week 13 ethics Flashcards
1
Q
autonomy
A
- right to self determination
- respect for all persons
- restricted by paternalism
- paternalism
- maternalism
- ie: informed consent
2
Q
beneficence
A
- requires positive/kindness action, to act to benefit the patient
- DOING GOOD!
- balancing harms vs benefit
- ex: caring for extremely contagious pts , holding a dying pt’s hand
3
Q
nonmaleficience
A
- do NO harm
- foundation of healthcare
- doesn’t require taking positive action
- ex: coercing a pt to participate in unwanted chemotherapy
4
Q
veracity
A
- truth telling
- used language pt understands
- ex: explaining what an advanced directive is
5
Q
fidelity
A
- keeping promise and avoiding false expectations
- ex: telling a pt I’ll request a consultation
6
Q
justice
A
- principle of fairness
- giving each what they’re due
- distribution of goods and services
7
Q
legal consideration in nursing
A
rely on nurse practice act and what the law allows
8
Q
top legal issues for NP’s
A
employment contract issures
firing / termination issues
improper incident to billing
9
Q
elements of negligence
A
- duty of care owed
- breach of duty occurred
- breached resulted in injury
- injury occurred
10
Q
risk management strategies
A
SHARE
- sense pt needs
- help one another
- respect the dignity and privacy of everyone
- explain what is happening
11
Q
why is EHR a health hazard?
A
- more steps = more likely for error
- alert don’t work
- security fail
- autofill dangerous
- no provider if it fails
12
Q
social media
A
don’t respond or give advice to negative post
13
Q
pt’s decisions to sue was based on what communication issues?
A
- deserting the pt
- devaluing pt and/or family views
- poor delivery of information
- failure to recognize or understand the pt/family views
14
Q
positive behaviors to communication
A
- managing pt expecatinos
- humor/laughter
- seeking pt’s opinion
- encouraging dialogue with pt
- confirming pt’s understanding of their care
- say “it’s my pleasure” or “You’re welcome” instead of “it’s not a problem” for good tone
- “I understand we did not meet your expectations”
15
Q
informed consent contains
A
- nature of procedure
- risks/complications
- expected benefits /effects of procedure
- reasonable alternatives/risks/benefits/side effects
- disclosure of conflict of interest (financial/research interests)
16
Q
universal protocols and timeouts
A
- maximize safety and minimize clinical risk
- 2 pt identifiers, pt confirms correct site, confirmation of procedure
- name of procedure, location, skin prep, anesthesia, description, meds used, how pt tolerated it
17
Q
informed refusal
A
- I discuss med consequences of refusal with pt
- treatment refusal form acknowledges the medical consequences of refusing the treatment and aware of the risks of not proceeding with tx
18
Q
pt adherence and compliance
A
- missed appt → f/u with letter to pt that summarizes consequences of f/u failure
- make sure referrals, tests, and other diagnostic studies are completed
- need return receipt 1st class mail
- grade 6 to 8 reading level
19
Q
patient dismissal
A
- from pt undermining the pt-provider relationship
- chronic tardiness for pt’s that inconveniences/upsets workflows and
- letter sent w return receipt includes: last day the practitioner will give care so pt has emergency care for 30 days, med refills are provided w/in this period, alternative sources of medical care, info on how to get medical records
20
Q
patient handoffs
A
- checklists! include major dx’s, recent hospitalizations, procedures, meds, allergies, pending lab/diagnostic studies
- limit interruptions (SBAR)
- read back for confirmation
21
Q
electronic mail
A
DON’T give medical advice through electronic mail (ie: pt has chest pain but im on vacation)
22
Q
respondeat superior
A
I’m responsible for the employee staff for negligent acts or omissions
23
Q
risk behaviors for suicide
A
- talking about feeling trapped or in unbearable pain
- talking about being a burden to others
- demonstrating extreme mood swings
- too little sleep or prolonged sleeping
- increasing use of alcohol or drugs
- isolation or withdrawal
- displaying extreme mood swings
24
Q
before prescribing opioids,
A
- screen for alcohol and brief intervention
- Screener & Opioid Assessment for patients with Pain-Revised (SOAPP-R) = predicts possible abuse in chronic pain pts
- Opioid risk tool - predicts aberrant behavior in pts getting chronic pain management
- CAGE for misuse
- 0-10 numeric pain scale
- educate about overdose
- pain management agreement (safety, freq of refills, 1 pharmacy, random drug tests,
25
Q
patient compliance tools
A
- random pill counts
- random urine tests
- use of Prescription Drug Monitoring Program (PDMP)
- applies to ALL pts (not just ones we think have drug problem)
- treat everyone same, no discrimination
26
Q
prescribing for family members
A
- sensitive info - may not share entire story
- blurring of personal and professional boundaries
- ok if
- isolated, rural community
- innocuous request
- minor urgent need (suture removal)
27
Q
decision making capacity (DMC)
A
- ability to communicate a choice
- voluntary choice (no coercion)
- understanding variables involving decision
- ability appreciate personal impact of choices
