of exit
Frequently those with a reduced natural resistance to infection
Susceptible host
Hospital acquired infection, occur more than 48 hours after being admitted to the hospitals
Healthcare associated infections (HAIs)
Two million patients admitted each year acquire one (10% of total)
Sources of information include: contaminated hands, instruments and urinary catheters
Wide and inappropriate use of antibiotics has led to more drug resistant infections
MRSA, VRE, penicillin resistant streptococcus and aeruginosa and C. Diff
Nosocomial infection
Route by which microorganisms gain access into the susceptible host, ex:
Respiratory, urinary and gastrointestinal tracts
Open wounds/breaks in skin
Mucous membranes of the eyes, nose or mouth
Bloodstream
Portal of entry
Healthcare workers acquire a nosocomial infection
Occupationally acquired/healthcare associated infections (HAIs)
6 main routes of transmission from the reservoir to the host (most effective way to stop the cycle of infection is to prevent transmission)
Direct and indirect contact including: Fomites Vectors Vehicles Airborne means Droplet contamination
Requires the host is touched by an infected person and the organisms are placed in direct contact with susceptible tissue
Direct contact
Objects that have been in direct contact with pathogenic organisms; ex: fork, urinary catheter
Fomites
Arthropod which harbors infectious organisms before eventually infecting a host, its bite can transmit disease to humans
Ex: malaria, dengue fever
Vectors
Any medium that transports organisms
Ex: food, drugs or blood
Vehicles
Large droplets come in contact with mucous membranes of the eyes, nose, or mouth of a susceptible person
Particles do not remain suspended in air and travel short distances
Ex: influenza, meningitis, diphtheria, pertussis, streptococcal pneumonia
Droplet contamination
Occurs from dust that contains spores or droplet nuclei
Particles of evaporated droplets that remain suspended in air for long periods
Dispersed by air currents and special handling and ventilation are required for prevention
Ex: M. tuberculosis, rubeola, varicella viruses
Airborne transmission
3 ways the body is protected from the invasion of microorganisms
Natural resistance
Acquired resistance/active immunity
Short-term passive immunity
Provided by mechanical barriers such as intact skin and mucous membranes
Mucous secretion by respiratory, urinary, gastrointestinal and reproductive system
pH, salt content and dryness of skin limit the number of bacteria
Normal flora prevent overgrowth of undesirable organisms
Natural resistance
Can become resistance to a disease by becoming infected with a specific organism
Can also be conferred via vaccines from dead or weakened strains of the microorganism
Acquired immunity
aProtein substances for medicine to a specific antigen, produced by the white blood cell (B-cell)
Antibodies
Injection of antibodies to a particular infection are given
The antibodies act immediately but will weaken over time since the body does not produce them on its own
Passive immunity
Appearance of an infectious disease or condition that affects many people at the same time in the same geographical area
Epidemic
Keeps track of infection and develops information control policies to protect staff and patients based on recommendations from the CDC
Infection Control Department
Monitors and studies infection types occurring in the US and compiles stat data then publishes it
Centers for Disease Control (CDC)
Studies, collects and compiles infection data from every country in the world
WHO (World Health Organization)
8 factors disease emergence is precipitated by
Increased human exposure to vectors (Reforestation leads to more deer -> vector for Lyme disease)
Population growth and migration to crowded cities
Rapid international travel and transportation of goods
Contact with new strains of dangerous pathogens
Pathogen mutation
Breakdown in public health measures (South America and Africa: cholera outbreaks from poor sanitation and low chlorine levels in water)
Climate change (SW US: Hantavirus respiratory syndrome due to drought followed by a mild wet winter and spring, lead to rise of deer and mice population)
Bioterrorism (Anthrax outbreak in US due to terrorism)
Widespread epidemic
Pandemic
Methicillin-resistant staphylococcus aureus
MRSA
Vancomycin-resistant enterococci
VRE
Gram positive bacillus that makes spores which are difficult to control, occurs when normal flora are killed off; clostridium difficile
C. Diff
RNA/retrovirus (replicated in a backwards manner
Can be transmitted several days after being acquired
HIV (Human Immunodeficiency Virus)
Has specificity for receptors on CD4 lymphocytes
AIDS (Acquired Immunodeficiency Syndrome)
Inflammation of the liver, classified as A, B, C, D and E
Hepatitis
Hepatitis transmitted by food and water
A and E
Bloodbourne hepatitis
B, C, and D
Hepatitis that has been shown to survive in dry blood for up to a week
B
Most common form of hepatitis
A
What should you do in case of needle stick?
Allow skin to bleed under cold water and wash with soap
What should you do if eyes, nose or mouth are splashed with body fluids?
Rinse mucous membranes with water
Contagious, airborne lung disease caused by M. tuberculosis
Most common among homeless, recent immigrants and immunosuppressed
Transmitted when an infected person coughs droplets into the air
Can be infected but remain dormant until the immune system weakens
Therapy consists of isoniazid for 6-9 months to prevent active disease
Tuberculosis (TB)
Simplest and most common test for tuberculosis, intradermal injection or anterior forearm and is measured 2-3 days later
Tuberculin skin test (TST)
Infected individuals were prevented from entering
No longer commonly used by US Public Health still has the authority to detain and do this to people to prevent the spread of serious infections
Diseases that may elicit this: cholera, diphtheria, infectious TB, plague, smallpox, yellow fever, SARS
Quarentine
All patients treated as reservoirs of infection
Emphasis placed on blood and body fluids being potential sources of infection
Introduced by the CDC in 1985
Universal precautions
Focused on barriers for all moist substances from all patients
Body substance precautions
Combination of universal and body substance precautions
Infection control to reduce infection transmission
Reduces the risk for airborne, droplet and contact precautions
Standard precautions
Absence of microorganisms
Asepsis
Second level of microbial dilution that involves destruction of pathogens by using chemical materials
Disinfection
Free of living microorganisms, the process of destroying all microorganisms
Accomplished via: heat, gas or chemicals
Sterilization
Reduce risk of transmitting dust particles of infectious organisms or airborne droplet nuclei
Protect against diseases such as TB and measles (rubeola)
Must wear particulate respirators which are fit tested
These patients are in negative air pressure rooms (do not let in a draft)
Airborne precautions
Protect against large particle droplets
Protect against diphtheria, pneumonia and influenza
Must wear surgical masks but no special air circulation for the room
Droplet precautions
Reduce infection by direct contact with skin or mucous membranes; MRSA, VRE, E. Coli and C. Diff
Contact precautions
Patients with low immune systems; includes burn victims, neonate and organ transplants
Compromised patients
