Flashcards in Informed Consent & Patient-Centred Care Deck (27):
Striking, touching, moving or applying force directly or indirectly to a person without their consent, or if the consent is obtained by fraud; or threatening to do so
What does "applying force" refer to?
Applying heat, light, electrical force, gas, odour or any other substance or thing that will cause injury or personal discomfort
Failure to exercise reasonable care and skill
When is a person negligent?
When the risk was foreseeable and significant and a reasonable person would have taken precautions
What 3 elements must be proven to recover compensation for alleged negligence?
1) There was a duty of care to the patient
2) There was a breach of that duty
3) The injury the patient sustained was caused by the breach of duty
What are material risks?
Risks that have particular significance for the patient
Define "informed consent"
When a person has given consent based on an appreciation and understanding of the facts and implications of an action. The person must have the relevant facts and reasoning facilities at the time of consent
What are the components of informed consent?
- Does the patient understand? (Age, mental capacity, language)
- Rights (right to withdraw consent at any time)
- Treatment/intervention options
- Risks (general, specific/significant, risk of doing nothing, uncertainty)
- Who will be performing the procedure
What are the four elements that result in consent being valid and informed?
1) Patient is competent to give consent
2) Full information of risks, benefits, alternatives and costs has been provided
3) Consent is freely given
4) Consent is specific to the procedure
Why is informed consent important?
Autonomy of the individual is protected by law, ethics & codes of conduct, things can go wrong
What is the most common allegation associated with poor informed consent?
Complication not mentioned
What are the 4 considerations associated with patient-centred care?
1) Body systems
2) Life stage (i.e. age)
3) Diversity (i.e. background, culture, disability)
4) Settings (i.e. hospital, workplace, recreation)
What does the Health Professionals Act 2004 deal with?
People pretending to be health professionals, registration of practitioners, health professionals misbehaviour, reporting misconduct
When is consent waived for a physio?
When the patient is unconscious but breathing (put in recovery position) or when the patient is unconscious and not breathing (commence CPR)
What are the 6 key expectations for patients with CLBP?
- The physio
- Individual care
- Organisation of care
What are the two key attributes of a good physiotherapist, as perceived by patients?
Competence (know what they're talking about, great depth of knowledge) and personality (friendly, professional, caring)
Why is there a complex combination of factors associated with patient-centred care?
Because patients who describe their physio as nice or competent don't necessarily perceive their treatment as being patient-centred and are not always satisfied
How does communication play a role in individual care?
Listening, understanding, getting to know the patient, allowing the patient to explain their problem and question the physio
How is decision-making linked with communication in patient-centred care?
Patients tend to be happy for the physio to make most decisions as long as they are accompanied by good explanations
How much information should a physio provide to a patient?
As much information as they can confidently provide about the diagnosis and what it means for them, or if there is no specific diagnosis, e.g. it could be one of these 3 options
What are the most important elements of organisation of care?
Access to physio (waiting times, amount of treatment, return access) and clarity over onward referral
What are the 4 elements of "expert" patient-centred care?
- Values & virtues
- Clinical reasoning/empowerment/collaborative problem-solving
- Clinical practice style
Therapists classified as experts have a patient-centre approach to care, characterised by what?
Collaborative clinical reasoning and promotion of patient empowerment
What are the 3 approaches to goal setting in regards to engaging a patient?
Therapist controlled, therapist led, patient-centred
What are the clinical implications of patient-centred care?
- Identifying and addressing psychological factors
- Facilitating the decision-making process
- Establishing a conducive learning environment
- Facilitating self-management
- Enhancing communication
What are 3 psychological models physios can use to enhance their skills in facilitating self-management?
- Self efficacy component of social cognitive theory
- Transtheoretical model
- Motivational interviewing