Professional Issues

Question 1

Just Culture

Answer 1

-blame free reporting to increase reporting to uncover the source of the error

Question 2

End of Life Issues
Corneal Donation

Answer 2

• elevate head 20-30 degrees
• instill artificial tears
• tape eyelids shut with paper tape
• apply ice over eyes

Question 3

advance directives

Answer 3

written guide detailing a patient’s wishes prepared when a patient is *competent

*enacted (to put into place) when the patient loses decision making capacity

Question 4

living will

Answer 4

-allows an individual to declare what treatments an individual does and does not want

-can only be applied once they have a terminal illness or in vegetative state

Question 5

durable power of attorney

Answer 5

-designates a surrogate decision maker

Question 6

DNR

Answer 6

may limit CPR or intubation but does not withhold comfort measures such as pain relief or O2

Question 7

family presence

Answer 7

-gives closure
-reduces questioning- of events
-decrease shock and anger

Question 8

death notifications

Answer 8

• md & nurse deliver together (not real life)
• ascertain family’s knowledge
• *use the words died & dead
• encourage them to touch the patient
• leave tubes in for coroner cases
• circle unsuccessful iv stick sites (not real life)

Question 9

forensic evidence
(not real life)

Answer 9

• use quotation marks in documenting
  -facts only no judgement
• do no cut through clothing
  double fold bag with tape no staples
• place paper bags over patient’s hand if - -suspecting firing arm for gsw residue
• do not label wounds entrance or exit (wound 1 & wound 2)

Question 10

Who is responsible for determining the best mode of transport, equipment needed in route, and qualified personal based on patient’s needs?

Answer 10

the transferring facility

Question 11

considerations before air transportation

Answer 11

> ground: takes longer but more room
rotor-wing helicopter: rapid point to point transfer but cabin no pressurized
fixed wing: pressured and can fly in inclement weather

• gastric tube to decompress abd
• 2 IVs
• foley
• no air splints
• may place chest tube for small pneumo for rotor

Question 12

professional negligence:
duty

Answer 12

the nurse has a duty to perform care

Question 13

professional negligence: breach of duty

Answer 13

the person failed to complete the duty

Question 14

professional negligence: proximate causation

Answer 14

the breach caused damage either physical, emotional, psychological, or social

Question 15

professional negligence: damages

Answer 15

damage actually exists

Question 16

patient consent: implied

Answer 16

allows appropriate treatment in an emergency, as in unrepsoinve patient

Question 17

patient consent: express

Answer 17

agreement to treatment by signing paperwork

Question 18

patient consent: informed

Answer 18

• patient understand risks and benefits of the treatment and in not under the influence
• has legal capacity to make the decision

Question 19

patient consent: involuntary

Answer 19

ensuring needed treatment when an individusal refuses care

ie: suicidal, dleusional, dementia

Question 20

COBRA & EMTALA are meant to protect patients from what?

Answer 20

“dumping” practices in which hospitals transferred patients based on their lack of ability to pay

Question 21

EMTALA applies to any patient who comes to ED requesting

Answer 21

an exam or treatment

these patients must be provided with a medical screen exam performed by a qualified medical provider

Question 22

check list of transferring a patient

Answer 22

• patient must be stabilized
• receiving hospital must be secured with an accepting physician
• patient must be notified of transfer
• patient must sign certification they understand the benefits outweigh the risks
• transferring hospital must send appropriate medical records
• transferring facility just arrange transportation with adequate life support

Question 23

COBRA

Answer 23

applies to any patient who comes to the ED requesting an exam or treatment.

a medical exam must be performed by a qualified medical provider

Question 24

Implied consent

Answer 24

allows appropriate treatment in an emergency for an *unresponsive * patient

Question 25

Express consent

Answer 25

agreement to treatment, signs paperwork

Question 26

Informed consent

Answer 26

patient understands risks and benefits of the proposed treatment, is not under the influence, and has legal capacity to make the decision

Question 27

Involuntary consent

Answer 27

ensuring needed treatment when an individual refuse care

i.e. suicidal, delusional, dementia

Question 28

mitigation

Answer 28

to prevent or minimize potentially adverse effects

Question 29

preparedness

Answer 29

emergency traning, mutual aid agreements, stokcplie supplies

Question 30

Response

Answer 30

evacuation, shelter, disaster triage

Question 31

Recovery

Answer 31

restoring systems, replenish supplies, dispose of waste