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Module 13 OSHA, HIPAA Flashcards

1
Q

Federal statutes regarding general medical practice such as….?

A

Informed consent
Record-keeping
Patient confidentiality
Reporting of communicable disease
Maintenance of an Exposure Control Plan
Additionally, other safety requirements

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2
Q

Hazard communication standard with ….?

A

Respect to toxic chemicals such as disinfectants and other chemical such as isopropanol in the workplace.

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3
Q

If the protective barrier becomes torn (урагдах), …..?

A

It should be replaced immediately or as soon as patient safety permit( өвчтөний аюулгүй байдлын зөвшөөрөл )

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4
Q

In the event of the injury to the healthcare practitioner…. What would you do?

A

The barrier should be removed and the wound treated promptly. Any such injury should also be followed up with an INCIDENT REPORT.

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5
Q

What is that Standard Precautions?

A
  1. Hand hygiene
  2. Use of personal protective equipment
  3. Safe injection practices
  4. Safe handling of potentially contaminated equipment or surfaces in the patient environment
  5. Respiratory hygiene/ cough etiquette
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6
Q

HCWs should comply with current guidelines for handwashing to reduce possible….?

A

Transient pathogenic organisms from being passed between patients.

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7
Q

HCWs who have exudative lesions or weeping dermatitis should refrain from……?

A

From all directions patient care, from handling patient-care equipment

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8
Q

What is NSPA?

A

The Needlestick Safety and Prevention Act

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9
Q

NSPA requires…?

A

Employers to develop and update exposure control plans annually.

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10
Q

Practitioners who have employees, whether they be a receptionist or custodian, who may be exposed to blood-borne pathogens by pulling needles, emptying the trash, assisting patients in dressing and undressing,…..?

A

Should have an ECP. This ECP must include information about preventing the spread of BBP, including availability of HBV vaccination, for all workers in an acupuncturist’s employ who may come in contact with blood or OPIM.

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11
Q

All healthcare facilities must maintain …..?

A

Exposure control plan for Blood-borne pathogens as well as a Hazardous Communication Plan for chemical exposures.

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12
Q

Exposure Control Plan for BBP consist of:

A
  1. Written policies ( including the plan )
  2. Program administration ( name of responsible officer for policies, training, reports)
  3. Employee exposure determination
  4. Methods of implementation and control
  5. Regulated waste
  6. Hepatitis B vaccination
  7. Post exposure evaluation and follow up
  8. Employee communication ( includes standards for labels and signs such as biohazard labels and warning signs, containers, bags)
  9. Employee training
  10. Record-keeping
  11. Hepatitis B vaccine declination statement/policy
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13
Q

What is that Employee exposure determination?

A
  1. A list of job classifications where all employees have occupational exposure
  2. A list of job classifications where some employees have occupational exposures
  3. A list of all tasks and procedures in which occupational exposure occurs
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14
Q

What is the Methods of Implementation and Control?

A
  1. Exposure Control Plan
  2. Engineering controls and work practices( handwashing facilities, sharps containment, procedures involving blood or OPIM, and handling of equipment that may become contaminated)
  3. PPE
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15
Q

What is included in Regulated waste?

A
  1. Housekeeping: worksite in clean and sanitary condition
  2. Sharps containment and disposal
  3. Laundry: policies and procedures for cleaning all laundry and polices for handling contaminated laundry
  4. Labels: for all containers which may have contaminated waste or sharps
  5. Disposal of biohazard materials and contaminated waste
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16
Q

What is Post-exposure evaluation and follow up?

A
  1. Administration of post-exposure evaluation and follow up
  2. Procedures for evaluating the circumstances surrounding and exposure incident
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17
Q

What is included in Employee training?

A
  1. New employees must be offered a hepatitis B vaccine and receive blood-borne pathogen education before having contact with blood or body fluids.
  2. All employees must receive annual training regarding the OSHA BBP standard.
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18
Q

What is included in Record-keeping?

A
  1. Employee training ( at least 3 years after the duration of employment)
  2. Medical records of those exposed ( maintain for the duration of employment plus 30 years)
  3. OSHA record-keeping - including maintaining contracts and receipts for biohazardous waste disposal ( maintain for a minimum 5 years )
  4. Sharps injury log ( annual program evaluation and maintained for at least 5 years following the end of the calendar year covered)
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19
Q

Hepatitis B vaccine declination statement/policy?

A

Maintain for duration of employment PLUS 5 years.

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20
Q

ECP should also provide…?

A

Schedule and methods for implementing precaution procedures and procedures for evaluating exposure incidents. A copy of plan must be made available to all employees. The plan must be reviewed and updated annually.

21
Q

All incidences must include at least:

A
  1. Date of the injury
  2. Type and brand of the devices involve
  3. Department or work area where the incident occurred
  4. Explanation of how the incident occurred
22
Q

OSHA Hazardous Communication Plan consists of of:

A
  1. Company policies regarding chemical exposures - written record
  2. Container labeling - list of labels and plans for labeling of chemicals after being put in new containers or changes
  3. Chemical list - list of all hazardous chemicals found at the practice location. This include cleaning solution, alcohol for swabbing, hand cleaning solutions
  4. Material safety Data Sheets
  5. Employee training and information
  6. Hazardous non-routine tasks (list)
  7. Policies regarding informing other employers/contractors who may enter the premises ( outside cleaning agencies)
  8. How the employer has trained and made this policy and program available to employees
23
Q

What is the Hazardous Non-routine tasks?

A

Confined space entry, tank cleaning, painting reactor vessels.

24
Q

A list of chemical list,,,,?

A

When new chemicals are received, this list is updated ( including date the chemicals were introduced) within the 30 days.

25
OSHA disposing of biohazardous waste, these rules require:
1. Waste generators must prepare, maintain, and implement a written plan to identify and handle such waste. Any employee who works in area where biohazardous waste is kept must be provided with an employee training program that explains procedures for on-site separation, handling, labeling, storage, treatment of biohazardous materials. 2. Biohazardous waste, except sharps must be packaged in impermeable,, red, polyethylene or polypropylene bags( red bags ) and sealed. 3. Discarded sharps must be separated from all other waste and placed in leak-resistant, rigid, puncture-resistant biohazard containers. All containers must be labeled properly, if the treatment and disposal are to take place off-site. 4. In storing the packaged waste, care must be taken to place it in a designated area away from general traffic flow and accessible only to authorized personnel. One option is to store biohazardous waste awaiting pick up in a locked closet not used for storage of clean items or food.
26
Gauze, cotton balls, gloves….?
Used during the patient visit, but are not saturated or soaked with blood or OPIM, can be discarded in regular waste.
27
All sharps must be disposed of….?
Proper sharps container or Mail-back program.
28
Patient with the intradermal needles and press tacks….?
Patient can be given a sharps container to take home, use it for intradermal needles when removed at home, then the sharps container would need to be returned to the practitioner for proper disposal.
29
Floors should be easily cleaned: ….?
Carpeting in areas where biohazardous waste is generated or stored is not recommended since it’s difficult to clean up spilled needles or fluids.
30
All providers and other clinic personnel should know….?
Where material safety data sheets and safety manuals are located and have access to them on a demand basis.
31
All patient records should be ….?
Completed in black ink, bee complete with respect to the data from the patient contact, and not be erased or otherwise rendered illegible after the patient contact.
32
Patient record must be protected against…?
Theft, fire or water damage.
33
Patient records 9 critical parts of any chart:
1. Patient information 2. Past medical history 3. Allergies and adverse reactions 4. Family history 5. Dated and signed records of every visit 6. Flow sheets for organization of health maintenance, chronic conditions, well-care visits 7. Narrative notes describing conversations with patients regarding treatments ( acceptable and refused) and preventative testing 8. Consent documentation 9. Flow sheets or narratives indicating that unresolved problems from previous office visits are addressed in subsequent visits
34
Blue or black non-erasable ink should be used on
Handwritten records.
35
Patients records should be….?
Chronological order (он цагаар дараалагдсан байх ёстой )
36
Documented information is considered credible in court. Undocumented information is….?
Considered questionable since there is no written record of it’s occurrence.
37
The chart should not be left…..?
Unprotected environment where unauthorized individuals may read or alter the contents.
38
SOAP notes: ?
Subjective( information reported by the patient) Objective (information gathered by the practitioner,,, tongue, pulse, palpation) Assessment ( of the patient’s condition and treatment progress) Plan ( treatment record for the day, points, herbs, dietary, new diagnosis )
39
Protected Health information includes:
HCWs put in medical record, conversations about patient care or treatment with other health professionals, specific health insurer information, personal billing information
40
Individually identifiable health information ?
Held or transmitted by a practitioner or it’s business associate, in any form or media, whether electronic, paper, or oral…
41
What is NOPP?
Notice Of Privacy Practices Content of a NOPP: 1. How the practitioner may use and disclose protected health information about an individual. 2. How the individual may complain to the practitioner. 3. Practitioner is required by law to maintain the privacy of protected health information. 4. Whom individuals can contact for further information about the practitioner’s privacy policies. 5. The notice must include an effective date.
42
What is informed consent?
All diagnostic and medical procedures require the consent of the patient or in the case of child or someone who has certain mental illnesses or communication limitations, his or her legal representative.
43
Informed consent required 5 elements:
1. The diagnosis, including the disclosures of any reservations the provider has concerning the diagnosis. 2. The nature and purpose of the proposed procedure or treatment 3. The probable risks and consequences of the proposed procedure or treatment. This includes only those risks and consequences of which the provider has, or reasonably should have, knowledge. It’s appropriate to disclose those risks which occur more than 1% of the time for a given procedure. 4. Reasonable treatment alternatives. 5. Prognosis without treatment. The patient must be informed of the potential consequences of, if he or she elects not to have the recommended procedure.
44
Written consent provides material proof of consent. Written consent must include the following elements:
1. It must be signed 2. It must show that the procedure was the one consented to. 3. It must address the nature of the procedure, alternatives, the risks involved, the probable consequences, and demonstrate that the patient understood these concerns. 4. The patient must fill in the date on which the form was signed.
45
Oral consent, if proven, is just as binding as written consent. However…?
Oral consent may be difficult to prove in court.
46
Informed consent is particularly important when using techniques that might be ……?
Causing damage to the body, this includes acupuncture as well as direct moxibustion, cupping or gua sha, which may leave petechiae/bruises.
47
Treatment records maintained for how many years?
Often 7 years,
48
An acupuncturist may be held liable for malpractice …..? Өвчтөнд хайнга хандсаныхаа төлөө үүрэг хүлээж болно?
Rendering treatment to a patient, he or she does not make a proper disclosure to the patient of the risks involved in the procedure.

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