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APEX > Unit 12 - Professional Issues > Flashcards

Unit 12 - Professional Issues Flashcards

1
Q

4 things that must be proven in a case of negligence

A
  1. duty
  2. breach of duty
  3. causation
  4. damages
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2
Q

difference in assualt and battery

A

Battery is the physical act of touching another person without either expressed or implied consent (direct physical contact)

Assault is making a person feel or perceive that battery is imminent (victim is made to “feel” a certain way in response to your actions)

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3
Q

Latin word that means “thing that speaks for itself”

A

Res Ipsa Loquitur

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4
Q

dictates the principles of conduct and professionl integrity that guide the decision-making and behavior of CRNAs

A

AANA code of ethics

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5
Q

authoritative statements that describe minimum rules and responsibilities for which anesthetists are held accountable

A

practice standards

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6
Q

systematically developed statements to assist providers in clinical decision-making that are commonly accepted within the anesthesia community

A

practice guidelines

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7
Q

express the AANA official positions or beliefs on practice-related topics

A

position statements

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8
Q

asserts that a provider has an obligation not to inflict hurt or harm

A

nonmaleficence

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9
Q

the patient’s ability to choose without controlling interference by others and without limitations that prevent meaningful choices

A

autonomy

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10
Q

failure of a provider to fully provide information that a reasonable person would want to know before making a decision is a violation of:

A

autonomy

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11
Q

inappropriate use of diagnostic tests with the inherent risk of false-positive or false-negative results is an example of violating which principle

A

nonmalificence

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12
Q

principle that providers should act for the benefit of others

A

beneficence

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13
Q

principle that underpins the fundamental guiding principle of evidence-based interventions

A

beneficence

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14
Q

principle that people under similar circumstances and conditions shouldbe treated alike

A

justice

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15
Q

principle that requires all patients have the same moral claim to evidence-based quality health care

A

justice

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16
Q

6 elements of informed consent

A
  1. competence
  2. decision-making capacity
  3. disclosure of information
  4. understanding of disclosed information
  5. voluntary consent
  6. documentation
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17
Q

patient has the legal authority to consent

A

competence

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18
Q

the patient has the ability to decide about specific anesthesia care

A

decision-making capacity

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19
Q

for disclosure of information, the patient is informed at minimum of the:

A
  • nature and purpose of proposed anesthesia technique
  • risks, benefits, and side effects of proposed techniques
  • alternatives and their risks, benefits, and side effects
  • risks of not receiving anesthesia care
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20
Q

assent

A

unless developmentally inappropriate, minor children should be included in the informed consent disucssion and agreement should be sought

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21
Q

what is implied consent?

A

permits healthcare providers to provide life-saving care when immediate treatment is required and the patient is unconscious or can’t consent

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22
Q

can family translate for a patient?

A

only in an emergency

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23
Q

exam used to evaluate for cognitive impairment

A

MMSE

Mini-Mental State Exam

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24
Q

informed consent and disclosure for obstetric patients receiving regional anesthesia should include:

A

general anesthetic - any risk with high incidence, high mortality, or adverse fetal effects

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25
Q

a legally binding document that delineates a patient’s wishes regarding healthcare interventions in the case of incapacity and delegates authority to make healthcare decisions to another party

A

advanced directive

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26
Q

what should be documented when an advanced directive is reconsidered before anesthesia

A
  • date and time of conversation with patient or legal representative
  • names of all parties present for discussion
  • specific interventions to be modified or withheld, including CPR, antibiotic use, intubation, and mechanical ventilation
  • specific duration of time for suspension or modification of directive
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27
Q

who does the AANA recommend to be present when discussing changes in advance directives during the informed consent process?

A

the patient, family, and healthcare team

28
Q

are DNR orders automatically suspended during procedures in the OR?

A

no

29
Q

when does a breach of duty occur?

A

when expert witnesses review the medical record and determine that the standard of care was not adhered to

examples - doing something that should not have been done, failing to do something that could have been done

30
Q

generally, if the odds are greater than___% that the breach of duty lead to the injury, proximate cause can be established.

A

50

31
Q

tests used to determine causation: but for or cause-in-fact

A

if the injury would not have occured but for the actions of the provider, proximate cause is established

32
Q

tests used to determine causation: substantial factor

A

if the act of the provider was a substantial factor in the injury despite other causes, proximate cause is established

33
Q

Res Ipsa Loquitur can shift the burden of proof from the plaintiff to the defendant if what 4 conditions can be established?

A
  1. if the injury wouldn’t have occurred in the absence of negligence
  2. the injury was caused by something under the complete control of the defendent (provider)
  3. the patient did not contribute in any way to the injury
  4. the evidence for the explanation of events is solely under the control of the provider
34
Q

classic example of the use of Res Ipsa Loquitur doctrine

2nd most common situation in which it is usually granted

A
  1. foreign object like a sponge or clamp inadvertently left in a surgical patient
  2. nerve injury sustained during the course of the surgery to an area remote from surgical site
35
Q

defamation in the verbal form

A

slander

36
Q

what would it be called if a CRNA knowingly writes a false statement in the patient’s chart that results in the defamation of the patient’s character

A

libel

37
Q

the physical act of touching another person without either expressed or implied consent

A

battery

38
Q

making a person feel or perceive that battery is eminent

A

assault

39
Q

can assault occur to unconscious patients?

A

no - can’t occur if the pt is unaware of their environment

40
Q

placing an epidural in a laboring patient without her consent is an example of (assault/battery)

A

battery

41
Q

if you’re preparing to place an epidural and she feels that you’re going to place it without her consent, you’ve committed (battery/assault)

A

assault

42
Q

administering a general anesthetic to a patient who has only consented for local by the surgeon is an example of (assault/battery)

A

battery

43
Q

does harm have to be proven when assault or battery charges are brought upon a provider?

A

no

44
Q

general rule for statute of limitations for a minor

A

doesn’t begin until the minor turns 18

ex: if the statute of limitation is 3 years, a minor can file the lawsuit up to the age of 21

45
Q

what are special damages in medical malpractice cases

A

actual damages that result from an injury

- medical expenses, lost income, property damage

46
Q

abandonment

A

failure to provide continuity of care once duty to a patient is established

47
Q

vicarious liability

A

a person or entity may be liable for the actions of another

48
Q

general damages in medical malpractice case

A

directly result from injury

- ex. pain and suffering

49
Q

punitive damages in medical malpractice case

A

punishment for reckless behavior

very rare

50
Q

requires medical insurance to cover certain preventative health visits without a co-pay in order to promote the early detection of disease and prevent long-term morbidity

A

affordable care act

51
Q

established an institute for comparative effectiveness research and authorized funding for research in pain management

A

affordable care act

52
Q

enacted to ensure public access to emergency services regardless of ability to pay

A

EMTALA (emergency in medical treatment and active labor act)

53
Q

act that imposes specific obligations on medicare-participating hospitals offering emergency services to provide a medical screening exam when a request is made, regardless of ability to pay

A

EMTALA

54
Q

a lawsuit based on EMTALA is filed against the hospital or the healthcare provider?

A

hospital

55
Q

schedule 1 controlled substance

A

no currently accepted medical use, high potential for abuse

ex - LSD, peyote, mescaline, heroine, etorphine, marijuana, MDMA, ecstasy

56
Q

schedule 2 controlled substance

A

high potential for abuse potentially leading to dependence

ex: pentobarbital, cocaine, meth, methylphenidate, methadone, hydromorphone, meperidine, fentanyl, morphine, opium, oxycodone, hydrocodone, phencyclidine

57
Q

class 3 controlled substance

A

moderate to low potential for abuse and dependence

ex: tylenol with codeine, buprenorphine, ketamine, anabolic steroids, testosterone

58
Q

class 4 controlled substance

A

low potential for abuse and dependence

ex: xanas, valium, ativan, ambien, talwin, tramadol, chloral, phenobarbital

59
Q

class 5 controlled substance

A

lower potential for abuse than schedule 4 or contain limited quantities of certain narcotics

ex- cough suppressants with codeine, Lomotil, pregabalin

60
Q

act that was intended to create a healthcare information technology infrastructure in order to improve quality care and coordination between providers

A

HITECH - health information technology for economic and clinical health act

61
Q

act that limits the amount a patient can be charged for copies of their PHI

A

HITECH

62
Q

sets minimum standards for private employee benefit plans

A

ERISA - employment retirement income security act

63
Q

a critical incident report is best recorded in what form

A

narrative

64
Q

what 4 things should be extensively documented in a critical incident report

A
  1. what happened
  2. what drugs and doses were given and when they were given
  3. time sequence of events
  4. all parties present
65
Q

initial response when named in a lawsuit

A

notify insurance carrier immediately

66
Q

what are the initial actions you should take if you’re named in a lawsuit?

A
  1. notify your insurance carrier
  2. do not discuss the case
  3. do not alter any records
  4. gather all records of the case
  5. make notes
  6. cooperate with your attorney
67
Q

top 4 causes of anesthesia related lawsuits

A
  1. death
  2. nerve damage
  3. permanent brain damage
  4. awareness

APEX (54 decks)

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