Chapter 7 Laws and Regulations Flashcards
(51 cards)
1
Q
Constitutional laws
A
- highest authority from constitution, federal and state
- first 10 amendments including the Bill of Rights
2
Q
What is the bill of rights?
A
To protect us from government overreaching, include freedom from unreasonable searches/seizures, from being tried twice for the same crime
3
Q
Statutory laws
A
-Second highest the laws, And acted by Congress and state legislatures
4
Q
Common laws ( and civil laws)
A
Legal precedents set by charges
5
Q
Administrative or Regulatory laws
A
Laws enacted by administrative agencies at federal, state, and local levels like Medicare or occupational safety and health (OSHA)
6
Q
American American disabilities act (ADA)
A
1-prevents discrimination against persons with disabilities in areas of employment, public accommodations, government services, and telecommunications.
7
Q
Defines disability the (ADA)
A
- physical or mental impairment that women it’s at least one major life activity (ADLs, ability to see, hear, speak, walk, care for self,, perform manual tasks, Engage in learning activities)
=== the person with a disability does need documentation of their disability===
8
Q
American disability association title 1: Employment discrimination (1992)
A
1-For employers employing 15+
2-person cannot be discriminated against if they qualified to perform the essential functions of the job
3- qualified individual must be able to perform the essential functions of a job with or without reasonable accommodations
4-
9
Q
What are some reasonable accommodations for the ADA Title I: Employment Discrimination 1992
A
- Making physical changes examples would be ramps or modifying office /bathrooms
- Providing sign language interpreters for deaf, readers for the blind
- Providing quieter places to decrease distractions for mentally disabled
- providing training/written Materials in BRAILLE , audiotape, large prints, reader
- providing teletypewriters (TTYs) for you with telephones for the deaf, software programs for vision impairments/hand impairments
- Time off for treatment of disability
- must be done upon request unless employer can prove “undo hardship” such as excessively difficult, costly, Disruptive, or would fundamentally change business
10
Q
Title II
A
Discrimination related to equal access to public and transport services
11
Q
Title III
A
Discrimination related to public accommodations
- includes all private businesses and services
- does not include religious and some private clubs
12
Q
Title IV
A
Discrimination related to equal access in telecommunications services
13
Q
Title V
A
Miscellaneous, States are not exempt, advocates cannot be retaliated against
14
Q
Individuals with disabilities education act (IDEA)
A
It is a law introduced in 1975 and modified in 1997 ensuring services two children with disabilities.
- governs how states and public agencies provide early education and special education
- children ages 3- 21 receive special Ed/services under part B
- children birth-2 receive early intervention services with their families under part C
15
Q
Purpose of IDEA
A
- ensure that all children with disabilities have available to them a free appropriate public education
- ensure the rights of children with disabilities are protected
- provide for early intervention multidisciplinary services
- ensure that parents and educators have the tools they need
16
Q
What is PTs primary goal for children?
A
Identifying and serving children with disabilities by developing and implementing cost-effective services within schools setting and an overall quality of life
17
Q
PT and PTAs provide what for children?
A
Early PT services for infants and toddlers and older children with disabilities in educational programs
18
Q
What is the roles for PT/PTA early intervention with children?
A
(infant/toddler’s with disabilities)
- consult with parents and providers to ensure effective services
- train parents and others
- multidisciplinary team assessments of children and their family
- develop goals for individualized family service plan
- screen, evaluate, assess infants to identify movement dysfunctions
- program planning to prevent, alleviate, or compensate for movement dysfunctions, and provide individual or group services to goals
19
Q
Licensure Laws contain what?
A
1- Enacted by all states to give licensees the exclusive right to practice their profession and protect consumers against professional incompetence.
20
Q
Licensure Laws are called “practice acts” for:
A
- Licensure educated in US been in foreign countries and relicensure
- continuing education
- temporary licensure
- reporting of unethical conduct
- restrictions, if any, on direct access
- provisions defining ground/procedures for disciplinary action
21
Q
More on Licensure Laws
A
- violations punishable as criminal offenses and form basis for civil malpractice lawsuits
- PTs are licensed in all states, PTAs and all but 48 (certified into remaining states)
22
Q
What are the minimum state regulations to become a PTA?
A
- require a graduation from CAPTE accredited program
- require NPTE (as developed/ directed by the FSBPT)
- provide title protection
- provide for disciplinary action
- many require jurisprudence exams (separate exams over the states specific practice art)
- Licensure includes defined scope of practice
- State laws define the amount of PT direction and supervision (also the number of PTAs each PT is allowed to supervise/Length of time between PT/PTA consultations)
23
Q
Occupational safety and health administration (OSHA)
A
-Federal government agency concerned with the health and safety of workers
24
Q
What are OSHA’s duties?
A
Developed protective standards and enforced standards.
25
Bloodborn pathogen's standard?
- Protect workers against blood or infectious agents
1. Have a plan to minimize risks of blood exposure and provide training
2. Require use of universal precautions and provide PPE
3. Provide work areas with minimized risk-sharps, containers, laundry equipment etc...
4. Provide hepatitis B vaccinations and post exposure exams
26
Universal precautions?
-treat all blood and body fluids as if they were infectious
=== include semen, vaginal secretions, cerebral spinal fluid, synovial fluid, saliva, etc.
27
Methods of infection control?
- work practices like careful hand washing immediately after removing gloves and before working with a patient
- safe procedures for handling sharps, Use of sharps containers
- immediately report any exposure to needle sticks/blood splashes
- disposal and handling of contaminated waste
- use of PPE, especially gloves, gowns and goggles
- use of mouthpieces, resuscitation bags
- use of disinfectants
- labeling and signs
- training and educations
- Post-exposure follow up
28
Domestic violence/abuse, Intimate partner violence (IPV) or battering:
- occurs between people in intimate relationships and involves: Coercion, threats, Intimidations, Isolation, Emotional, Sexual, and physical abuse.
- found in all races, religions, ages, socioeconomic groups and ethnicities
29
More on domestic violence?
- It is often not reported but involves more then 12 million women and men physically abused, raped or stocked by their partners, with about 1000 deaths.
- it is estimated at 27% of women and 11.5% of men for physically or sexually abused by an intimate partner at some point in their lives, with greater than 15 million children in these families
- One study found that 1 in 10 adults greater than 60 experienced abuse each year.
30
What are some domestic violence patterns
=== the abuser always seeks power and control===
Physical and sexual violence--hitting, kicking, Forcing the partner against their will
- using children as pawns, accusing their partner of bad parenting, threatening to take child away, using kids to relay messages
- denial of the abuse, shifting the blame to their partner
- coercion and threats, like hurting pets, children, even themselves
- economic abuse--controlling all finances, refusing to share money, not allowing partner to be employed, demanding an accounting of all money spent
- intimidation--Breaking things, instilling fear, abusing pets
- emotional abuse--insults, name-calling, criticism
--isolation--limiting contact with family and friends
-controlling, treating partner as a possession or servant
31
Most victims are reluctant to report domestic abuse
-not realizing impact of abuse, fear or partner/sharing, embarrassment
32
Healthcare providers experience difficulty in helping
- lack of knowledge of community resources
- fear of offending the victim and jeopardizing the patient relationship
- lack of time/training/feeling and able to help
- victims appointments are in frequent
- victim is unresponsive to question/offers to help
33
Domestic violence results in not only physical injuries, but has devastating mental health consequences what is one?
-Post traumatic stress disorder, depression, suicide, Substance abuse, and anxiety disorder
34
Signs of abuse?
- the abuser always the accompanies the victim to appointments, refusing to leave their side and using verbal/Nonverbal communication to direct answers to questions
- patient is noncompliant with the home program or frequent missed appointments, abuser canceling patient appointments
- patient statements about not being allowed to take meds
- patient changing therapist frequently
- patient whacking independent transportation, access to finances, or ability to communicate by phone
- abuser portraying themselves as good caregiver and constantly praising therapists
- harassing therapist with threats of legal action, reporting to superiors
- creating divisions among healthcare team
35
More signs of abuse?
- injuries -burns, lacerations, etc...
- injuries during pregnancy
- repeated and chronic injuries
- unattended gynecological problems
- symptoms of stress, anxiety, depression
- hyper vigilant signs, easily startled, guarded
- suicide attempts, self mutilation, eating disorders
- car accidents
- overuse of prescription painkillers
36
Helping with domestic abuse how can I?
- observe the victim for physical/behavioral clues
- ask--question the victim and validate the abuse
- respect the victims privacy
- assess and treat the victim
- keep accurate records and concise documentation of the abuse
- support and follow up on the victims care
- make available information about healthy relationships, parenting skills, and warning signs of abuse
- inform the victims that domestic abuse can't spread to other types of abuse
37
PT/PTAs can help
| Therapist have ethical duty to help:
- if PTA has suspicions, these should be reported to the PT
- ask direct questions about injuries, evasive behavior, fear of partner (ask when away from partner/family member)
- consult with legal counsel to determine legal obligations to report the abuse (consult with patient to permit them to get to safety)
- detailed documentation in the medical chart, can be evidence if need in court, includes details and photographs with informed consent.
- establish department guidelines for identifying abuse and protocol for what to do when identifying abuse
- have legally required notifications and release of information to the proper authorities available
- have available a list of appropriate referrals for victims
- provide in-service training in continuing Ed about domestic violence to our PT person now
38
Questions to ask for domestic abuse?
- I am concerned about your symptoms, has someone been hurting you? Did someone hit you?
- you seem to be concerned about your partner, are you having problems with them? What types of problems?
- how does your partner feel about you having PT?
39
Questions not to ask for domestic abuse?
- why would you stay with someone like that?
- what could you have done to diffuse the situation?
- why don't you just leave?
- what did you do to aggravate your partner?
- did you do something to cause this?
40
What is elder abuse?
- when someone knowingly, intentionally, or by negligence causes harm to an older adult
- can be physical, sexual, Negligence, exportation, emotional abuse, abandonment, or not confronting an elder's self neglect
- grants are available for staff training in elderly facilities
41
What's harassment in the workplace?
- unwanted contact, possibly do to race, color, religion, sex, age, Or disability from supervisors, coworkers, Those who are not employees, such as patients
- is illegal when it affects continued employment or is intimidating or hostile in nature
- generally, the employee should express feelings to the person directly or to the supervisor (who has responsibility it is to prevent this from happening)
- consequences for the perpetrator include referral for training/counseling, reprimand, demotion, reassignment, loss of employment or criminal case
- PT/PTA should have response is ready for inappropriate patient comments. Don't be shy to tell patients.
- it is not legal for patients and therapist to date.
- that comment is not appropriate in the clinical environment
42
What is fraud?
- knowingly misrepresenting the truth or concealing the facts to the detriment of another
- billing for him provided services, referring patient to a clinic for financial gain.
43
What is abuse?
- often means misuse or unintentional, but can mean physical harm.
- using inappropriate billing CPT codes, Providing unneeded services
44
What happens if you fail to report suspected physical abuse?
- healthcare providers are required to report suspected child, domestic or elder abuse.
- failure to report may be considered a breach of duty
- Report to supervising PT first and document all signs and symptoms
45
Malpractice Law?
-liabilities-generating contact on the part of a clinician associated with an adverse outcome of patient care
46
Legal responsibility with in the Pt/ Pta team?
- every member of the team is responsible for knowing the state therapy laws, the state "practice art"
- PTAs must know the state laws
- Stating "the PTA told me to do it" does not get you off the hook
- must report all inappropriate behaviors
- PTA retains ultimate responsibility for any actions of the PTA
47
What is vicarious liability?
- it means the PT is ultimately responsible for the actions of the PTA
- PT may also be held liable went to PTA is found liable
48
Professional negligence
Substandard care
49
Intentional misconduct
-It includes violations of ethics
-patient injury from abnormally dangerous a treatment activities or defective patient equipment/supplies
-PT and PTAs can both be sued but the supervising PT is the primary person liable PT/PTA supervising non-licensed staff are responsible for their actions
---sanctions can include:
Licensure restrictions / denial, fines, monetary awards
50
What is negligence?
Failing to do what another competent clinician would have done under similar circumstances, failing to give reasonable care or providing unreasonable care
- PT/PTAs and students are all liable for their own negligence, even if the supervising PT is also liable
- occurs only one home to patient actually occurs
- to prove negligence, the patient must prove that they were harmed when the therapist did something wrong or fail to do something that normally would have been done
- therapist need to show that they perform correctly and safely, and this should be demonstrated in their notes
- for example: if a patient became injured not following hip precautions, the PT/PTA Would have to demonstrate in documentation Proof of both giving proper instructions and the patient understanding them
51
Healthcare malpractice?
Here are some examples of malpractice involving PT/PTA/students:
- Burns due to lack of paddling/defective equipment (most common malpractice suit against therapist)
- utilization of defective equipment
- patient falls during gait training or exercise it injuries
- any action inconsistent with the code of ethics
- expert witnesses can be called and their question to answer:
- would the treatment performed be what a competent therapist should do in that given situation?
- patients have a 1-4 years statue of limitations after injury to make a claim
- always make sure that employers have malpractice insurance (and they should) and therapist should consider taking out their own personal policies
