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

CREDENTIALING

Establishes a minimum knowledge baseFor a given health care profession

Many typesRegistrationCertificationLicensure