Week 1 (Exam 1) Flashcards
Exam 1
What is Diagnostic Methods
Tools utilized to aid in a formal diagnosis
- not make a diagnosis
- ex: imaging and lab samples
What key attributes are important in establishing a strong PA- Patient relationship
Open communications
Shared trust
Beneficence (best for pt)
Honesty
What are the types of patient provider relationships and describe them
Paternalistic: provider determines treatment in patients best interest, regardless of pt values
- based on beneficence
Informative: patient determines which treatments to accept or refuse based on personal values
Deliberative: decision regarding treatment determined from shared deliberation between patient and provider
- patient centered model
Define paternalism
physician focused in nature, based on beneficence
- desire to do good for the patient
Define patient centered model and benefits
Recognizes autonomy, right to self determination
- pt feeling
- questions
- shared decision making
Define informed consent
a formal agreement that a patient SIGNS or VERBALIZES to give permission for a medical procedure AFTER having been told about the risks and benefits
Define assent
an act of agreeing to something especially after thoughtful consideration
What are the 3 types of consent and define them
Are these informed consent
implied: used when immediate action is needed
- ER
general: for routine services
- hospital admission
special: specific high-risk procedures and treatment
- children, minors, ivf, fetus rights, etc
NO!
What is needed for informed consent
adequate information regarding the proposed treatment
- comprehensible
this needs to be obtained prior to ALL medical interventions that have “potential for harm”
what are 3 essential components of informed consent
- capacity/competency
- given enough info (alternatives)
- voluntarily consent
Is a minor considered competent?
minor is legally incompetent unless state-specific legislation declares competency
What do you need to provide for there to be adequate info to then gain informed consent
- diagnosis
- nature of PROCEDURE
- RISKS
- consequences
-likelihood procedure will achieve desired outcome - any ALTERNATIVE and their risks
P(procedure that will be performed)
A( alternatives)
R(risks)
Q(questions pt’s might have)
What can limit a patients understanding of informed consent
language barrier
education levels
Additional limits (not in red/”important”):
any anxiety
emotional impairments
physical impairments
How do you ensure understanding in patients?
ask questions
use interpreters (non-family)
Additional (not in red/”important”):
material is available in native language
various comm methods
layman’s terms
can you influence a patient’s decision?
YES!
make sure not to exert any influence on patient’s decision making based on your opinion of treatment
Does informed consent need to be in writing?
no, verbal consent is as binding as written consent
- ALWAYS document verbal consent in a patient’s chart
- ALWAYS document refusal and risks associated
In IL a minor can sign own informed consent procedures if
married
a parent
pregnant
When can a provider inform a parent or guardian without a minor’s consent in IL
Illinois Public Act 87-460
Under the new Act, a physician or counselor is explicitly barred from providing notice to a parent or guardian without the minor’s consent, UNLESS the purpose is to protect the safety of the minor, another family member, or another individual
Minors can seek care for primary services in IL if:
over the age of 12 in relation to a sexual health issue
emancipated
any age may obtain an abortion (since June 1, 2022, abortion does not require parental consent in IL) and birth control
What is the policy regarding mental health and minors (informed consent)
Minors aged 12 and over may consent to counseling or psychotherapy on an outpatient basis.
(not in red):
If the minor is under 17, counseling or psychotherapy sessions are initially limited to eight in number without parental consent; after that, additional sessions without parental consent are available only if the provider determines that obtaining such consent would be detrimental to the minor’s well-being.
Is a nurse able to obtain informed consent
no because they don’t have
- authority
- unable to inform all potential risks and benefits
- unable to appropriately answer any patient questions
What is the Health Care Consent Act
guides the selection of a substitute decision-maker
- POA
- spouse (living together in a married or common law relationship)
- parent or child
- siblings
- other relatives
- you (if no one else)
What are social determinants of health
conditions in the places where people live, learn, work, and play that affect a wide range of health and quality of life risks and outcomes
What are other factors we need to consider
risks (to pt) vs costs (to pt)
Why is medical record documentation so important
main source of communication for the patient between healthcare providers
legal and billing purposes
Since jan 1st of 2021, what do patients have immediate access to
all clinical documentation is immediately available to patients
What are some legal considerations regarding medical documentation
document carefully and accurately
Do’s and Don’ts of written documentation
Do’s:
- sign and date each encounter
- use military time
- read all transcriptions before signing off
- use a single line through on error and initial it
Don’ts:
- use white out/correction tape
- write in margins of pages
- destroy records
- skip lines in rule pages
Define panic value
test results that fall significantly outside the normal range and may represent life-threatening values and require urgent medical intervention
Stat vs Routine
stat: lab values return ASAP
- cost more to pt
routine: lab values may come back later in afternoon or next day
postprandial vs prepandial
postpandial: after eating a meal
prepandial: before eating a meal
NPO
nothing by mouth
- lab testing, pre surgery, acute patients
precision vs accuracy
precision: how close measure values are to each other
accuracy: how close a measure value is to the true value
*best when measurements are both precise and accurate
Define reference range
set of values that include upper and lower limits of a lab test based on a group of otherwise healthy people
Specificity vs sensitivity
specificity: true neg rate, refers to the proportion of those who received a neg result on this test out of those who do not actually have condition
- ex: where a condition is located
sensitivity: true pos rate, refers to the proportion of those who received a positive result on this test out of those who actually have condition
- ex: yes or no to a condition
Define gold standard
any test that is felt to be the current best for diagnosis of a particular condition
- for any specific disease
- changes over time with research
before obtaining a specimen, what should you do
make sure you have correct labels
- name, DOB, lab test
