Flashcards in ANCC AGACNP Issues, Trends, and Health Policy Deck (54):
What is a key to therapeutic communication?
Listening more than talking.
What should you focus on during therapeutic communication?
Feelings (Mad, Sad, Glad, Ashamed)
Should you use euphemisms for therapeutic communication?
What must you ensure during crisis intervention?
Safety and boundaries
Who do you call during a crisis (if necessary)?
What should your goal be during crisis intervention?
What are 2 keys to therapeutic communication during crisis/acute grief?
1. Acknowledge feelings
2. Offer self
What is an advanced directive?
A written statement of a patient's intent REGARDING MEDICAL TREATMENT
What law requires that all patients entering a hospital should be advised of their right to execute an advanced directive?
The Patient Self-Determination Act of 1990
What is a healthcare directive?
A TYPE of AD that may (OR MAY NOT) include a living will and/or specifications regarding DPOA in 1-2 separate documents
What is a living will?
Written compilation of statements in document format that SPECIFIES WHICH LIFE-PROLONGING MEASURES ONE DOES AND DOES NOT WANT TO BE TAKEN IF HE/SHE BECOMES INCAPACITATED
What is the stance of most US states in regards to living wills?
Most states will abide by them if they are specific enough to address the problem at hand
Other than stating one's healthcare wishes in the event of incapacitation, what does a living will also often specify?
What is a DPOA?
A significant other who may act as a proxy/agent/attorney-in-fact IN MAKING HEALTHCARE DECISIONS should the patient become incapacitated
What is the essential responsibility of the DPOA?
Articulating the patient's advanced directive
What is a common requirement in order for the POA to be honored?
What is the difference between an advanced directive and a living will?
•Living will vs AD: recall, AD talks about the MEDICAL care of the patient in the case of incompetence.
•Living will specifies life prolonging measures that one does or does not want to be done should they become incapacitated. Often, they include DPOA to a significant other, who acts as a proxy (aka agent aka attorney in that).
What does Title I of HIPAA protect?
Health insurance coverage for workers and their families when they lose or change jobs
What is the name of the health insurance coverage, granted under Title I of HIPAA, for workers and their families when they change/lose their jobs?
Comprehensive Omnibus Reconciliation Act (COBRA)
What is Title II of HIPAA best known for?
Administrative Simplification (AS) provisions
What do the Administrative Simplification provisions under Title II of HIPAA require?
1. the establishment of national standards for electronic health care transactions
2. National identifiers for providers, health insurance plans, and employers
What department ENFORCES HIPAA?
The Office for Civil Rights
What does HIPAA protect?
The privacy of individually identifiable health information
What does the HIPAA Security Rule do?
Sets national STANDARDS for the SECURITY of electronic protected health information
What doe the confidentiality provisions of the Patient Safety Rule protect?
Protect identifiable information from being used to analyze patient safety events improve patient safety
What are "Covered Entities"
Those required to follow HIPAA Regulations
List 3 examples of covered entities.
1. Health Plans (insurance co, HMOs, company health plans, Medicare, Medicaid)
2. Most health care providers (esp. those that use electronic billing to health insurers)
3. Health Care Clearinghouses (those that process nonstandard health info data received from another entity into a standardized [ie electronic] format)
List examples of HIPAA Protected Information (4)
1. Written info in medical record
2. Conversations amongst HCPs
3. Pt info stored in health insurer's computer
4. Pt billing info stored at a clinic
*Most health-related information about a patient
In order to use or share a patient's health info, what generally must be required?
The patient's WRITTEN AUTHORIZATION
What must be provided in order for a provider to disclose information to one's employer?
Patient's written authorization
What must be provided in order for a provider to use or share a pt's info for marketing or advertising purposes?
Patient's written authorization
What must be provided in order for HCPs to share private notes about a patient's health care?
Patient's written authorization
What is outlined by the HIPAA Privacy Rule?
The patient's rights!
List the Patient's Rights under the Privacy Rule (6)
1. See/receive a copy of their health records
2. Have corrections added to health info
3. Receive a notice telling pt how his info may be used/shared
4. Decide if they want to permit their health info to be used/shared (ie for marketing)
5. Receive a report of when/why their info was shared for certain purposes
6. File complaints w/ HCP, insurer, and/or US gov if their rights are being denied or if health info is not being protected
Is this allowed to be viewed/shared: to ensure proper treatment and coordination of care
Is this allowed to be viewed/shared: to pay for healthcare services
Is this allowed to be viewed/shared: with a patient's family, relatives, friends, or others that the PATIENT IDENTIFIES as being involved with their healthcare/bill payment (unless patient objects)
Is this allowed to be viewed/shared: to ensure quality care given by HCPs
Is this allowed to be viewed/shared: To protect the health of the public (ie outbreak reporting)
Is this allowed to be viewed/shared: To make required reports to the police (ie GSW)
List entities NOT required to follow HIPAA (7)
1. Life insurers
3. Workers comp carriers
4. Schools/school districts
5. State agencies (CPS)
6. Law enforcement
7. Municipal offices
What is the Patient Safety and Quality Improvement Act (PSQIA)?
Est a VOLUNTARY REPORTING SYSTEM to enhance the data available to assess and resolve patient safety and health care quality issues
Under the Patient Safety and Quality Improvement Act, what is patient safety information called?
Patient safety work product
What does the PSQIA provide for patient safety work product?
2. Federal privilege
Why does PSQIA provide confidentiality and federal privilege for patient safety work product?
To encourage reporting and analysis of MEDICAL ERRORS
What is included in patient safety work product?
Information collected and created during the reporting and analysis of patient safety events
What is the purpose of the confidentiality provisions in the PSQIA?
To improve patient safety outcomes by creating an environment where providers may report and examine pt safety events without fear of increased liability risk.
What is the ultimate aim of the PSQIA?
Greater reporting and analysis of patient safety events will yield INCREASED DATA AND BETTER UNDERSTANDING of patient safety
What are Patient Safety Organizations (PSOs)?
External experts established by the Patient Safety Act to collect and analyze patient safety information
Who has the responsibility of listing PSOs?
AHRQ (Agency for Healthcare Research and Quality)
When does the "duty to warn" supersede confidentiality?
If the patient's condition may endanger others
Other than the "duty to warn", which other scenario supersedes a patient's rights to confidentiality?
The duty to protect a patient from harming him/herself
What is an "invasion of privacy"?
Damaging one's REPUTATION as a result of info being shared without the patient's permission