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Exam 2 Flashcards

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1
Q

What is bioethics?

A

Truth-telling and advocating for patients, even when you disagree with the choices the patient has made

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2
Q

What are the important factors of truth-telling as a PA?

A

Critical to relationship building with patients
Need self-evaluation of our own values
Issues occur when our values collide with patient’s values

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3
Q

What are the four famous medical ethics topics?

A

Roe v Wade
Karen Ann Quinlan
Terri Shiavo
Tuskegee Syphilis Study

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4
Q

What is the importance of the Karen Ann Quinlan case?

A

Doctors didnt want to disconnect patient from life support even though the parents did
Brought about the “right to die”

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5
Q

What is the importance of the Terri Shiavo case?

A

Husband wanted to take wife off life support when in vegetative state, parent’s didn’t
Brought about advanced directive

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6
Q

What is the importance of the Tuskegee Syphilis Study?

A

Informed consent and actual treatment was never actually given to the patients participating

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7
Q

What is the importance of Roe v Wade?

A

Expanded privacy

Gave the right to abortion

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8
Q

What are the fundamentals of PAs professional growth?

A

Continued improvement of technical skills and medical knowledge
Self-directed reflective advancements

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9
Q

What are the goals of PAs as professional moral agents?

A

Work within acceptable boundaries
Exercise responsibility with significant level of dependent autonomy and personal judgement
Develop appropriate PA - patient judgement
Strong knowledge base and technical skills

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10
Q

What is morality?

A

Practices and conduct that arise from customs

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11
Q

What is eithics?

A

Choices arising from reasonable examination of morality

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12
Q

What are the different character and virtue aspects of professional moral agents?

A 
Empathy
Respect
Honesty
Kindness
Fairness
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13
Q

What are the four fields of bioethics?

A

Theoretical bioethics
Clinical bioethics
Regulatory and policy bioethics
Cultural bioethics

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14
Q

What are the four principles of biomedical ethics?

A

Autonomy
Nonmaleficence
Beneficence
Justice

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15
Q

What is autonomy regarding biomedical ethics?

A

Privacy, freedom of choice, self determination
Patient is self governing
Patient allowed to act freely

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16
Q

What is nonmaleficence regarding biomedical ethics?

A

Concept in Hippocratic Oath
Inflict no harm or evil
Maximize benefits while minimizing possible harms

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17
Q

What is beneficence regarding biomedical ethics?

A

Keep patient safe and keep from harm
Act in the interest of the patient (PA’s major responsibility)
Altruistic (unselfish)

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18
Q

What is the georgetown mantra?

A

Mainstay of ethical principles in the healthcare setting

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19
Q

What is liability?

A

An obligation or a debt

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20
Q

What is liability insurance?

A

Insurance against loss due to claims for damages alleging malpractice

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21
Q

What is malpractice?

A

Alleged professional misconduct or lack of ordinary skill in the performance of a professional act

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22
Q

What is ocurrence form policy?

A

Protects future
More expensive
Covers for an incident that occurred during the coverage time

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23
Q

What is claims-made policy?

A

Protects for term of specific employment

Covers when the lawsuit is filed regardless of when the incident actually happened

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24
Q

What do the majority of lawsuits come from?

A

Come from incidents that do not raise red

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25
What are the six main reasons that PAs are sued?
``` Lack of adequate supervision Untimely referral Failure to diagnose Inadequate examination Lack of documentation Lack of communication ```
26
How can the pitfalls of lack of adequate supervision be avoided?
Know your state laws Communicate with your supervising physician regularly Document "in consult with Dr." in chart for assessment and plans sections
27
How can the pitfalls of untimely referral be avoided?
Discuss plans with supervising physicians
28
How can the pitfalls of failure to diagnose be avoided?
Discuss case with supervising physician and document
29
How can the pitfalls of inadequate examination be avoided?
Confirm and expand on history of CC Focues on PE and any abnormal findings Be sure to complete exam yourself and document Include inspection, ausculatation, palpation, and percussion in PE
30
How can the pitfalls of lack of documentation be avoided?
If it wasn't written, it wasn't done | Document!!!!!
31
How can the pitfalls of lack of communication be avoided?
Communicate with patient and with the supervising physician
32
What are the strategies for avoiding lawsuits?
``` Documentation Strengthen the Medical Record Confidentiality and professionalism Dictation Legibility Alterations of medical record ```
33
What is the function of the medical record as a legal document?
Serves as a record of what you have done to and for the patient Lets other know what has been done to and for the patient
34
What can be done to strengthen the medical record documentation?
Initial and date all documents you review Address all body systems pertinent to the CC Write full notes Limit use of abbreviations Use a consistent method of charting and organizing medical records
35
How can confidentiality and professionalism help prevent lawsuits?
Do not discuss patient matters where you can be overheard Don't speak about details regarding patients Only give information to authorized people
36
How can dictation help prevent lawsuits?
One of the best modes to document cases Encourages complete entries Be sure to have patient chart in front of you as you dictate
37
What is the proper way to handle errors?
``` SLIDE method SL - single line through the mistake I - initial the error D - date the error and new entry E - note "error" in the area ```
38
What are the different ways that communication can be used to decrease likelihood of being sued?
Spend more than 15 minutes with patient Use humor and laugh with patients Explain things before doing them Encourage your patient to talk and then listen
39
What are the different forms of prevention that can be used to stop patients from being upset?
Patient-centered office The receptionist makes first impression Make the waiting rooms comfortable Adhere to appointment times Maintain privacy, comfort and compassion Document and follow up missed appointments Don't assume compliance with testing and treatment
40
What is the discovery rule?
Statue of limitations does not begin until the occurrence of the event puts the plaintiff on notice
41
What is the discovery rule period?
The patient has two years to notice the wrong doing | From here the patient has one year from the discovery in order to file a lawsuit
42
What are the four elements of medical malpractice?
Duty Breach Causation Injury-damages
43
What does the national practioner databank do?
Prevents incompetent providers from moving freely from hospital to hospital All medical malpractice payments are reportable to the databank Allows employers and insurance companies to look to see if you have any claims filed against you
44
What is informed consent?
Comprehensive discussion and documentation indicating that patient was informed and fully understands procedures, risks, benefits, and alternative options
45
What must be in front of you in order to make it okay to refill Rx?
Patient chart
46
What is a system of health care?
Corporate body that may own or manage health care provider facilities
47
What is a network of health care?
Group of physicians, hospitals, insurers, or community agencies that deliver broad spectrum health services
48
What are hospitals?
Liscensed institutions that provide diagnostic and therapeutic patient services
49
How are hospitals classified?
Based length of stay Ownership Primary focus of care
50
What is considered a short stay at a hospital?
Less than 30 days
51
What are the four different categories for length of stay regarding hospital visits?
Subacute Acute Tertiary - specialized Quaternary - most specialized
52
What is a community hospital?
Non-federal short stay hospitals Open to the public ACH
53
What is a voluntary hospital?
Established by community rather than federal gov Non-profit Operated by churches, fraternal groups, etc
54
What is a proprietary hospital?
Operated to make a profit
55
What is a government hospital?
Includes VA hospitals and military hospitals | May be federally, state, city, or county funded
56
What is JCAHO?
Joint Commission on Accreditation of Healthcare Organizations Commission established to improve quality of public health care Performs hospitals visits every 3 years
57
What is the role of the board of trustees in a hospital?
Oversees with hospital administration, finance, planing, fundraising, and quality improvement
58
What is the role of the CEO in a hospital?
Develops hospital's management organization
59
What is the definition of guidelines?
Evidence based recommendations for practice
60
What is the definition of policies?
Methods of communicating about roles, responsibilities, and functions
61
What is the definition of quality indicators?
Screening tools to identify potential problems in the quality of care delivered by a hospital department
62
What are the four categories of health policies outcomes?
Health status Health-related knowledge Health-related behavior Patient satisfaction
63
What is HIPAA?
Health Insurance Portability and Accountability Act Started in 1996 Ensures security and privacy of individual health information
64
What effects did HIPPA have?
Improved communication Standardized security procedures Streamlined more efficient systems Basic privacy expectations are now standard
65
Who are the covered entities that HIPAA applies to?
Health plans Health care clearinghouses Health care providers
66
What are some examples of entities that are not covered by HIPPA?
Workers compensation Government programs Government oversight
67
What are examples of protected health information?
``` Hospital bill Job application Pharmacy prescription Drivers' licenses Employee ID badge Any list of patient names and their respective health insurance provider ```
68
How is the US healthcare system ranked worldwide?
Ranked 37th out of 191
69
What is the majority of money spent on in the US healthcare system?
Last 30 days of life
70
The use of Evidence-Based research places attention into what?
Public health measures Health promotion Disease prevention
71
What is HPDP?
Health promotion and disease prevention | PA is primary player is establishing
72
What factors influence health?
``` Age, sex and hereditary factors Individual lifestyle factors Social and community influences Living and working conditions General socioeconomic, cultural and environmental conditions ```
73
What is the definition of health promotion?
Any combination of educational, organizational, economic and environmental supports for healthy living
74
What is primary prevention?
Attempts to remove or modify risk factors or causes of disease in patients Use of helmets, safety belts, and condoms
75
What is secondary prevention?
Detects condition in earliest stage Provides an opportunity to intervene to cure or stop disease Use of pap smears
76
What is tertiary prevention?
Aimed at treatment of an existing symptomatic disease or condition to prevent complications Goal is to limit disability, morbidity, premature death, or rehabilitation
77
What is the USPSTF?
US Preventative Services Task Force | Develops recommendations for clinical preventative services
78
What are the barriers to health prevention and promotion?
Time Money Language
79
What are the strategies PAs use to cause behavioral changes in patients?
Use empathy Be respectful and genuine Develop trust
80
What is motivational interviewing?
Interview aimed at getting the patient to make the choice about behavior changes
81
What is the Prochaska's Transtheorectical Model?
PA facilitates the patient's self change
82
What are the stages of the Prochaska Transtheoretical model?
``` Pre-contemplation Contemplation Preparation Action Maintenance Termination ```
83
What occurs in the precontemplation stage?
Clinician's role is to get the patient to start thinking about the problem and possible solutions Ask patient to think about issue between visits
84
What happens in the contemplation stage?
Patient thinks about problem on their own Patient dabbles in action Clinician should identify pros and cons of change Ask what would promote commitment
85
What occurs in the preparation stage?
Patient understands change is needed Patient begins to form a commitment to goals Clinician should negotiate a start date Reassure patient that action is the right thing to do
86
What occurs in the action stage?
Patient follows care plan of regular activity to change problem Patient shows commitment to plan Clinician should help patient modify plan if needed Show interest in improvement Discuss slips and relapses
87
What occurs in the maintenance stage?
Behavior change is now part of normal life Intensity of effort may taper off Clinician should ask how patient is doing, discuss slips, and be alert for signs of waning enthusiasm
88
What occurs in the relapse stage?
Patient reverts to old problem behavior Patient talks and acts like one in earlier stages Patient may be resistant to discuss problem Clinician needs to remind reasons for change Say when not if for next attempt Normalize relapse
89
What are the major roles of the clinician in counseling change of behaviors?
Recognize change is a process Promote patient to move through stages Allow patient to remain in control Apply thoughtful influence as opportunities present

PA Profession (2 decks)

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