Midterm Flashcards
(119 cards)
1
Q
is the process of correctly matching a patient to appropriately intended interventions and communicating information about the patient’s identity accurately and reliably throughout the continuum of care.
A
Patient Identification
2
Q
“Correct patient identification is fundamental to safe care”
A
Joint Commission International (National Patient Safety Goals)
3
Q
Sample Wrong-Patient Events from ECRI Institute PSO’s Database (9)
A
- Medical-surgical unit
- Surgery
- Dietary
- Diagnostic imaging
- Pharmacy
- Maternity ward
- Doctor’s office
- Eye clinic:
- Nursing home
4
Q
A patient in cardiac arrest was mistakenly not resuscitated because the care team pulled up the wrong patient’s record and adhered to a do-not-resuscitate order.
A
Medical-surgical Unit
5
Q
A cardiac clearance meant for a different patient was given to a patient who previously had an abnormal electrocardiogram. The patient underwent surgery and was found unresponsive in his hospital room the next day.
A
surgery
6
Q
The wrong meal tray was given to a patient with a nasogastric tube who was not to receive any food or fluids orally. The patient attempted to eat the food and choked
A
Dietary
7
Q
The wrong patient was taken to the radiology department for a magnetic resonance imaging exam with general anesthesia. The patient was intubated and sedated before the error was caught.
A
Diagnostic Imaging
8
Q
A patient received a different patient’s hypertensive medication, at 10 times the intended dose. The patient was admitted to intensive care for hypotension.
A
Pharmacy
9
Q
An infant received another infant’s breastmilk. The mother who produced the breastmilk was infected with the hepatitis B virus, so the infant had to be treated with hepatitis B immune globulin.
A
Maternity Ward
10
Q
The wrong patient was marked as deceased in the doctor’s office’s electronic health record. All her outstanding appointments were automatically cancelled. When the patient arrived for a previously scheduled appointment, she was not happy that all her appointments had been cancelled.
A
Doctor’s Office
11
Q
Two patients with the same first name were scheduled for cataract surgery. The wrong patient was brought into the operating room and received the lens implant intended for the other patient.
A
Eye Clinic
12
Q
A patient from a nursing home was scheduled for a computed tomography scan at an affiliated hospital. The wrong patient (who had a similar name) was picked up from the nursing home, taken to the hospital, and underwent the exam.
A
Nursing Home
13
Q
is the act of transferring information from one place, person or group to another
A
Communication
14
Q
is fundamental to the existence and survival of humans as well as to an organization. It is a process of creating and sharing ideas, information, views, facts, feelings, etc. among the people to reach a common understanding.
A
Communications
15
Q
Ways of Patient Communication:
A
Rapport
Explain
Show
Practice
Empathy
Collaboration
Technology
16
Q
Physical appearance, level of eye contact with patients or how often you use their names in conversation-can shape your relationships with patients.
A
Rapport
17
Q
Ask patients a variety of questions that encourage them to explain more about their health and habits outside their appointments.
A
Explain
18
Q
Regardless of your specialty or practice setting, you will have to deliver constructive criticism during your career. In those instances, it’s best to show patients “collaborative thinking, and work with them in an active way rather than telling them what to do
A
Show
19
Q
Practice may not always “make perfect,” but it certainly can help physicians in training get ahead of tough conversations with patients. Practice good communication as much as possible.
A
Practice
20
Q
Avoid being judgmental by providing encouragement to your patients. This can be expressed through verbal and nonverbal cues.
A
Empathy
21
Q
Partner with your patients, noting that people are far more likely to positively respond to recommendations and questions in collaborative settings.
A
Collaboration
22
Q
Don’t overdo. Choose no more than three communication channels, communicating through technology is no excuse to use vague language or lazily fire off emotions in place of real conversation.
A
Technology
23
Q
2 Types of Communication:
A
Verbal
Non-Verbal
24
Q
organized by language ( oral/written forms)
A
Verbal
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includes facial expressions, eye contact, tone of voice, body posture and motions, and positioning within groups.
It may also include the way we wear our clothes or the silence we keep.
non-verbal
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non-verbal communication/body language (10)
1. ways of talking
2. posture
3. appearance
4. head movements
5. hand movements
6. eye movements
7. facial expressions
8. body contact
9. closeness
10. sounds
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consists of the views and opinions of patients and service users on the care they have experienced.
Patient feedback
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will give a direct insight into what is working well - and not so well - in the way an organization delivers care.
Examining feedback
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will help discover examples of good practice where lessons can be learnt, and, areas of concern where improvements can be made.
Feedback
30
Factors that Affect Communication
( 5)
* Age and sex of the patient
*Educational background
*Social and economic levels
* Culture and ethnicity
*Physical abilities and disabilities
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Therapeutic Communication Technique (10)
* Establishing guidelines
* Reducing distance
* Listening
* Using silence
* Responding to the underlying message
* Restating the main idea
* Reflecting the main idea
* Seeking and proving clarification
* Making observation
* Exploring, Validating and Focusing
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* A detailed description of the preparation necessary for the procedure /exam
PATIENT EDUCATION
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* A description of the purpose and the mechanics of the procedure and what will be expected of the patient
Patient Education
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* The approximate amount of time the procedure will take
Patient Education
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* An explanation of any unusual equipment that will be used during the exam
Patient Education
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* The follow-up care necessary when the procedure is complete
Patient Education
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Skills needed to establish plan for patient teaching (5)
1. Assessment skills
2. Critical skills
3. Thinking skills
4. Problem-solving skills
5. Therapeutic communication skills
38
Styles of Learning (5)
1. Global
2. Linear
3. Visual
4. Auditory
5. Kinesthetic
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some people look at the entire picture and details
Global
40
people look at each component of the material before looking at the whole
Linear
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material must be presented as graphic design or in pictures
Visual
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learning is by verbal explanation alone
Auditory
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learning is by verbal demonstration and followed by return demonstration
Kinesthetic
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a normal response to the loss of a loved one, a prized possession, social status, a bodily function or body part
Grief
45
a person is faced with the possibility of imminent death
Anticipatory grieving
46
Phases of Grieving Process (5)
1. Denial
2. Anger
3. Bargaining
4. Depression
5. Acceptance
47
not accepting the truth
1. Denial
48
patient may become angry preceding death or disfigurement
Anger
49
patient may seek alternative modes of treatment some of which may be unusual or non therapeutic
Bargaining
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patient accepts the impending loss and begins to mourn for his past life and all that will be lost
Depression
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patient accepts the loss and loses interest in all outside occurrence
Acceptance
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- establishes guidelines concerning patients' wishes when confronted with serious illness
- creates clear understanding of the patient's desires if he has an illness that cannot be cured or if the illness renders him or her so infirm that the life is without quality
Patient Self-Determination Act (PSDA), 1990
53
- legal documents that are formulated by a competent person and that provide written information concerning the patient's desire if the patient is unable to make the decision on his/her own
Advance Directives
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3 Instruments through which patient's wishes are dictated:
1. A living Will
2. Durable Power of attorney for health care
3. Five Wishes
55
- expresses the patient's wishes concerning their future medical care
A living will
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- appoints an agent that the person trusts to make decisions if the patient is unable to do so
Durable Power of Attorney for Health Care
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- a combination of directive
Five Wishes
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Five Wishes may specify the following:
1. The person I want to make care decisions for me when I cannot
2. The kind of medical treatment I want or do not want
3. How comfortable I want to be
4. How I want people will treat me
5. What I want my loved ones to know
59
It is the process of influencing patient behaviour and producing the changes in knowledge, attitudes and skills necessary to maintain or improve health through the provision of information and the teaching of patients.
PATIENT EDUCATION
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is crucial since the highest causes of death worldwide, including heart disease, cancer, stroke, lung disease, and injuries, are strongly connected to unhealthy lifestyle habits.
Patient education
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AIMS of PATIENT EDUCATION (4)
1.) Promote and maintain HEALTH
2.) Prevent illness and health complications
3.) Restore health and facilitate recovery from diseases
4.) Manage impaired functions
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FOUR VITAL COMPONENTS OF PATIENT EDUCATION
1. Assessment
2. Implementation
3. Planning
4. Evaluation
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* Analyzing barriers that affect care delivery is essential for developing a personalized plan that aligns with the patient's needs, abilities, and preferences.
ASSESSMENT
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In Assesment there are 4
1 Age
2. Gender/ preferred pronoun
3. Ethnicity
4. Identify patient's Learning preferences
65
* The healthcare professional collaborates with the patient to create an education plan. The selection of evidence-based strategies is influenced by several factors, with the patient's unique learning needs identified during the assessment being the most important, followed by the availability of resources.
PLANNING
66
SMART goals
specific,
measurable,
action- oriented
relatable and
time-bound
67
The steps of ____ are:
* 1. Carry out the teaching plan with an emphasis on the patient.
* 2. Keep the core principles of patient education in mind while teaching. Adapt the instruction based on the patient's response and evolving learning needs.
* 3. Implement the plan:
* Prioritise the patient by preserving their self-esteem and being attentive to both verbal and nonverbal cues through active listening.
* Employ clear language and concise messaging, and review key points.
* Modify teaching based on the patient's responses and changes in their learning needs. Encourage the patient to ask questions and provide answers.
IMPLEMENTATION
68
* __ assesses the level of learning achieved. Evidence of learning is shown by a patient's ability to apply information and tackle problems.
* Assessments should occur after each concept is taught and at the end of the teaching session. If needed, re-teaching may involve using different methods or resources.
EVALUATION
69
in health care means delivering effective, quality care to patients who have diverse beliefs, attitudes, values, and backgrounds.
This practice requires systems that can personalize health care according to cultural and linguistic differences.
CULTURAL COMPETENCE
70
Cultural competence significantly benefits healthcare organizations and patients alike. It results in more patient participation and engagement, fostering respect and improved understanding, which can lead to: (4)
* Increased patient safety
* Reduced inefficiencies
* Reduced care disparities
* Decreased costs
71
* Clear communication allows healthcare providers to collect accurate medical information. It also encourages active dialogues in which patients and providers can ask questions, correct misunderstandings, and build trust.
* Studies have shown that the absence of culturally competent care can lead to preventable mistakes and adverse events.
IMPROVED PATIENT OUTCOMES
72
* Healthcare environments that show an awareness of and respect for differences create more satisfying experiences for patients. When providers adjust treatments to meet patient needs and preferences, patients notice, and their overall experience improves.
IMPROVED PATIENT EXPERIENCES
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* Many modern healthcare training programs introduce cultural competency training in their schools and residencies in an effort to make healthcare more inclusive. It is an essential part of medical school, nursing, and health administration degree programs as well as post-secondary training programs for certified nursing assistants (CNA) and surgical technicians.
CULTURAL COMPETENCY EDUCATION IN MEDICAL AND NURSING SCHOOL
74
* A pregnant farm laborer from Mexico arrives at an emergency room in medical distress. Doctors discover the patient's placenta has separated from the uterine wall, making an urgent C-section necessary. The patient responds "yes" to all questions, though it appears they have little understanding
* After the C-section, doctors admit the newborn to the NICU because the baby is premature and has respiratory distress syndrome. The patient, their husband, and their mother, all indigenous, speak Spanish and no English. Spanish-speaking staff members try to get a clear history about the mother and explain the baby's condition to the family, but communication is a challenge
* As the baby's condition becomes tenuous, the family wants to bring in a traditional healer to cleanse the baby of its illness.
NAVIGATING A CHALLENGING BIRTH
75
* In this case, cultural competence in health care requires securing an interpreter who speaks the patient's native language. Only then can the healthcare providers take a thorough medical history of the patient, learn about potential exposure to pesticides through their work, and give the patient the opportunity to fully understand the medical conditions of both the mother and the baby.
CULTURALLY COMPETENT RESPONSES
76
* A severely ill 80-year-old patient learns that one of their heart valves has stopped working. To survive, they need surgery to replace the valve. The patient has a history of excessive bleeding.
This will require doctors to perform blood transfusions during the surgery.
* The patient is a devout Jehovah's Witness. According to their religious beliefs and interpretations, the Bible does not allow any type of blood transfusion, so the patient refuses the surgery.
RESPECTING A PATIENT'S CHOICES
77
* The patient's medical team engages the patient, their family, and trusted members within the patient's religious community in discussions about the nature of the surgery and the risk that the patient might not survive without it.
After the patient gets all the information and seems to understand all the risks, the medical team respects their choice to forgo the operation.
CULTURALLY COMPETENT RESPONSES
78
Determination of Pregnancy
The diagnosis of pregnancy requires a multifaceted approach using three main diagnostic tools:
* HISTORY AND PHYSICAL EXAMINATION
* LABORATORY EVALUATION; AND
* ULTRASONOGRAPHY
79
The diagnosis of early pregnancy is usually based on measurement of _____ in urine or blood
human chorionic gonadotropin (hCG)
80
the classic presentation of pregnancy is ___ as well as any combination of nausea, vomiting, generalized malaise, and breast tenderness.
amenorrhea
81
* Several hormones can be measured and monitored to aid in the diagnosis of pregnancy. The most commonly used assays are for the beta subunit of human chorionic gonadotropin (hCG). Other hormones that have been used include progesterone and early pregnancy factor.
LABORATORY EVALUATION
82
With the advent of ____, the diagnosis of pregnancy can be made even earlier than is possible with ___.
transvaginal ultrasonography (TVUS)
transabdominal ultrasonography (TAUS)
83
* ____ is the most accurate means of confirming intrauterine pregnancy and gestational age during the early first trimester.
transvaginal ultrasonography (TVUS)
84
Dose-dependent effects are referred to as
deterministic effects
85
dose-dependent probability is referred to as a
stochastic effect
86
* Short-term, adverse tissue reactions resulting from a dose that is significantly high enough to damage living tissues. The severity of a deterministic effect increases with radiation dose above a threshold, below which the detectable tissue reactions are not observed.
DETERMINISTIC EFFECTS OF RADIATION
87
Effects of deterministic effects (6)
* Radiation-induced skin burns
* Acute radiation syndrome
* Radiation sickness
* Cataracts
* Sterility
* Tumor Necrosis
88
* Effects that occur by chance, generally occurring without a threshold level of dose, whose probability is proportional to the dose and whose severity is independent of the dose.
STOCHASTIC EFFECTS OF RADIATION
89
Effects of stochastic effect
* Cancer
* Heritable or genetic changes
90
RESPONSIBILITIES OF A RADIOGRAPHER TO THEIR PATIENTS: (3)
* CLINICAL RESPONSIBILITY
* ETHICAL RESPONSIBILITY
* LEGAL RESPONSIBILITY
91
* Radiologic Technologists need accurate knowledge of practical procedures in the care of the patient, some knowledge of pathology and disease processes in order to prevent the disease from worsening by uninformed handling of the patient
* Knowledge of first aid and what to do in an emergency situation so that they will be able to help the patient until the medical assistant arrives.
* Understand the patient's psychological state
* Should not leave the patient unattended
* The patient should be reassured and shown completely professional behavior
* Assist physicians during procedures
* Process and evaluate radiographs
CLINICAL RESPONSIBILITY
92
* The appearance of a radiologic technologist is important
* They must remain neat and clean
* Female radiologic technologists should avoid keeping long nails and avoid wearing jewelry to avoid scratches during handling of patients and films
PROFESSIONAL RELATIONSHIP
93
* Discretion in speech
* Do not reveal information about the patient as it is confidential
* It is part of their duty to give minimum radiation dose to the patient
ETHICAL RESPONSIBILITY
94
STANDARD OF ETHICS: (2)
* Code of Ethics
* Rule of Ethics
95
* Responds to a patient's needs and supports co-workers and associated in providing quality patient care
* The timing of radiographs, proper side marking and labeling are also important duties
Code of Ethics
96
* Examinations may be requested by a physician
* The radiographer should examine the requisition carefully
* If the position were to cause pain or discomfort to the patient, the patient should be informed
* Well-mannered speech and behavior
* Treats the patient gently during the procedure
RULE OF ETHICS
97
LEGAL RESPONSIBILITY (3)
* Break of Confidential Information
* Negligence
* The Process in the event of an Accident
98
* Radiographers should regard information about the patient as confidential
* To disclose any such information, the results of investigation done in the department or any other confidential or personal information gained about the patient will constitute as professional misconduct
BREAK OF CONFIDENTIAL INFORMATION
99
* Occurs when the radiologic technologist fails to take care of the patient under his/her care which results in an injury to the patient
NEGLIGENCE
100
The Process in the event of an Accident PROCEDURES IN SUCH CASES ARE: (3)
* Care of the Victims
* Reporting the Accident
* Recording the Accident
101
* An agreement for a doctor or healthcare professional to provide a patient with treatment, including any medical or surgical management care therapy, test, or procedure.
CONSENT
102
Types of Consent (3)
1. Implied Consent
2. Verbal Consent
3. Written Consent
103
* An agreement is given by the patient in cooperating with a healthcare professional's instructions for routine procedures
IMPLIED CONSENT
104
* A ___ is where a patient states their consent to a procedure __ but does not sign any written form
* A patient's agreement is given ____ for a treatment or procedure that doesn't carry a significant risk
* While ____ is valid, a record of the agreement must be kept
* It is important to be clear about what is being asked and to make sure the other person understand
VERBAL CONSENT
105
* ___ is a formal document that allows a patient to give permission for a medical procedure or treatment.
* It should include information about the procedure, the patient's rights, and the option to withdraw consent.
* A patient's agreement is given by signing a document for a treatment or procedure that is complex or carries a higher risk.
WRITTEN CONSENT
106
means an order from the Physician admitting the patient to the Tenet Hospital or the Physician responsible for the patient's general medical management during the admission. The order may be electronic, in writing or be a telephone/verbal order as allowed by the Tenet Hospital's medical staff bylaws.
Physician Order
107
For healthcare systems and hospitals, lost patient belongings cost much more than reimbursement claims, though a single emergency department can easily pay out thousands in lost patient property claims in a years time, especially if documentation processes arent properly followed.
CARE OF PATIENT VALUABLES
108
Consideration of Screening pregnant patients (4)
* Examinations of Concern
* Pregnancy Test
* Questioning the Patient
* Minor Patients
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