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Legal and Ethical Issues in Midwifery > Week 10-14 > Flashcards

Week 10-14 Flashcards

1
Q

What is involved with validating a drug order

A
  • The medication chart needs to identify the patient
  • Any allergy
  • Medication order dated
  • Medication written with the generic name and strength of medication
  • Route of administration specified
  • The dosage documented
  • Time of administration documented
  • Medication chart signed by the Doctor
  • If NO to any of the above do NOT administer the medication.
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2
Q

What are the 5 Rights of drug administration

A
  1. The right patient
  2. The right medication
  3. The right dose
  4. The right route
  5. The right time/date
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3
Q

What is the NSW Legislation that controls drugs

A

Poisons and Therapeutic Goods Regulation (2008)

Poisons and Therapeutic Goods Act (1966)

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4
Q

What are Schedule 4 and 8 drugs

A

Schedule 4: Prescription Only Medicine Substances that are prescribed by a person permitted under state or territory legislation to prescribe, and available from a pharmacy by prescription

Schedule 8: Controlled Drug Substances with potential for dependence. E.g Morphine, Pethidine.

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5
Q

What are the medication categories in pregnancy

A

Category A: These drugs have been taken by a large number of pregnant women without identified risk
to the fetus.

Category B1: These drugs have been taken by limited numbers of women without evidence of increased
fetal malformation or other harmful effect. Animal studies have not indicated a higher than
normal incidence of fetal impairment.
Category B2: These drugs have been taken by limited numbers of women without evidence of increased
fetal malformation or other harmful effect. Animal studies are inadequate. There is no data
to suggest increased risk.
Category B3: These drugs have been taken by limited numbers of women without evidence of increased
fetal malformation or other harmful effect. Animal studies have shown increased incidence
of fetal effects.

Category C: These drugs have caused or been suspected to cause harmful fetal or neonatal effects, but
the effects are often reversible and not congenital malformations.

Category D: These drugs have caused, or have been suspected as causing, fetal malformation or
irreversible damage.

Category X: These drugs are not recommended for use in pregnancy due to a high risk of causing
permanent damage to the fetus.

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6
Q

What is the aim of quality documentation

A
  • To provide evidence of care and the patient’s response to that care
  • To be an important source of reference between members of the health care team
  • To facilitate the continuity of quality care by keeping all members of the team informed of the current health status
  • To improve outcomes for patients
  • To protect staff if they are called upon to explain the care they have given in any circumstance
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7
Q

What are the general principles of documentation

A
  • Line drawn across any empty space
  • No blank lines
  • Must be legible
  • Incorrect entry must remain readable – draw single line through it, write ‘written in error’ and initial
  • Must follow BU documentation guidelines
  • ‘Taken over care’ report
  • Minimum 2 hrs between reports or if changes
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8
Q

Under the Child and Young People Act 2008 (ACT)..

Define: Child and young person

A
  • a child is a person under the age of 12 (section 7)

- a young person is a person aged 12 or older but not yet considered and adult (section 8)

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9
Q

What are the 6 strategies of the “Protecting children is everyone’s business” National framework for protecting Australia’s children 2009-2020

A
  1. Children live in safe and supportive families and communities
  2. Children and families access adequate support to promote safety and intervene early
  3. Risk factors for child abuse and neglect are addressed
  4. Children who have been abused or neglected receive the support and care they need for their safety and wellbeing
  5. Indigenous children are supported and safe in their families and communities
  6. Child sexual abuse and exploitation is prevented and survivors receive adequate support
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10
Q

What is the Keep It Safe initiative

A

Is part of a 5 year plan established by NSW Government to reform child protection in NSW

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11
Q

What is the NSW Child Protection Act

A

Children and Young Persons (Care and Protection) Act 1988 (NSW)

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12
Q

Children and Young Persons (Care and Protection) Act 1998
Section 8

What are the objects of this Act?

A

(a) that children and young persons receive such care and protection as is necessary for their safety, welfare and well-being, having regard to the capacity of their parents or other persons responsible for them, and
(b) that all institutions, services and facilities responsible for the care and protection of children and young persons provide an environment for them that is free of violence and exploitation and provide services that foster their health, developmental needs, spirituality, self-respect and dignity, and
(c) that appropriate assistance is rendered to parents and other persons responsible for children and young persons in the performance of their child-rearing responsibilities in order to promote a safe and nurturing environment.”

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13
Q

Children and Young Persons (Care and Protection) Act 1998
Section 9- Principles for administration of Act

What is the principle of this Act

A

Subsection One: “This Act is to be administered under the principle that, in any action or decision concerning a particular child or young person, the safety, welfare and well-being of the child or young person are paramount.”

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14
Q

Children and Young Persons (Care and Protection) Act 1998
Section 12- Aboriginal and TSI participation principles

What are the Aboriginal and TSI participation principles

A

Aboriginal and Torres Strait Islander families, kinship groups, representative organisations and communities are to be given the opportunity, by means approved by the Minister, to participate in decisions made concerning the placement of their children and young persons and in other significant decisions made under this Act that concern their children and young persons

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15
Q

Children and Young Persons (Care and Protection) Act 1998

What sections have reports relevant to midwifery

A

Section 23: Child or young person at risk of significant harm
Section 24: Report concerning child or young person at risk of significant harm
Section 25: Pre-natal reports
Section 27: Mandatory reporting

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16
Q

Children and Young Persons (Care and Protection) Act 1998
Section 38A- Parents responsibility contracts

Explain: parent responsibility contract

A

The Act states: a parent responsibility contract is an agreement between the director-General and one or more primary care-givers for a child or young person that contains provisions aimed at improving the parenting skills of the primary care-givers and encouraging them to accept greater responsibility for the child or young person

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17
Q

Children and Young Persons (Care and Protection) Act 1998
Section 44- Assumption of Care

Explain: assumption of care in the act

A

The Director-General may assume care responsibility of child or young person in hospital or other premises
- (a) suspects on reasonable grounds that a child or young person is at risk of serious harm, and
- (b) is satisfied that it is not in the best interests of the child or young person that the child or young person be removed from the premises in which he or she is currently located

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18
Q

Who is a mandatory reporter

A

A person who, in the course of his or her professional work or paid employment, delivers health care, welfare, education, children’s services, residential services or law enforcement, wholly ot partly to children

19
Q

What is the mandatory reporting role of the midwife

A

Competency One element 1.1statesthat:
- “ The graduate midwife has a sound knowledge of the Australian health care system, relevant legislation and the role of the midwifery profession both locally and internationally. She practises within legislation and common law”
 Competency One Element 1.2 states that the graduate midwife:
- “Complies with policies and guidelines that have legal and professional implications for practice….for example, occupational health and safety, child protection, family violence.”

20
Q

Mandatory reporting can be done how?

A

Online or over the phone with Family and Community Services

21
Q

Mandatory reporting- child protection

What are the consequences for failure to report

A

Failure to report a suspicion of abuse may produce liability in negligence, regardless of the presence or absence of a legislative reporting duty, where the person with suspicion owes the child a duty of care.

It is possible for a midwife to be held liable for damage caused to a child through their failure to report suspected abuse

22
Q

Mandatory reporting

What type of protection is there for reporters

A

There is a common law protection for those reporting in ‘good faith,’ as well as statutory protections. In 2001 the HCA in Sullivan v Moody and Thompson v Cannon upheld the principle that a person who has a statutory duty to report a reasonable suspicion of child sexual abuse owes no duty of care to persons who may be wrongly suspected of perpetrating the harm, and therefore cannot be liable in negligence

23
Q

What are the 7 rights if the Australian Charter of Healthcare Rights

A 
Access
Safety
Respect
Communication
Participation
Privacy
Comment
24
Q

What are the 10 Conduct Statements of the Code of Professional Conduct

A

Midwives practise competently in accordance with legislation, standards and professional practice

  1. Midwives practise in a safe and competent manner.
  2. Midwives practise in accordance with the standards of the profession and broader health system.
  3. Midwives practise and conduct themselves in accordance with laws relevant to the profession and practice of midwifery.
  4. Midwives respect the dignity, culture, values and beliefs of each woman and her infant(s) in their care and the woman’s partner and family, and of colleagues.
  5. Midwives treat personal information obtained in a professional capacity as private and confidential.
  6. Midwives provide impartial, honest and accurate information in relation to midwifery care and health care products.

Midwives practise within a woman-centred framework

  1. Midwives focus on a woman’s health needs, her expectations and aspirations, supporting the informed decision making of each woman.
  2. Midwives promote and preserve the trust and privilege inherent in the relationship between midwives and each woman and her infant(s).
  3. Midwives maintain and build on the community’s trust and confidence in the midwifery profession.

Midwives practise midwifery reflectively and ethically
10. Midwives practise midwifery reflectively and ethically.

25
Q

What are some reasons why people make complaints against a health professional

A
  • practising unsafely
  • practising while intoxicated by alcohol and / or other drugs
  • a breach of confidentiality of patient information
  • engaging in sexual conduct with a patient
  • lack of informed consent
  • communication issues
  • inappropriate manner
  • lack of responsiveness to patient needs
  • a breach of infection control standards
  • inadequate or inaccurate patient records
26
Q

Explain: Professional Misconduct

A

refers to ‘the wrong, bad or erroneous conduct of a (midwife) outside of the domain of his or her practice; conduct unbefitting a (midwife)’ (eg sexual assault, theft or drunk and disorderly conduct in a public place).

27
Q

Explain: Unprofessional Conduct

A

conduct refers to ‘conduct that is contrary to the accepted and agreed practice standards of the profession’ (eg violating confidentiality in the woman-midwife relationship).

28
Q

How is a complaint made

A

Complaints can be made directly to the hospital within which the midwife is employed, via a written complaint, using an online form or over the phone.

29
Q

Who are complaints made too

A
  • the hospital in which the person of the complaint works
  • the Nurses and Midwives Council, the Health Care Complaints Commission (HCCC),
  • the Health Professional Councils Authority (HPCA) or
  • the Australian Health Practitioner Regulation Agency(AHPRA).
30
Q

What are the 5 stages of the complaint process

A
  1. Receipt of notification/complaint
  2. Preliminary assessment
  3. Investigation
  4. Panel Hearing
  5. Tribunal Hearing
31
Q

What Act legislates the process of complaints in NSW relelated to healthcare

A

The Health Care Complaints Act of 1993

32
Q

What is the bjective and principle of the The Health Care Complaints Act of 1993

A

The primary object of this Act is to establish the Health Care Complaints Commission as an independent body for the purposes of:

(a) receiving and assessing complaints under this Act relating to 	health services and health service providers in New South Wales, 		and
(b) investigating and assessing whether any such complaint is 		serious and if so, whether it should be prosecuted, and
(c) prosecuting serious complaints, and
(d) resolving or overseeing the resolution of complaints.

(2) In the exercise of functions under this Act the protection of the health and safety of the public must be the paramount consideration.

33
Q

Explain: Health Professional Councils Authority

A

The HPCA provides the administrative and secretarial support to each of the 14 NSW Councils in their primary role to protect the public
Nursing and Midwifery Council of NSW

34
Q

What is the 3 complaint management pathways of the Nursing and Midwfiery Council

A

Health notifications
Performance notifications
Conduct notifications

35
Q

What is the key aim of the 3 complaint management pathways of the Nursing and Midwifery Council

A

Health pathway
The key aim of the health pathway is allow the Council to deal with identified concerns relating to a nurse, midwife or student with an impairment.

Performance pathway
The key aim of the performance pathway is the successful remediation of a nurse or midwife’s professional performance.

Conduct Pathway
The conduct pathway allows the Council to manage notifications (complaints) that may constituteunsatisfactory professional conductorprofessional misconduct.

36
Q

What is the primary role of the Coroner in NSW

A

Primary role of the Coroner is to detect unlawful homicide meaning if a person has died in unusual, unexpected, violent or unnatural circumstances it is necessary to inquire into the manner and cause of death to ensure no ‘foul play’ is undetected.

37
Q

What is the Primary task of the Coroner

A

is to establish the following facts:

That death occurred,
The identity of the deceased,
The date, place, manner and cause of death, and where relevant, the cause of fires or explosions.

38
Q

What are 6 reportable deaths that may lead to an inquest

A
  1. Where the person died unexpectedly and the cause of death is unknown,
  2. Where the person died in a violent or unnatural manner,
  3. Where the person died during the process or as a result of an administration of an anaesthetic,
  4. Where a person was ‘held in care’ or in custody immediately before they died.
  5. Where a doctor has been unable to sign a death certificate giving the cause of death; or
  6. Where the identity of the person who has died is not known.
39
Q

Who notifies a reportable death to the Coroner

A

In hospital or a healthcare setting where a death is ‘reportable’ the relevant hospital or health care authorities notifies the local police station.

The local police in turn submits the notification of that death to the Coroner’s office.

If a person died in a healthcare setting and the relevant healthcare authority did not notify the police, a member of staff or relative of the deceased could report the death.

The police would then investigate that report and notify the Coroner if satisfied the death was reportable.

All States and territories make provision that ‘ any person who has reasonable grounds to believe that a reportable death has not been reported’ must report it to a police officer or Coroner as soon as possible’.

40
Q

Is a stillbirth reportable to the Coroner

A

Stillbirths are not generally reportable to the Coroner BUT there may be circumstances which arise where a still birth may have resulted from a criminal action

41
Q

Explain: Wrongful birth

A

Claims can be made by the parents of a child born as a consequence of medical negligence that deprived them of the choice of avoiding contraception or terminating a pregnancy

42
Q

Explain: Wrongful life

A

claims for compensation made by a child who can claim medical negligence for the life they were born into.

43
Q

Who has ownership of medical records

A

the hospital or health organisation

44
Q

How long should files be stored in NSW

A

For 7yrs for an adult

- up to the age of 25 for a child

Legal and Ethical Issues in Midwifery (2 decks)

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