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LEGAL CONCEPTS, RISK MANAGEMENT, ETHICAL ISSUES
ANES 1501Introduction to Anesthesia TechnologyCollege of DuPage
LEGAL ISSUES Health care environmentConsiderable agreement over basic valuesReflected in laws, standards, and guidelines
Basic legal terminology Definitions of general legal terms Definitions of legal doctrines and traditional
principles Tort law
Any civil wrong independent of a contract
INTENTIONAL TORTS
Intentional acts Willful and violate the civil rights of a patientAssault and batteryDefamationFalse imprisonmentIntentional infliction of emotional distressInvasion of privacy
INTENTIONAL TORTS (CONT’D) Intentional tort requires proof of the following: Defendant intended to interfere with plaintiff’s propertyConsequences of the act were also intendedThe act was a substantial factor in bringing about the consequences
UNINTENTIONAL TORTS
Negligence and malpracticePatient misidentificationPerforming an incorrect procedure Foreign bodies left in patients and patient burnsFalls or positioning errors resulting in patient injuryImproper handling, identification, or loss of specimens
UNINTENTIONAL TORTS (CONT’D)Incorrect drugs or incorrect administrationHarm secondary to use of defective equipment/instrumentLoss of or damage to patient’s propertyHarm secondary to a major break in sterile techniqueExceeding authority or accepted functions; violation of hospital policy
Abandonment of a patient
DOCUMENTATION Medical record componentsIdentification of the patient, physician(s), nurse(s), and other health care providers
Medical history and physical examinationDiagnosisTreatment plan, details, and resultsMedication recordPhysical findings during the hospital stayDischarge condition and follow-up treatment
SENTINEL EVENT/INCIDENT REPORTS Constitute much of the information used by the hospital in risk managementEffort to collect and use data to decrease the chance of harm to patients and staff or damage to property
Events that would require reportingFalls, medication errors, intraoperative burns, and loss of specimens
ADVANCED DIRECTIVES
Characteristics Written instruction dealing with the right of an incapacitated patient to self-determination
Carries weight of state law Expresses a patient’s wishes about the kinds and amount of medical treatment that will be provided
Examples: living will and durable power of attorney
AHA PATIENT CARE PARTNERSHIP Patient’s Bill of Rights Emphasized collaboration between patients, physicians, and hospitals is essential
Patient Care PartnershipReplaced Patient’s Bill of Rights Contains plainer language
RISK MANAGEMENT AND LIABILITY Risk management Developed for prevention and control of areas of potential liability
Objectives Minimize risks Avoid or control financial loss Identify causes of accidents Implement programs, policies, and procedures Collect and use data to decrease harm
MEDICAL ERRORS
Prevention/reduction techniquesTechnology: best weaponExamples: bar-coded medications, identification strips, handheld wireless devices, and computer drug order-entry systems
Written policies and procedures; standard precautionsExposure prevention strategies
SAFE MEDICAL DEVICE ACT
CharacteristicsExpanded U.S. Food and Drug Administration’s authority to regulate medical devices
Requires hospitals and distributors and manufacturers of devices to cooperate in implementing methods of device tracking
Requires medical device users to report incidents that suggest probability of adverse reactions
MANAGING PATIENT AND EMPLOYEE INJURIES Sentinel events Include patient and employee injuries
Components of managing injuries Injury is immediately reported Individual is rendered medical treatment if necessary
Reports and documentation Contributes to implementation of controls Serves as legal documentation
MALPRACTICE INSURANCE
Hospital employees who commit negligent acts Typically covered by facility insurance polices
Professional liability insurance Should be carried by all practicing surgical technologists and surgical assistants
HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY (HIPAA) OverviewFirst federal act to establish privacy standards to protect patients’ medical records and other health-related information
Standards developed by the Department of Health and Human Services
Provides patients with easy access to their medical records and more control over how personal health information is disclosed
HIPAA CONT’D
ObjectivesEnsure health insurance portabilityGuarantee privacy of health informationDecrease incidences of fraud and abuse
HIPAA CONT’D
Access to medical recordsNotice of privacy practicesLimits on use of personal medical informationProhibition on marketingConfidential communicationsComplaints
ETHICAL AND MORAL ISSUES
Ethics What is good for the individual and for societyEstablishes the nature of duties that people owe themselves and one another
System of moral principles and rules
Morality Dictates codes of conductGuide to behavior
MORAL PRINCIPLES
Guides for ethical decision makingExamples: benevolence, trustworthiness, and honesty
Include concern that we have for the well-being of others and respect for their autonomy
Include basic justice, prevention of harm, and refusal to take unfair advantage
ELEMENTS OF ETHICAL DECISION MAKING Basic questionsWhat makes a “right act” right?To whom is moral duty owed?What “kinds” of acts are right?What is the relationship between specific situations and ethical principles or guidelines?
What action is to be taken in the situation at hand?
ELEMENTS OF ETHICAL DECISION MAKING CONT’D Factors in ethical decision Personal valuesAccountability for one’s actionsResponsibility for one’s actionsReligious beliefsCultural beliefsCorporate integrityMethod(s) of problem solving
SCOPE OF PRACTICE
Legal term Identifies knowledge and skills to provide effective and reliable services
SourcesFederal law and federal agenciesState law and regulationsLegal precedentHospital policyProfessional organizations
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