Midterm Flashcards
1
Q
Combining Vowel
A
When a medical term contains more than one root, each is joined by a vowel, usually an “o”. It allows for easier pronunciation.
Ex. hyperlipoproteinemia
2
Q
Simple vs Compound suffixes
A
Simple: form basic terms. For example -ic meaning pertaining to. When combined with the root gastr it forms gastric
Compound: Formed by a root and a suffix combined to create another suffix. For example the root tom (to cut) combined with the suffix -y forms the compound suffix -tomy meaning incision
3
Q
4 catagories of suffixes
A
Symptomatic suffix: describes the evidence of illness. Ex: -spasm
Diagnostic suffix: identifies a medical condition. Ex: -emia or -itis
Surgical suffix: describes a surgical treatment. Ex: -tomy or -ectomy
General suffix: has general application such as to form an adjective or noun. Ex: -al, -ic, or -logy
4
Q
4 rules of medical terminology
A
- A combining vowel is used to join a root to another root or to a suffix that begins with a consonant. Ex: gastr/o + entr/o + -stomy
- A combining vowel is NOT used before a suffix that begins with a vowel. Ex: vas/o + -ectomy is spelled vasectomy
- If the root ends in a vowel and the suffix begins with the same, drop one and do NOT use a combining vowel. Ex: cardi + -itis is spelled carditis
- Occasionally when a prefix ends in a vowel and the root begins with a vowel, the vowel is dropped from the prefix. Ex: para- + enter/o + -al is spelled parenteral
5
Q
Macron and breve
A
Macron is placed above vowels that have a long sound (when they say their letter name such as the ā in day or the ē in bee). It is a straight line above the letter
Breve is placed over vowels that have short sounds such as ă in alone or the ŭ in sun. It is a little curve above the letter
6
Q
Levels of organization
A
cell - tissue - organ - organ system - organism
7
Q
Body planes
A
Coronal/Frontal = front and back (or anterior/ventral and posterior/dorsal) halves
Sagittal = right and left halves
Transverse = top and bottom (or superior/cephalic and inferior/caudal) halves
8
Q
Recumbent meaning
Decubitus meaning
Supine vs Prone
A
Recumbent: lying down
Decubitus: lying down especially in a bed. Lateral decubitus is lying on your side
Supine: lying on back; face up
Prone: lying on stomach; face down
9
Q
Flexion vs Extension
A
Flexion: bending at the joint. Angle between bones is decreased
Extension: straightening at the joint. Angle between bones is increased
10
Q
Abduction vs Adduction
A
Abduction: movement away from the body
Adduction: movement towards the body
11
Q
Rotation
A
circular movement around an axis
12
Q
Eversion vs Inversion
A
Eversion: turning outwards (ex. foot)
Inversion: turning inwards (ex. foot)
13
Q
Supination vs Pronation
A
Supination: turning upward or forward of the palmar surface (palm of hand) or plantar surface (sole of foot)
Pronation: turning downward or backward of the palmar surface (palm of hand) or plantar surface (sole of foot)
14
Q
Dorsiflexion vs Plantar flexion
A
Dorsiflexion: bending of the toes or the foot upward
Plantar flexion: bending of the sole of the foot by curling toes towards ground
15
Q
Divisions of the abdomen
A
4 quadrants: Right upper, left upper, right lower, left lower
- Right and left hypochondriac regions (top, lateral)
- Epigastric region (in between the hypochondriac regions)
- Umbilical region (below epigastric region. Right in the centre)
- Right and left lumbar regions (on either side of the umbilical region)
- Right and left iliac regions (below lumbar regions)
- Hypogastric region (between the iliac regions and below the umbilical region)
16
Q
H&P
Hx
CC
c/o
A
History and physical
History
Chief Complaint
Complains of
17
Q
PI
HPI
Sx
PH/PMH
A
Present illness
History of present illness
Symptoms
Past history/past medical history
18
Q
UCHD
NKDA
FH
SH
OH
A
Usual childhood diseases
No known drug allergies
Family history (A&W = alive and well or L&W = living and well)
Social history (hobbies, alcohol, use of tobacco)
Occupational history
19
Q
ROS/SR
PE
Px
NAD
A
Review of systems/systems review (head to toe review of all body systems to evaluate other symptoms that may not have been mentioned)
Physical examination
Physical
No acute distress
20
Q
HEENT
PERRLA
WNL
R/O
A
Head, eyes, ears, nose, and throat
Pupils equal, round and reactive to light accommodation
Within normal limits
Rule out
21
Q
IMP
Dx
A
P
A
Impression
Diagnosis
Assessment (identification of disease or condition is recorded in the IMP, Dx or A)
Plan (plan for treating patient. Also called recommendation or disposition)
22
Q
SOAP method for documenting patient’s progress
A
Subjective: what patient describes (only what patient can feel such as shortness of breath or sharp pains)
Objective: test results, vitals, swelling (what we can see/what the patient can’t tell us)
Assessment: patient progress and evaluation of plan effectiveness
Plan: decision to proceed or alter plan strategy
23
Q
Attending physician
Physician’s orders
Nurse’s notes and physician’s progress notes
A
Attending physician: doctor who admits patient to the hospital
Physician’s orders: lists the directives for care prescribed by the doctor attending to the patient
Nurse’s notes and physician’s progress notes: record the care throughout the patient’s stay
24
Q
Consultation report
Operative report
Anesthesiologist’s report
A
Consultation report: filed after a specialist examines the patient after being called in by the attending physician
Operative report: required from the primary surgeon where a detailed description of the operation is given including method of incision, tools used, method of closure, etc
Anesthesiologist’s report: must be filed post surgery covering the drugs used, dose and time given, and vital signs throughout the procedure
25
Ancillary reports
Discharge summary
Ancillary reports: note any additional procedures and therapies including diagnostic tests and pathology reports
Discharge summary: also called clinical resume, clinical summary, or discharge abstract summarizes patient's care (tests, treatments, final diagnoses, date of admission, etc)
26
AD
AS
AU
OD
OS
OU
AD: right ear
AS: left ear
AU: both ears
OD: right eye
OS: left eye
OU: both eyes
27
DC
D/C
h.s.
q.d.
q.o.d.
ss
SC, SQ, sub-Q
DC: discharge
D/C: discontinue
h.s.: bedtime
q.d.: everyday
q.o.d.: every other day
ss: one half
SC, SQ, sub-Q: subcutaneous
28
CCU
ECU
IP
OP
PACU
PAR
RTC
RTO
CCU: coronary (cardiac) care unit
ECU: emergency care unit
IP: inpatient
OP: outpatient
PACU: post-anesthesia care unit
PAR: post-anesthesia recovery
RTC: return to clinic
RTO: return to office
29
BRP
CP
ETOH
L with circle around it
R with circle around it
m with circle around it
BRP: bathroom privileges
CP: chest pain
ETOH: ethyl alcohol
L with circle around it: left
R with circle around it: right
m with circle around it: murmur
30
Pt
RRR
SOB
Tr
Tx
VS
Pt: patient
RRR: regular rate and rhythm
SOB: shortness of breath
Tr: treatment
Tx: treatment, traction
VS: vital signs
31
T
P
R
BP
Ht
Wt
WDWN
y/o
T: temperature
P: pulse
R: respiration
BP: blood pressure
Ht: height
Wt: weight
WDWW: well developed well nourished
y/o: years old
32
cc
g or gm
cu mm
fl oz
gr
gt
gtt
qt
cc: cubic centimeter
g or gm: gram
cu mm: cubic millimeter
fl oz: fluid ounce
gr: grain
gt: drop
gtt: drops
qt: quart
33
Tab
Cap
Suppos
p.o
SL
PV
PR
Tab: tablet
Cap: capsule
Suppos: suppository (inserted into body and continuously releases medication)
p.o: per os = by mouth
SL: sublingual = under the tongue
PV: per vagina
PR: per rectum
34
ID
IM
IV
Transdermal
ID: intradermal = within the skin
IM: intramuscular = within the muscle
IV: intravenous = within the vein
Transdermal: absorption of drug through unbroken skin
35
Rx
Sig
Rx: recipe (commonly used to identify a prescription)
Sig: specific instructions for administration
36
Chemical name
Generic name
Trade or brand name
Chemical name: assigned to the drug in the lab at the time it is invented. It is the formula for the drug written according to its chemical structure
Generic name: the official, nonproprietary name
Trade or brand name: the manufacturer's name for a drug
37
ā
a.c.
a.m.
b.i.d.
d
h
noc
p̄
ā: before
a.c.: before meals
a.m.: before noon
b.i.d.: twice a day
d: day
h: hour
noc: night
p̄: after
38
p.c.
p.m.
p.r.n.
q
qh
q2h
q.i.d.
q.o.d.
p.c.: after meals
p.m.: after noon
p.r.n.: as needed
q: every
qh: every hour
q2h: every 2 hours
q.i.d.: 4 times a day
q.o.d.: every other day
39
STAT
t.i.d.
ad lib.
c̅
NPO
per
s̅
STAT: immediately
t.i.d.: three times a day
ad lib.: as desired
c̅: with
NPO: nothing by mouth
per: by or through
s̅: without
40
Acute
Benign
Chronic
Degeneration
Acute: a condition that has intense, often severe symptoms in a short course
Benign: mild or noncancerous
Chronic: a condition that develops slowly and persists over time
Degeneration: gradual deterioration of normal cells and body functions
41
Degenerative disease
Etiology
Exacerbation
Febrile
Degenerative disease: any disease in which deterioration of the structure or function of tissue occurs
Etiology: the cause of a disease
Exacerbation: an aggravation or flare up of symptoms
Febrile: relating to a fever
42
Localized
Malignant
Prognosis
Progressive
Remission
Localized: limited to a definite area or part of the body
Malignant: harmful, cancerous
Prognosis: prediction of the likely outcome
Progressive: the advance of a condition as the signs and symptoms increase in severity
Remission: a period in which symptoms and signs stop
43
Sign vs Symptom
Sign: a mark; objective evidence of disease that can be seen or verified by an examiner
Symptom: subjective evidence of disease that is perceived by the patient and often noted in their words
44
Communication loop
Sender --> Receiver --> Feedback
The end goal of communication is understanding
45
Barriers to communication
Process - disease (such as Alzheimer's)
Personal - cultural/personal beliefs, fear, healthcare worker has a bad day and patient picks up on it
Physical - immobility, hearing aids, glasses
Semantic - language difference, miscommunication, jargon, symbols with different meaning (misinterpretation). Ex: using words the patient won't know, have to dumb it down
46
Goals of patient communication
Primary: proximal to the purpose of the specific patient - professional interaction; e.g. gather information, make decisions, informed consent.
Enabling: elements that affect the ability to achieve primary goals; building trusting relationship (first impressions ie smile to make them feel comfortable)
Secondary: bi-product of effect communication; e.g. reduced anxiety as a result of the interaction .
47
Verbal and Nonverbal communication
Verbal: spoken. Makes up 35% of face to face communication
Nonverbal: facial expressions, tone of voice, movement, appearance, eye contact, gestures, posture, etc. Makes up 65% of face to face communication
48
DISC
D: DOMINANT
- Direct, decisive, doer, demanding, task focused, active
I: INFLUENTIAL
- inspirational, interactive, interesting, impulsive, irritating, people focused, active
S: STEADY
- stable, supportive, sincere, slow, sensitive, people focused, reflective
C: COMPLIANT
- cautious, careful, conscientious, calculating, condescending, task focused, reflective
49
4 E's to communication
Engagement: first contact with patient, establish a connection, first impression based on nonverbal communication. Ex: getting patient from the waiting room
Empathy: make sure the patient feels seen, heard, and accepted. Make eye contact, get down on their level, give them their space, don't put anything between you like a desk, don't interrupt them, never appear judgemental. Ex: preparing for a discussion about the procedure that's about to happen
Education: what do you need the patient to know? What does the patient want to know? How ready is the patient to receive information? Make sure to check for understanding. Ex: explaining the procedure
Enlistment: working together to achieve what needs to be done, remember patient's have the choice
50
CLASS
Context --> physical space (privacy, eye level, barriers), body language, eye contact
Listening skills
Acknowledgment
Strategy
Summary
51
Communication styles
Controller/Director: the D in DISC
commander, values getting the job done, delegating work to others, risk taker, not shy but private, takes charge, competitive, perceived as bossy, insensitive, goal oriented, motivated
Promoter/Socializer: the I in DISC
entertainer, full of ideas, impulsive to try them, talkative, wants work to be fun, open, brainstorm, flexible, creative, optimist, life of the party, loves people, enthusiastic, expressive
Supporter/Relator: the S in DISC
values acceptance and stability, harmonizer, slow to make decisions, dislikes change, listener, scared to speak up/share opinions, concerned for others feelings, friendly, sensitive, relationship oriented, patient, dislike conflict, competent, steady,
Analyzer/Thinker: the C in DISC
assess situations, value accuracy, detailed, plans thoroughly, works alone, introverted, slow to speak, shy, organized, cautious, logical, facts, analytical, serious, purposeful,
52
Parson's theory
Rights and obligations for the sick person
Parson's theory: unspoken agreement in society based on the concept that a sick individual is not a productive member of society. They are released from obligations and responsibilities.
Rights: exemption from normal social roles
Obligations: try to get well, seek the assistance of qualified individuals
53
Factors affecting whether a
person seeks help
Triggers to seeking care
Factors: personality type, gender, age, social/family support, role in family, physical impairment, cultural norm, socioeconomic position
Triggers: symptoms are new and alarming, symptoms affect ability to do normal daily activities, symptoms affect social roles and interactions, permission (or persistence) from someone else
54
Stages of grief
1969 Kubler - Ross model of death and dying. Not necessarily in that order, some people don't go through them all, some stages are repeated. Getting stuck limits recovery
Denial: "This can't be happening to me" shock, confused, afraid, numb, autopilot, can't perform small routine tasks
Anger: "If only I had taken care of myself sooner" second guessing, hate, self-doubt, embarrassment, shame, frustration. May look for someone to blame
Bargaining: " I will stop smoking if..." struggle to find meaning in what has happened, possibly still angry but willing to explore alternatives
Depression: "What's the point" helpless, hopeless, overwhelmed, lack energy, withdraw
Acceptance: have processed initial grief and emotions, able to accept that the loss has occurred and cannot be undone, able to once again plan for the future and re-engage in daily life
55
Dealing with a patient complaint or concern
HEART:
Hear their story
Empathize with them
Apologize
Respond to the problem
Thank them
56
Culture
Cultural Pluralism (multiculturalism)
Culture: a group of people who share values, attitudes, beliefs, and norms that guide their thinking, decisions, and actions in patterned ways
ex: communicating, eating, sharing and showing affection
Multiculturalism: the existence of different cultures living side by side. Permits peaceful coexistence of different interests, convictions and lifestyles. Requires that we learn how to relate effectively to people who may behave, think and feel differently from our own personal and cultural expectations. Increases the difficulty in client relations for the many different helping professions– social workers, doctors and nurses, psychologists, educators, and many others.
57
Cultural domains
Family roles and organization (gender roles, roles of elderly, social status)
High risk behaviours (tobacco, alcohol, recreational drugs, physical activity, etc for disease prevention)
Nutrition (fasting, deficiencies, rituals)
Pregnancy and fertility practices (birthing, postpartum, views on pregnancy, circumcision, gender preferences)
Spirituality, death rituals (prayer, meaning of life, how long before bury, autopsy?, family gathering?, grieving)
Health care practices (traditional vs alternative therapies, self-medication)
Attitudes towards health care practitioners
Communication (volume, tone, nonverbal communication, distance, eye contact, touch, gestures)
58
Low and high context cultures
Indicates the extent to which words are needed to convey a message.
Low context cultures: Many words needed to convey message. Relies heavily on spoken/written word. Topic is discussed in an explicit, straightforward manner. May repeat info to ensure no misunderstanding
High context cultures: Few, carefully chosen words needed to convey message. Inferences are drawn. Relies heavily on the context in which words are spoken. More common in Eastern cultures. Yes can mean anything from I agree to I hear what you are saying (might not mean they agree)
59
Radiation Therapy
High energy ionizing radiation to get rid of cancer cells and shrink tumours while sparing normal tissue. Can be curative or palliative. Radiation therapy is delivered via photon or electron radiation. Photons are accelerated through the linear accelerator.
Patients get a CT to see where the tumour is. They receive radiation in the same position as the CT. They receive tiny dot tattoos which the therapists line up with the lasers so they ensure the patient is in the same, correct position every time.
Dosimetry: creates an optimal plan. Contours (outlines in the CT image) the areas of interest and areas to avoid. They calculate how much radiation each organ will receive and whether or not that is safe.
Brachytherapy: radioactive isotopes are placed directly inside the patient. As the radioactive source decays, dose is emitted and treats the area of interest.
Side effects: skin reactions, sore throat, irritated bowels, fatigue. Acute side effects occur during treatment period and subside a few weeks later. Chronic side effects occur months to years after treatment and do not subside.
60
Non-Learning, Non-Reflective, and Reflective actions
Non-Learning: habitual behaviour, follows established patterns. Presumption: Action and outcome are predetermined. Non-consideration: Unexpected outcome is ignored. Rejection: unexpected outcome is given attention but
dismissed – doesn't fit with existing ideas
Non-Reflective: actions that take some degree of thought. Takes mental and physical activity. Involves emotional response (introspection)
Reflective: contemplation, person considers the experience and makes an intellectual decision about it. Consciously and critically goes through a thoughtful process of considering the implication(s) of the experience in order to further improve or alter actions. Includes theory, reflection, and planning
61
Experiential learning cycle
Act --> Reflect --> Conceptualize --> Apply
Act: concrete experience, "what happened?"
Reflect: reflective observation, feelings, "what did I experience?"
Conceptualize: findings, "why did this happen?"
Apply: active experimentation, "what will I do?"
Do it --> What happened? --> So what? --> Now what
62
Types of reflection
Content: Reflect on WHAT is/was being done
Process: Reflect on HOW it is/was being done. If not well, why or why not? What can you do about this?
Premise: Reflect on WHY it is/was being done. Why are you learning this? What relevance does it have?
63
Bloom's Taxonomy (from the bottom up)
Knowledge - recall
Comprehension - understanding
Application - using knowledge in new situations
Analysis - breaking things down, critical thinking
Synthesis - putting things together, creative thinking
Evaluation - judgement
64
Reflection in action vs reflection on action
Reflection in action occurs while the event is occurring. Draws on previous, similar experiences to create a solution
Reflecting on action occurs after the event has taken place. Learn from new and unique elements and add them to your "toolbox" of skills to be drawn upon
65
Ultrasonography
We can hear 20-20 000 Hz (one cycle per second), so "ultra"sound is above human hearing range. Ultrasound is 2-24 MHz (one million cycles per second). Higher frequency provides better quality but less penetration.
Acoustic impedance (Z) describes how much resistance an ultrasound beam encounters as it passes through the tissue. It is dependant on density of the tissue (p) and speed of the sound wave (V). Z=pV. Attenuation includes absorption, reflection, refraction, and scatter. It is basically what causes beams to be lost/ impacts the image. We want reflection to occur, but absorption shows us fluid.
Bright areas are known as echogenic and dark areas as anechoic
Gel is used to eliminate air. Sound has a hard time travelling through air
66
radi/o
tom/o
son/o
somn/o
electr/o
vagin/o
ray or radiation
to cut
sound
sleep
electricity
vagina
67
4 methods of physical examination
1. Inspection: close visual examination to detect any apparent abnormalities. Ex: physician uses light to look in patient's mouth
2. Auscultation: involves listening to sounds within the body, typically with the aid of a stethoscope. Ex: typically done to listen to the heart and lungs
3. Palpation: refers to an examination with the hands to feel tissues and organs
4. Percussion: a method of tapping over the body to elicit vibrations and sounds in order to estimate the size, boarder, or fluid content of a cavity such as the the chest, or using a percussion hammer to elicit deep tendon reflexes (tapping knee with hammer to make it stretch outwards)
68
steth/o
colon/o
opthalm/o
an/o
bronch/o
duoden/o
pharyng/o
sigmoid/o
chest
colon (large intestine)
eye
anus
bronchus (airway)
duodenum
pharynx or throat
sigmoid colon
69
bi/o
cis/o
life
to cut
70
phlebotomy/venipuncture
blood chemistry
blood sugar/blood glucose
blood culture
Phlebotomy/venipuncture: incision into or puncture of a vein to withdraw blood for testing
Blood chemistry: a test of the fluid portion of the blood to measure the amounts of its chemical constituents (glucose, cholesterol)
Blood sugar/blood glucose: measurement of the level of sugar or glucose in the blood
Blood culture: a test to determine if infection is present in the blood stream by isolating a specimen of blood in an environment that encourages the growth of microorganisms. The specimen is observed and the organisms that grow in the culture are identified.
71
albumin
alkaline phosphatase
alanine aminotransferase
aspartate aminotransferase
bilirubin
Blood urea nitrogen (BUN)
Albumin: used to evaluate conditions related to the liver and kidney
Alkaline phosphatase: used to evaluate conditions related to the liver, bone, and gallbladder
Alanine aminotransferase: used to evaluate conditions related to the liver, and heart muscle
Aspartate aminotransferase: used to evaluate conditions related to the liver and heart muscle
Bilirubin: used to evaluate conditions related to the liver. Chemical test used to detect bilirubin in the urine (seen in gallbladder and liver disease)
Blood urea nitrogen (BUN): used to evaluate conditions related to kidney function
71
blood chemistry panel
basic metabolic panel (BMP)
comprehensive metabolic panel (CMP)
lipid panel
Blood chemistry panel: specialized combinations of automated blood chemistry tests performed on a single sample of blood. Used as a general screen for disease or to target specific organs for conditions
BMP: combination of tests used as a general screen for disease. Includes calcium, carbon dioxide, chloride, creatinine, glucose, potassium, sodium, and blood urea
CMP: tests in addition to the BMP for expanded screening. Includes albumin, bilirubin, alkaline phosphatase, protein, alanine aminotransferase, and aspartate aminotransferase
Lipid panel: a measure of fat in the blood including the level of total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol, as well as triglycerides
71
complete blood count (CBC)
white blood count (WBC)
red blood count (RBC)
hemoglobin (HGB or Hgb)
hematocrit (HCT or Hct)
blood indices
differential count
platelet count
CBC: a common test performed as a screen of general health or for diagnostic purposes. The following is a list of the components included in a CBC
WBC: a count of the number of white blood cells in a given volume of blood, obtained using manual or automated laboratory methods
RBC: a count of the number of red blood cells in a given volume of blood, obtained using manual or automated laboratory methods
HGB: a test to determine the blood level of hemoglobin (expressed in grams)
HCT: a measurement of the percentage of packed red blood cells in a given volume of blood
Blood indices: calculations based on the RBC, HGB, and HCT results to determine the average size, hemoglobin concentration, and content of red blood cells for classification of anemia. Reported as mean cell volume (MCV) , mean cell hemoglobin (MCH), and mean cell hemoglobin concentration (MCHC)
Differential count: a determination of the number of each type of white blood cell (leukocytes) seen on a stained blood smear. Each type is counted and reported as a percentage of the total examined
Platelet count: a calculation of the number of thrombocytes in the blood, the normal range is 150 000 to 450 000 platelets in a given volume of blood
71
Measurment of these evaluates what:
Calcium
Creatinine
Electrolytes (bicarbonate, chloride, potassium, and sodium)
Glucose
Lipids (cholesterol, LDL, HDL)
Protein
Calcium: used to evaluate conditions related to the heart, nerves, bones, kidneys, and teeth
Creatinine: used to evaluate conditions related to the kidney
Electrolytes: used to evaluate conditions related to metabolic balance (homeostasis)
Glucose: used to diagnose and monitor diabetes mellitus
Lipids: used to evaluate risk for coronary artery disease
Proteins: used to evaluate conditions related to the liver, and kidney
71
urinalysis (UA)
specific gravity (SpGr)
pH
glucose/sugar
albumin (alb) /proteins
ketones
UA: physical, chemical, and microscopic examination of urine
SpGr: measure of the concentration or dilution of urine
pH: measure of the acidity or alkalinity of urine
Glucose/sugar: chemical test used to detect sugar in the urine, most often used to screen for diabetes mellitus
Albumin: chemical test to detect the presence of albumin (protein) in the urine. High levels are a sign of kidney disease
Ketones: chemical test used to detect the presence of ketone bodies in the urine. A positive test indicates that fats are being used by the body instead of carbohydrates, which occurs during starvation or an uncontrolled diabetic state.
72
occult blood, urine
urobilinogen
nitrite
microscopic findings
urine culture and sensitivity (C&S)
Occult blood: chemical test for the presence of hidden blood in the urine as a result of red blood cell hemolysis; indicated bleeding in the kidneys (occult= hidden)
Urobilinogen: chemical test used to detect bile pigment in the urine (increased amounts are seen in gallbladder and liver disease)
Nitrite: chemical test used to detect the presence of bacteria in the urine by measuring the amount of nitrite (a waste product that bacteria produce)
Microscopic findings: microscopic identification of abnormal constituents in the urine (eg. red or white blood cells). Reported per high power field (hpf) or low power field (lpf)
C&S: isolation of a urine specimen in a culture medium to encourage the growth of microorganisms. The organisms that grow in the culture are identified, as are the drugs to which they are sensitive.
73
uter/o, metr/o, hyster/o
append/o
coron/o
herni/o
splen/o
cry/o
uterus
appendix
circle or crown
hernia
spleen
cold
74
cryosurgery
electrosurgery
electrocautery
Cryosurgery: destruction of tissue by freezing with application of an extremely cold chemical, such as liquid nitrogen
Electrosurgery: use of electric currents to destroy tissue
Electrocautery: use of an instrument heated by electric current (cautery) to coagulate bleeding areas by burning tissue
75
endoscopic surgery
arthroscopic surgery
laparoscopic surgery
Endoscopic surgery: procedure using an endoscope that includes examination and operative treatment
Arthroscopic surgery: procedure with an arthroscope to examine, diagnose, and repair a joint from within
Laparoscopic surgery: operative procedure within the abdominal and pelvic regions after insertion of a laparoscope (appendectomy, cholecystectomy, hysterectomy)
76
endovascular surgery
laser surgery
LASER
Endovascular surgery: minimally invasive interventional technique performed within a vessel. Most commonly done at the same time as a diagnostic procedure such as cardiac catheterization or diagnostic neuroadiological exam
Laser surgery: surgical use of a laser to make incisions or destroy tissues to create fluid passage or obliterate tumours. Commonly applied to delicate tissues such as the eye
LASER: acronym for light amplification by stimulated emission of radiation. The instrument produces a small, extremely intense beam that is precise in depth and diameter. It is applied to body tissues to destroy lesions or for dissection
77
chemotherapy
psychotherapy
radiation therapy
physical medicine and rehabilitation therapy
Chemotherapy: treatment of malignancies, infections, and other diseases with chemical agents that destroy selected cells or impair their ability to reproduce
Psychotherapy: treatment of psychiatric disorders using verbal and non-verbal interaction with patients, individually or in a group employing specific actions or techniques
Radiation therapy: treatment of disease, especially cancer, using ionizing radiation to impede the proliferation of abnormal cells
Physical medicine and rehabilitation therapy: therapy to restore function and prevent disability resulting from illness or injury. Includes physical therapy, occupational therapy, speech therapy, and massage therapy
78
physical therapy
occupational therapy
speech-language therapy
massage therapy
Physical therapy: treatment to rehabilitate patients who are disabled by illness or injury, involves many methods such as exercise, hydrotherapy, and therapeutic ultrasound
Occupational therapy: rehabilitation of individuals suffering from physical, developmental, mental, or emotional disabilities to regain or improve functions in areas of self-care and tasks needed to perform everyday activities independently
Speech-language therapy: therapy to assess, diagnose, treat, and prevent communication disorders related to speech or language
Massage therapy: manipulation of the soft muscle tissues of the body to improve circulation and remove waste products. Used to treat overworked muscles as a result of sports injuries, reduce stress, and promote general health
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Complementary and alternative medicine
Integrative medicine
Refers to various healthcare practices not considered conventional medicine (medicine practiced by doctors, psychologists, physiotherapists, etc)
Complementary: when using nontraditional therapies together with conventional medicine
Alternative: when using nontraditional therapies instead of conventional medicine
Integrative medicine: an approach to healing in which 2 or more modalities or systems are combined, designed to treat the person as a whole
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Whole medicine systems
Mind-body medicine
Biologically based practices
Manipulative and body-based practices
Energy medicine
Whole medicine systems: complete systems of theory and practice such as homeopathic medicine, naturopathic medicine, traditional Chinese medicine
Mind-body medicine: a variety of techniques designed to enhance the mind's ability to affect bodily functions and symptoms such as yoga, meditation, prayer, mental healing, music, art, dance
Biologically based practices: use of substance found in nature such as herbs, foods, vitamins to treat illness
Manipulative and body-based practices: practice based on manipulation such as chiropractic medicine and massage
Energy medicine: treatment that involves the use of energy fields, including biofield therapy (reiki, therapeutic touch) and bio-electromagnetic based therapy (magnetic fields, pulsed fields)
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autograft
allograft/homograft
heterograft/xenograft
Autograft: type of graft that involves the transfer of a patient't own tissue
Allograft/Homograft: transfer of tissue from one human to another
Heterograft/Xenograft: the graft of a tissue from one species to another, such as animal to human
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-lytic (adjective form of -lysis)
-emetic (adjective form of -emesis)
anxi/o
coagul/o
pertaining to breakdown or dissolution
pertaining to vomiting
anxiety
clotting
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analgesic
narcotic
anesthetic
antacid
antianginal
antianxiety agent/anxiolytic
Analgesic: a drug that relieves pain
Narcotic: a potent analgesic with addictive properties
Anesthetic: a drug that temporarily blocks transmission of nerve conduction to produce a loss of sensation
Antacid: a drug that neutralizes stomach acid
Antianginal: a drug that dilates coronary arteries, restoring oxygen to the tissue to relieve pain of angina pectoris or chest pain
Antianxiety agent/anxiolytic: a drug used to reduce anxiety
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antiarrhythmic
antibiotic
anticoagulant
anticonvulsant
antidiabetic
Antiarrhythmic: a drug that counteracts cardiac arrhythmia
Antibiotic: a drug that kills or inhibits the growth of microorganisms
Anticoagulant: a drug that prevents the clotting of blood
Anticonvulsant: an agent that prevents or lessens convulsions or seizures; commonly used to treat epilepsy
Antidiabetic: any of several agents used to control blood sugar levels in the treatment of diabetes mellitus
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antidepressant
antiemetic
antifungal
antihistamine
histamine
Antidepressant: an agent that counteracts depression
Antiemetic: a drug that prevents or stops vomiting
Antifungal: a drug that kills or prevents the growth of fungi
Antihistamine: a drug that blocks the effects of histamine in the body
Histamine: a regulating body substance released in excess during allergic reactions, causing swelling and inflammation of tissues
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antihyperlipidemic
antihypertensive
anti-inflammatory
antipruritic
antipyretic
antiseptic
Antihyperlipidemic: a drug that reduces serum fat and cholesterol
Antihypertensive: a drug that lowers blood pressure
Anti-inflammatory: a drug that reduces inflammation
Antipruritic: a drug that relieves itching
Antipyretic: a drug that relieves a fever
Antiseptic: an agent that inhibits the growth of infectious microorganisms
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antispasmodic
antithyroid drug
antiviral
bronchodilator
cardiotonic
Antispasmodic: a drug that prevents or relieves muscle spasm
Antithyroid drug: an agent that blocks the production of thyroid hormones; used to treat hyperthyroidism
Antiviral: an agent that destroys a virus or weakens its action
Bronchodilator: a drug that dilates the muscular walls of the bronchi
Cardiotonic: a drug that increases the force of myocardial contractions in the heart; commonly used to treat congestive heart failure
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cathartic
decongestant
diuretic
expectorant
hypnotic
Cathartic: a drug that causes movement of the bowels, also called a laxative
Decongestant: a drug that reduces congestion and swelling of membranes such as those of the nose and the eustachian (auditory) tube during an infection
Diuretic: a drug that increases the secretion of urine; commonly prescribed during hypertension
Expectorant: a drug that breaks up mucus and promotes coughing
Hypnotic: an agent that induces sleep
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hypoglycemic/antihyperglycemic
nonsteroidal anti-inflammatory drug (NSAID)
psychotropic drug
antipsychotic agents
sedative
Hypoglycemic/antihyperglycemic: a drug that lowers blood glucose level (ex. insulin)
NSAID: a group of drugs with analgesic (pain relief), anti-inflammatory, and antipyretic (fever relief) properties (ex. ibuprofen and aspirin). Commonly used to treat arthritis
Psychotropic drug: a medication capable of affecting the mind, emotions, and behaviour. Used to treat mental illness
Antipsychotic agents: a class of psychotropic drugs used to treat psychosis, especially schizophrenia
Sedative: an agent that has a calming effect and quiets nervousness
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thrombolytic agents
vasoconstrictor
vasodilater
Thrombolytic agents: a drug used to dissolve thrombi (blood clots)
Vasoconstrictor: drug that causes the narrowing of the blood vessels, thereby decreasing blood flow
Vasodilater: a drug that causes dilation of the blood vessels, thereby increasing blood flow
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Radiography
The process of using x-rays to obtain images of internal structures of the body. X-rays are a man-made type of electromagnetic radiation. Radiation is energy that is transmitted by waves through space or through a medium. Ionization is any process by which a neutral atom loses an electron. Discovered in 1895 by Wilhelm Roentgen. 1896: First biologic effects of x-rays reported. 1928: First international recommendations on radiation protection adopted. Used for posture, and shoe fitting.
X-rays are produced when fast moving electrons hit a metal target in the x-ray machine. A heated cathode filament emits electrons and shoots them across a space, electrons are accelerated when they hit the anode on the other side of the space and bounce off producing x-rays.
One of the most important goals of a radiographer is to ensure the safety of patients and all others against unnecessary radiation exposure. Lead vests are worn by patients and staff to reduce the exposure to radiation. Scan ER patients, inpatients, outpatients, OR, portables. Can work in hospitals, clinics, or mobile x-ray companies. Can advance to do CT, angiography, or mammography.
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APA - 4 reasons to cite, copyright, and fair dealing
4 reasons to cite: Findability (so others can use the same sources you did), Fairness (give credit to author, avoid plagiarism), Failing (academic dishonesty in a course), and Fortification (assist your opinion, fact vs opinion)
Copyright is a law that protects moral and economic rights of content creators. Copyright has rights for both creators and users in an effort to create a balanced and fair use of copyrighted works. There are also exceptions available, such as fair dealing. Only the copyright owner has the right to decide when and how the work is used.
Fair dealing is a user’s right in copyright law permitting use of a copyright protected work without permission or payment of copyright royalties. The fair dealing exception in the Copyright Act allows you to use other people’s copyright protected material for the purpose of research, private study, education, satire, parody, criticism, review or news reporting, provided that what you do with the work is ‘fair’. When considering whether something is "fair" 6 aspects are weighed: Purpose, Nature of the work, Amount, Effect, Alternatives, and Character (how far is the work being distributed and for how long)
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APA - latest edition
-Publisher location is no longer included
-Citations with 3 or more authors are shortened in text to first one et al
-Include up to 20 authors in the reference list
-DOI formatted as URLs
-Don't include "retrieved from" in front of URL
-Don't include format, platform, or device for ebooks
-Cite contributors
-Inclusive and bias free language
-Use "they" as a gender-neutral pronoun
-Use descriptive phrases instead of labels ie "people living in poverty" rather than "poor people"
-Use exact age ranges "65 to 75" rather than "over 65"
-Fonts include Calibri 11 Arial 11 Lucida Sans Unicode 10 Times 12 and Georgia 11
-Running head does not include "Running head:" beforehand
-No running head in student papers
-Heading levels 3-5 are updated
-One space after a period
-Use double quotation marks for linguistic examples
- 1 inch margins on all sides
- Double spaced with page numbers and a title page
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APA- anatomy of a citation
Need to find author/creator, date, title, and publishing information. Listed in alphabetical order.
Personal communications are not listed in the references list as they are not recorded and thus can not be found anywhere. Cited as so: (Name of the person, personal communication, date of the interaction)
Journal Article: Last name, initial. (date). Article title. Name of the journal in italics. Link
Ex: Wiesener, C., Speaker, L., Axelgaard, J., Horton, R., & Niedeggen, A. (2020). Supporting front crawl swimming in paraplegics using electrical stimulation: A feasibility study. Journal of NeuroEngineering and Rehabilitation, 17(1). https://ezproxy.mohawkcollege.ca/loginhttp://search.ebscohost.com/login...
Book or ebook: Last name, first initial. middle initial. (date). Book title in italics. Publication info. DOI if applicable
Ex: Obourn, M. W. (2020). Disabled futures: A framework for radical inclusion. Temple University Press.
Website: Author. (Date). Website title in italics. Link
Ex: W3C Web Accessibility Initiative. (2020). Web content accessibility guidelines overview. https://www.w3.org/WAI/standards-guidelines/wcag/
Video: Author. (Date). Video title in italics [Video]. YouTube. Link
Ex: Harvard University. (2019, August 28). Soft robotic gripper for jellyfish [Video]. YouTube. https://www.youtube.com/watch?v=guRoWTYfxMs
In text: (Last name et al., year, page or paragraph # or video time)
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Governing Bodies
Organizations responsible for ensuring safe delivery of health care. They establish ethical standards, policies, practice guidelines, expectations for the health care worker, ensure professional accountability, protect the public, and support the health care worker. They provide educational opportunities for students and graduates, ensure ongoing competence of technologists once graduated, indicate how technologists must perform in the health care setting, and ensure that standards of performance are followed by practicing technologists This is done by...
Legal system (National and Provincial):
-Establish laws/acts to ensure ‘safe’ behaviour and accountability
-Regulated Health Professions Act (RHPA)
-Ex: Canadian Law, Ontario Acts
Regulatory bodies (Provincial):
-Administer legal ‘Acts’ for specific profession(s)
-Ensures accountability
-Ex: CMRITO (establish standards of practice)
Associations (National and Provincial):
-Support the profession/professional
-Ex: CAMRT (National Competency Profile (NCP) for rad and RT), Sonography Canada (NCP for ultrasound), OAMRS (all 3 professions)
Health care institutions (employer):
-Establish policies and procedures
-Ensure accountability
-Ex: hospitals, departments, clinics
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College of Medical Radiation Imaging Technologists of Ontario (CMRITO)
Established by the Medical Radiation Technology Act in 1991
Set standards of practice provincially
Code of ethics stating "behaviour that is right, good, fair and just”
Protect the Public of Ontario by developing and maintaining standards of qualification, code of ethics and standards of practice to ensure quality in the practice of Medical Radiation Technology, and programs to promote continuing competence. Ensure MRTs abide by laws, rules, regulations set out by RHPA and the legal system. Provide documents (code of ethics, SOP) that clearly outline expected standards of practice for professionals - incorporates RHPA and legal requirements (e.g. HCCA, PHIPA, sexual abuse, malpractice)
Professional misconduct is run through the CMRITO disciplines committee (similar to civil court)
"MRTs must perform their duties responsibly and in
a manner that reflects the profession’s
commitment to respect the personal dignity of every individual patient who entrusts himself or herself to the MRTs care.”
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Regulated Health Professions Act (RHPA)
Medical radiation technology is a self-governing health profession in Ontario under the Regulated Health Professions Act, 1991 (RHPA)
Regulated Health Professions Act, 1991 (RHPA) and associated health profession Acts, set out the governing/ legislative framework for the regulated health professions in Ontario.
The RHPA framework is intended to :
*better protect and serve the public interest
*be a more open and accountable system of self-governance
*provide a more modern framework for the work of health professionals
*provide consumers with freedom of choice
*provide mechanisms to improve quality of care
Key features of RHPA:
- Scope of practice (statement that describes what the profession does)
- Identifies a list of controlled acts (procedures or activities which may pose a risk to the public if not performed by a qualified practitioner) and determine health care workers who are permitted to perform these acts
- Health Regulatory Colleges (a corporation that governs each regulated health profession responsible
for regulating the practice of the profession and governing its members according to the RHPA)
- Health Professions Regulatory Advisory Council (an independent advisory body to the Minister of Health and Long-Term Care with a mandate to advise the Minister of various items related to the regulation of health professions)
- Health Professions Appeal and Review Board (an independent third party with a mandate to review
registration and complaints decisions of the health regulatory College)
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Professional Accountability
The obligation of one party to provide a
justification and to be held responsible for its
actions by another interested party
MRTs are accountable for their decisions and
actions
They must understand and comply with legal and
ethical requirements that govern the practice
of medical radiation technology in Ontario
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Regulated Health Professional
MRTs are regulated health professionals
Accountable to their patients and the public to provide safe, effective and ethical medical radiation technology services
Several governing bodies are responsible for ensuring this happens:
Health care law (i.e. ‘Acts’) and Regulatory body (ies) (e.g. CMRITO)
- These governing bodies are responsible for ensuring that acts are adhered to by MRTs. This makes MRTs accountable, sets performance standards for MRTs
Professional associations (e.g. CAMRT, Sonography Canada)
These associations establish performance requirements for MRTs (i.e. competencies), and provide credentialing of MRTs (entry to practice exams)
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Guiding principles in medical radiation technology
Provide optimal care of the patient
- Ensure safe delivery of care
- Includes diagnostic and therapeutic
procedures
- Anyone working with them is qualified to do the job
- All relevant people are involved in their decision-making
- The environment is safe
- Procedures (e.g. aseptic measures)
- Privacy of medical information, and self (informed touch, covering them up as much as possible)
Provide optimal work environment for the
health care worker
- Safe work environment such as providing TLD monitors for those who work with radiation, providing necessary training such as WHMIS, and providing proper PPE
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Personal Health Information
Personal Health Information Protection Act (PHIPA)
Personal, highly sensitive, identifying information about an individual in oral or written form:
Physical or mental health
Health care and payment
Donation of body parts
Plan or service under Long term health care act
PHIPA: Act in Ontario that sets out rules for the collection, retention, use, disclosure and disposal of personal health information. The information and privacy commissioner of Ontario acts independently of government to protect privacy of information. Attempts to balance the protection of the person’s health information with that of the health care system’s need to know to provide optimal care. Handles complaints.
Health Information Custodians: “Certain persons or organizations with custody or control over personal
health information” Includes Health care practitioners who provide health care, Health facilities, long term care facilities, or ambulance services
Agents: Those who act for or on behalf of health information custodians (physician, nurse, allied health professional, records storage company)
PHIPA provides individuals with the right to access and seek correction of their personal health information (under supervision of health information custodians)
PHIPA allows those that are engaged in delivering patient care to share the health information necessary to provide that care. This is called the Circle of Care Principle. PHIPA states that the custodian or agent cannot disclose more than reasonably necessary. They must ask what information is needed and how much is required.
Must have a legitimate need to know when retrieving information. Can not provide information to patient outside scope of practice
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Ontario Association of Medical Radiation Sciences (OAMRS)
Ontario Framework:
Ministry of Health, Ministry of Long-Term Care, and Ministry of Labour. RHPA, CMRITO, and HARPA are Ontario acts that represent the public. OAMRS represents the technologists, they can challenge laws/ regulations (help inform politicians of the impacts so they can make an informed decision).
OAMRS, is critical for reasons of advocacy and representing the profession at the government table and other interest groups since decisions concerning health care are provincial. They provide a strong voice to influence decisions and ensure the profession is recognized in the Ontario Healthcare system.
As a student member of the OAMRS, you are assigned to a specific geographical chapter in which they live/work, as students you are a member of the chapter in which your institution/clinical placement is located. You can attend meetings and education days (webinars, online courses, training, etc) in any of the chapters.
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What is ethics?
What is medical ethics?
Ethics: Moral principles that govern a person's or group's behaviour
Medical Ethics: A system of moral principles that apply
values and judgments to the practice of medicine. It encompasses its practical application in clinical settings as well as work on its history, philosophy, and sociology
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CMRITO code of ethics and standards of practice (SOP)
Code of Ethics:
Set of principles that precisely lays out responsible, ethical, moral conduct of members of the CMRITO. Intended to help MRTs choose the right, fair, good and just action. Ensures safe, professional performance to ensure safe, effective and ethical outcomes for patients. MRTs are personally responsible for behaving according to the ethical principles set down in the Code. Misconduct is run through the CMRITO disciplines committee. Used in conjunction with Standards of Practice.
Standards Of Practice:
-Document that sets out minimum standards of professional practice and conduct for MRTs.
-Assists MRTs in understanding CMRITO’s expectations with respect to the professional practice of medical radiation technology.
-Helps managers in making appropriate decisions regarding management of the practice of MRTs and in developing suitable policies and procedures.
-Assists educators in developing curriculum and in providing appropriate instruction.
-Assists the public in assessing quality of care
-Focuses on the Principles of competency, accountability, and collaboration
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Who are MRTs responsible to?
The public: appearance, competence, qualifications, integrity, advancing the profession
The patients: informed consent, dignity, privacy, non-bias, safe practice
The profession: adhere to the law, SOP, research, honesty
Colleagues and other health care professionals: communicate, collaborate, safe practice, educate other professions
Themselves: continual improvements in practice, adhere to laws, SOP
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MRI
5 basic principles requirements:
- Hydrogen ions present in the water that makes up our bodies
- Super-cooled magnets (MRI machine never turns off)
- Radio-frequency
- X, Y, Z coils (magnets): can energize just one coil to get one slice
- Radio-frequency coils
What else:
- Noise (caused by fluctuations of gradient fields)
- Computer/fast processing
- Safety (not a regular magnet, everything has to be MR safe. Missile effect is when things shoot across the room to the magnet, are lifted of the ground, and squished due to the strength of the magnet)
- Quench (cryogens that keep the magnet cooled are released/vented to turn off the magnet. This is done when something is on the magnet. It is only bad if it occurs as a result of a malfunction)
- Consultation (intense form filled out 3 times to ensure no metal goes near the machine. Filled out by the doctor, the technologist, and the receptionist. Have to watch out for body alterations such as piercings, tattoos (some ink contains metal), makeup, jewellery, transdermal patches, clothing)
How it works:
Magnets make the body's hydrogen ions line up with the magnet. Energy knocks over the hydrogen ion. When it realigns it gives off extra its extra energy in the form of an RF signal. RF coils placed near where the slice is receives the RF signal to produce an image. MRI is superior in subject contrast
Titanium and Copper are non-ferromagnetic meaning they are MR safe. Faraday cages prevent other RF signals from entering the MR suite.
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Healthcare Law (terminology)
Civil law: Branch of law that deals with relations between individuals or organizations.
- Case brought on by another person who has been
wronged - sue for ‘damages’.
Malpractice: Improper, illegal, or negligent professional activity or treatment, especially by a medical practitioner, lawyer, or public official.
* e.g. misconduct, breach of ethics, unprofessionalism,
unethical behaviour
Impropriety: Action which may be seen to be inappropriate and bring individual or profession into disrepute
e.g. dishonesty, inappropriate touch, overly intimate, use of power and position
Professional misconduct: Actions that violate a federal or provincial law, a municipal bylaw or a bylaw or rule of a hospital if the contravention is relevant to the member’s suitability to practise.
e.g. Omission (act of failing to do something required by the practice of our profession), Violation (doing something which goes against the legislation or standards of practice), abuse, failure to receive consent, working under the influence, failing to adhere to SOP, etc
Negligence: Failure to exercise the care that a reasonably prudent (wise, good judgement, common sense) person would exercise in similar circumstances.
- The senior person in absolute charge is held liable for the negligence of others, even when they are entirely free of blame. (ex: surgeon performing surgery is also liable if nurses miscount instruments, and one is left behind). This is called Respondeat Superior
Fraud: Aspect of professional misconduct
e.g. altering a record related to an MRT’s practice, trying to influence a patient to change his or her will or any other testamentary document, signing or issuing a document that an MRT knows contains false or misleading statements
- No one may use the title medical radiation technologist or any abbreviation without being a member of the College and holding corresponding specialty certificate (don't perform the procedure if you are not qualified).
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Healthcare in Canada
Legislation: PHIPA, HARP, RHPA, HCCA
Regulatory Colleges: SOP, Accountability
Canada is 10th in the global health ratings (judged by life expectancy, premature mortality, mortality of various diseases such as cancer and diabetes, infant mortality, etc). By 2036 23-25% of Canadians will be over the age of 65, this increases the burden on the health care system.
The federal government sets and administers national principles for the health care system (Canada Health Act), assist in the financing of provincial health care services, deliver health care services to specific groups such as veterans or first nations, and provides and fund other health related functions such as public health, health protection programs, and health research.
Healthcare Delivery in Canada: publicly funded (mostly free at the point of use), services are provided on a needs basis rather than ability to pay, available to all and doesn't discriminate.
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Canada Health Act (CHA)
- Federal healthcare legislation
- Specifies conditions and criteria by which provincial and territorial health insurance programs must conform in order to receive funding for health care services (gives rules as to how the provinces can spend the money given to them).
5 main principles:
- Public Administration: health insurance must be carried out by a public attorney at a non for profit and they are accountable to the province. Health services in Canada is funded and operated by the provinces
- Comprehensiveness: all these institutions must be insured
- Universality: all insured residents are expected to get and able to get the same level of care
- Portability: coverage will remain valid for a period of time if you move provinces
- Accessibility: there should be reasonable access to healthcare facilities regardless of location. All those providing this healthcare must be compensated for the services they provide. Ex: those in northern communities receive funding to be able to travel to the nearest location that provides the service they need.
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Role of provinces in healthcare
Provincial Funding in Ontario
Cons to the healthcare system in Canada
Role:
Each province is responsible for administration of own delivery of health services (ex: decide the number of health care providers and settings)
Ministry of health and long term care (MOHLTC) in Ontario receives the money and directs it to hospitals and ensures equitable care.
Healthcare is a provincial matter
Funding:
Ontario Health Insurance Plan (OHIP)
Cost of health care covered primarily by taxes
Need to qualify for coverage
Minimize fraud
Cons:
- Different settings use different health information systems which don't always integrate well
- Wait times for some health care and diagnostic treatments
- Management systems that don't focus enough on the quality of life (just have them live to be alive)
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Ministry of health and long term care (MOHLTC)
Establishes overall strategic direction and provincial priorities for the health system.
Develops legislation (RHPA, PHIPA, HARP), regulations, standards, policies, and directives to support those strategic directions
Monitors and reports on the performance of the health system and the health of Ontario citizens
Plans for and establishes funding models and levels of funding for the health care system
Ensures that expectations are fulfilled
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Controlled acts that apply to MRTs (Authorized acts)
1. Administering a subject by injection or inhalation (contrast medium for CT or MRI)
2. Tracheal suctioning of a tracheostomy
3. Administering contrast media, or putting an instrument, hand or finger...
- beyond the opening of the urethra
- beyond the labia majora
- beyond the anal verge
- into an artificial opening of the body
4. Performing a procedure on tissue below the dermis (ex: tattoos on patients for RT)
5. Applying a prescribed form of energy
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Health care consent act (HCCA)
Provincial law
Health care professional must ensure patient is:
- capable with respect to the treatment, and has given consent; OR
- incapable with respect to the treatment, and another person has given consent in accordance with the HCCA
Must not proceed with the procedure if valid consent has not been obtained
Criteria for consent:
- Patient is informed, relates to the treatment, given voluntarily, not obtained through fraud or misrepresentation.
A substitute decision maker is used if:
- Patient shows evidence of confused or delusional thinking, or appears unable to make a settled choice about treatment.
- If patient is experiencing severe pain or acute fear/ anxiety, if the person appears severely depressed, or if the person appears impaired by alcohol or drugs
A person is mentally capable of making treatment decisions if they are able to:
- understand the info that is relevant to making a decision about the proposed treatment
- appreciates the reasonably foreseeable consequences of accepting or refusing treatment
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Healing Arts Radiation Protection Act (HARP)
Ontario's medical radiation safety legislation
Regulations that define the safe limits of operation of x-ray machines in Ontario
Applies to radiography and radiation therapy
- Who can order exams
- Who can operate the equipment
- Installation and operation of standards
- Radiation Protection Officer
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Privacy
Confidential vs Privileged information
Privacy:
The state of being free from unsanctioned intrusion
Touch: physical modesty, and integrity of individual's body. Ex: touching the patient, keeping them covered whenever possible
Behaviour: all aspects of behaviour, especially sensitive matters, sexual preferences, religious practices, or habits
Communication: ability of individuals to communicate without monitoring by others (take them to a private area to talk)
Data: limitations of access of individuals to records without consent, authority, or justifiable cause
Information:
Confidential - private information communicated in a relationship of trust (doesn't need to be documented; for example: a patient shared sexual preferences)
Privileged - private information received coincidently in the practice of a profession. Confined to an exclusive or chosen group of individuals. Documented and accessible to others in the healthcare profession
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Sexual abuse prevention program
Discussed by CMRITO
Sexual abuse does not include touching, behaviour, or remarks of a clinical nature appropriate to service
To avoid sexual abuse:
- talk before you touch
- never assume
- speak directly to patient
- never judge
- maintain confidentiality
- create a safe environment
- maintain patient's dignity (keep covered when possible)
- show respect
- touch only where necessary
- get patient's consent
