QUIZ- vulnerability

Question 1

what is vulnerability?

Answer 1

the quality or state of being exposed to the possibility of being attacked or harmed, either physically or emotionally

Question 2

CNA code of ethics and vulnerability?

Answer 2

recognize the potential of vulnerability of persons receiving care and do not exploit their trust and dependency in a way that might compromise the therapeutic relationship

Question 3

dimensions of vulnerability?

-social, psychological, physical

Answer 3

social: demographic data in relation to potential for illness
psychological: actual/potential harm to identify of self/emotional effects
physical: physiological state and susceptibility to morbidity/mortality

Question 4

vulnerability in perioperative patients?

Answer 4

• increased risk of harm
• needing surgery can create feeling of loss of power
• anxiety can effect health outcomes: predominately prolongs recovery time

Question 5

key findings in the semi-structured interviews of 10 nurses in perioperative environment?

Answer 5

• vulnerability exists! needs to be managed appropriately!
• the importance of holistic approach
• value of integrity, advocacy, empathy, and presence

Question 6

QSEN?

Answer 6

quality safety education for nurses

-six QSEN competencies

Question 7

6 QSEN competencies?

Answer 7

• patient centered care
• teamwork and collaboration
• evidence based practice
• quality improvement
• safety
• informatics

Question 8

why are the QSEN competencies important?

Answer 8

-you must understand them so you are aware when practicing and reduce harm of the patient, increase safety for your self too

Question 9

history of informed consent…?

Answer 9

• modern informed consent came from the nuremberg trials (1947) in germany… conducted on patients without their consent and without letting them know the the risks of those trials
• concluded that all experiments and all trials involving humans should be coded and informed consent taken

Question 10

informed consent is for:

Answer 10

any invasive or minimally invasive procedure

Question 11

consent=

Answer 11

voluntary agreement to some act or purpose made by a capable invdividual

Question 12

a client or substitute decision maker must be: (to give consent)

Answer 12

• adequately informed
• capable of giving/refusing consent
• free from coercion, fraud, or mirepresentation

Question 13

ethical considerations of consent?

Answer 13

• support clients with reduced capacity to make decisions that they are capable of
• obligated to take action if any concerns about consent

Question 14

physicians role for informed consent?

Answer 14

• inform of the procedure and risks
• inform of the benefits and alternatives
• provide an opportunity to ask questions
• inform of their ability to withdraw consent
• inform if the protocol differs from the actual procedure

Question 15

consent is valid if:

Answer 15

• it is freely given without coercion
• patient is competent
• it is provided in writing
• pt is able to understand

Question 16

nurses role for informed consent?

Answer 16

• may ask the patient to sign
• may witness the patient signing
• clarifies the patients understanding
• ensure the patient is not impaired prior to signing

Question 17

what is informed consent required for?

Answer 17

• invasive procedures
• radiation
• non-surgical procedure with more than slight risk
• procedure involving sedation or anesthesia

Question 18

who can provide informed consent?

Answer 18

• individual (pt)
• surrogate (pt not of age or competent)
• emancipated minor
• physician in an emergency

Question 19

informed consent process (4)

Answer 19

1. assess any barriers to communication and understanding
2. obtain decision and consent
3. re-establish consent
4. assess for coercion

Question 20

infants act?

Answer 20

• legislation related to persons under the age of 19
• provides rules for qualification as a “mature” minor… we assess who is a mature minor
• mature minor can make own health care decisions independent of parents

Question 21

when can a mature minor consent to healthcare and treatment in their best interest (if HCP believes they understand…?)

Answer 21

• what the treatment involves
• risks/benefits
• need for treatment

Question 22

implications of the infants act

Answer 22

-no set age for when someone can give consent

Question 23

informed consent is a legal mandate, but it also helps…

Answer 23

to psychologically prepare the patient by ensuring that the patient understands the surgery

Question 24

is consent valid if the pt was under meds that can affect judgement and decision making?

Answer 24

NOPE!

Question 25

if legal age and mentally capable, pt personally signs form... if not...

Answer 25

- surrogate - emancipated minor (married or independently living) - in an emergency: surgeon

Question 26

ways to improve consent process?

Answer 26

- audiovisual material or discussion - ensure content is understandable - braille---> sign language - multiple languages or interpreter for diff cultures

Question 27

voluntary consent=

Answer 27

freely given without coercion | -18 y/0 unless emancipated

Question 28

incompetent pt=

Answer 28

individual who is not autonomous and cannot give or without consent

Question 29

informed subject=

Answer 29

should be in writing -should contain: explanation of procedure and risks, description of benefits and alternatives, an offer to answer questions, instructions

Question 30

patient must be able to comprehend so...

Answer 30

- if non-english: in a language that is understandable - trained medical interpreter - alternative formats - questions answered

Question 31

what is a fundamental principle of the health care consent and care facility admission act?

Answer 31

presumption of capability | -assume pt can give consent unless there is a reason to believe otherwise

Question 32

advanced directive=

Answer 32

a consent or a refusal in advance of the need for health care

Question 33

substitute decision maker=

Answer 33

authorized under a representation agreement to make particular health care decisions

Question 34

three main themes of vulnerability?

Answer 34

1. labels 2. recognition 3. management

Question 35

labels as a theme of vulnerability?

Answer 35

Classification into groups heightened awareness of existing vulnerability within specific groups prior to surgical intervention & alerted practioners to utilize effective management strategies

Question 36

recognition as a theme of vulnerability?

Answer 36

- Physical & behavioral signs were identified along with awareness of the patient’s state of mind & the anxietal state caused by the environment, surgery & perception - Patients appearance, vital signs, trembling, rigidity Manifests differently in each patient

Question 37

management as a theme of vulnerability?

Answer 37

- Professional qualities & strategies - Professional, communication and personal alongside the value of presence - Knowledge & experience was imperative knowledge and experience was imperative knowledge of their role, being confident and competent - Observation skills facilitated assessment & subsequent planning and implementation of care designed to meet the patient needs Dignity & respect

Question 38

aim of the qualitative study of perioperative patients and vulnerability?

Answer 38

-reduce preoperative anxiety, therefore minimizing postop complications, promoting patient outcomes

Question 39

etic perceptions=

Answer 39

anaesthetic, surgery, environment with equipment and unknown surroundings

Question 40

emic perceptions=

Answer 40

previous and current life experiences, individual responses to these

Question 41

actual vs. potential vulnerability?

Answer 41

Actual vulnerability: known circumstances rending an individual susceptible while potential vulnerability is defined as circumstances which may or may not cause vulnerability

Question 42

precedents to vulnerability?

Answer 42

o Surgical intervention o Admittance to hospital for surgery o Undergo general anesthesia or regional o Preparation for surgery Exposure to a stressor causing an anxiety response

Question 43

aggravating factors to vulnerability?

Answer 43

-fear, anxiety, anticipated pain and discomfort, fear of unknown, fear for ones life