Flashcards in Surg 102--Unit 1 Test Review (From Class) Deck (50):
What is the "borrowed servant" rule?
The surgeon is liable for acts of team members only when he has the right to control and supervise the way in which a perioperative caregiver performs the specific task. A good example of this is counting sponges, sharps, and instruments.
What information is included on the informed consent form?
1.The name and type of surgery
2. The risks, benefits, and possible outcomes
3. Alternatives to the procedure
4. An assessment of the patient's understanding
5. The patient's acceptance of the procedure
Which of the following is not routinely covered when obtaining an informed consent?
1. Why is the procedure being done
2. What is going to happen during the procedure
3. What are the risks
4. What are the names of all staff members that will be present
Can the patient signed the informed consent if they have been given pre-op medications?
What is cognitive impairment?
The patient is unable to form rational conclusions and cannot act in their own best interest.
What is an advanced directive? What are examples?
A document in which a patient gives instructions about his medical care in the event he cannot speak for himself because of incapacity. Examples are DNR, organ donation, refusal of blood transfusion, living will, medical power of attorney.
What are ethical dilemmas?
A personal conflict that arises from the need to make a decision based on choices that are not completely acceptable.
What are examples of ethical dilemmas?
1. Right to die
2. Stem cell research
3. Human cloning
4. Good Samaritan law
6. Refusal of treatment
7. Organ donation
10. Spiritual values
Which of the following is a negative effect of computer documentation?
1. Terminology is standardized
2. Paper records must be kept
3. Patient data can be transferred online
4. Only personnel with clearance can access the documents
Who records the operative report and what is contained within it?
Completed by the RN circulator. Includes patient assessment, care plan, and technical information about the equipment and devices used during the procedure. Sponge, sharps, and instrument counts and details about specimens and medications. Names of all perioperative personnel who participated in the procedure and those participating in the counts must sign at the close of surgery.
According to the TJC, which of the following is not required for a contractor working in a hospital under a surgeon?
1. Appropriately credentialed
3. Required to give care under direct supervision of a licensed practitioner
4. The cannot have a criminal record
According to TJC, the standards for independent contractors are:
1. Must be appropriately credentialed
2. Must be competent
3. Must be providing direct care under the supervision of a licensed practitioner
4. May perform duties only within the scope of his intended role
5. Must adhere to the policies and procedures of the facility
6. Must be oriented to the facilities emergency evacuation procedures
7. Must be current in immunizations and health screening
8. Must display appropriate identification at all times
9. Must comply with all background checks, possibly including fingerprinting and drug testing
What is battery?
Unlawful physical contact (bodily harm)
What is the purpose of aseptic technique?
A set of practices and methods that prevent the transmission of disease.
Factors contributing to a successful lawsuit on behalf of the plaintiff have been called the "four D's of malpractice." What are they?
1. Duty to deliver of standard of care directly proportional to the degree of specialty training received
2. Deviation from that duty by omission or commission
3. Direct causation of a personal injury or damage because of deviation of duty
4. Damages to a patient or personal property caused by the deviation from the standard of care
This act provides for the confidentiality of health data involved in research or transmitted or stored by electronic or any other means?
HIPAA (Health Insurance Portability and Accountability Act)
When did HIPAA take effect?
How are surgical techs legal boundaries defined?
What does OSHA do?
Issues and enforces standards that protect employees and patients against risks in the environment.
Each state (and its laws) has the power to regulate _____?
practice of medicine and professional nursing
Is a hospital required to show all new employee's the policies and procedures of the hospital?
What principles are codes of conduct based on?
Honesty, professionalism, compassion, and integrity.
Are codes of conduct (standards of conduct) laws?
What is delegation?
The transfer of responsibility of a task from one person to another.
What are the conditions of delegation?
1. Must be legally permitted to perform the task
2. Must have received the proper training to perform that task safely, without harm to the patient
3. Must be competent to perform the task
An employer is responsible for the actions of an employee
res ipsa loquitur
"The thing speaks for itself." Negligence is so evident that there can be no defense, or no further information is needed to prove negligence.
primum non nocere
Do no harm
What is a civil wrong (tort)
An act committed against a person or a person's property.
What are two types of torts?
Intentional and unintentional
What is an intentional tort?
A wrong purposefully and knowingly committed against another person.
What is an unintentional tort?
A wrong committed inadvertently, without intent to harm
What is negligence?
The commission of an act that a prudent person would not have done or the omission of a duty that a prudent person would have fulfilled, resulting in injury or harm to another person.
What is malpractice?
Negligence committed by a professional. Also may be committed if a person deliberately acts outside of his scope of practice or while impaired
What are the four elements of negligence that must be proven?
1. A duty to the patient existed
2. The duty was breached when a failure to meet the standard of care occurred
3. The breach of duty caused injury to the patient
4. The breach of duty resulted in damage to the patient
What are the guidelines for preventing or reducing negligence?
1. Be aware of what you do not know. Ask questions. Ask for help when you are unsure.
2. Be conscious of what you are doing.
3. Come to work mentally and physically prepared for extreme situations.
What is an example of abandonment?
1. Leaving patient unattended in OR
2. Leaving OR at the end of shift and no relief is available
3. Patient left unattended in hallway
4. Agrees to work overtime and then leaves without telling anyone
5. Refusing overtime when a mandatory overtime policy is in place
6. Delegation to an unqualified colleague
What does the CDC establish?
What is the AORN?
Association of periOperative Registered Nurses.
What does the AORN do?
Sets the standards and recommends procedures for the OR practice
What does The Joint Commission do?
Accredits health care facilities
Who sets standards for sterilization and disinfection in the healthcare setting?
What does asepsis mean?
What does it mean if an object is sterile?
It is completely free of all viable microorganisms, including bacterial spores
What is surgical conscience?
Admitting and reporting any break in aseptic technique
What is surgical attire?
Scrub suit, head cap, eye wear, mask, shoe covers
Should masks be changed between surgical procedures?
What is the purpose of the surgical scrub?
To reduce the number of resident and transient microorganisms on the skin to an absolute minimum
When is the surgical scrub performed?
1. Immediately before donning sterile gown and gloves.
2. After direct exposure (skin contact) with blood or body fluids