Lecture 5: Orders, Sexual Abuse and the HCCA Flashcards
What prerequisites are needed for you to perform an authorized act?
- Some sort of order/requisiton from a phycisian
- have training and compentence/confidence
What is an order?
Authorizing statement from a regulated health professional with perscribing authority
CMRITO members require orders to perform a procedure even if it falls under their scope of practice
What legislation mandates who can prescribe an X-ray procedure in Ontario?
HARP
Who can order an x-ray procedure in Ontario
- phycisian
- dental surgeons
What are the 2 types of orders?
- direct order
- medical directive or protocol
Direct Orders
an order for a specific patient, procedure or treatment
must be from a regulated health professional with authority to perscribe
must be in writing, dated, authenticated by ordering health professional
Verbal Order
a direct order communicated over the phone or electronically transmitted
typically when we need to change an order
Must contain:
- name of the health professional ordering it
- date and time it was ordered
- be signed by the individual accepting it
- MRTs need to document changes and verbal order
What is a medical directive?
- something you’re allowed to do for a certain situation
- an order for a specific range of patients and a specific treatment
- always written
- can be called a standing order
4 Things to do when resolving concerns
- discussing the concern directly with the health care professional
- identifying outcomes desired for resolution
- providing a rationale and best practice in evidence in support of the concern
- documenting the concern and steps taken to resolve it in the appropriate record
Can you perform a controlled act that you are not authorized to perform?
No unless delegated
What is delegation?
Transfer of authority to perform a controlled act given by someone who is authorized
ie; an inpatient in ur exam room needs tracheostomy suctioning and RT says to do it past the larynx. We can do it if were competent and confident
Delegation of Authorized Acts
MRTs can accept the delegation of a controlled act but cannot delegate one of their acts to others
What does an MRT need to be to complete any type of order?
To be
- competent
- accountable
- collaborative
As per the RHPA what is sexula abuse
- inappropriate touching in a sexual nature
- sexual intercourse or other forms of sexual relations between MRT and patient
- behaviour or remarks of a sexual nature by the member towards the patient
What duties as an MRT can be contstrued as sexual abuse?
- feeling for landmarks
- asking personal questions
- asking them to change & what you ask them to take off
How can an MRT prevent sexual abuse accusation?
- being careful how we word things
- clear communication
- approacability (body language)
What is the CMRITO policy on sexual abuse?
- zero tolerance
- ## the CMRITO recognizes the seriousness and extent of injury that sexual abuse causes victims
What is the discipline for sexual abuse?
- reprimand the member
- revoke the members registration
- fine the member up to $35k
- require the MRT to pay any legal fees incurred by the college
Communication tips from the CMRITO
- avoid jargon
- be careful of words that can cause miscommunication
- know when to call an interpreter
- use diagrams or charts
Mandatory reporting for child abuse
CMRITO members are required to report when a child is in need of protection
- reporting must be done immediately even outside the hospital
- includes non-accidental injury, sexual abuse and neglect
X-ray signs of child abuse
- posterior rib fractures
- metaphyseal corner fractures
- diaphyseal fractures in children under 3
- skull fractures
- multiple injuries at different healing stages
Physical signs of child abuse
- cigarette burns
- bruises
- behavior
- improbable explanations
What members must report when things happen to them?
- they have a professional malpractice against them
- they have been found or pled guilty to an offence
- they are a member of another regulatory body
- there have been findings of misconduct or incompetence against them by another regulatory body
What is consent?
- agreeing to something & knowing the risk of what youre going to
- important for health care workers because anything we do can cause harm
