Week 2 PANCE material highlights Flashcards
21st Century Cures Act “Open chart” did what?
Give Access to Medical Record- 4/5/21-
Patient responsibilities:
Accept care from medical students, residents, and other trainees under appropriate supervision… nonetheless, patients’ (or surrogates’) refusal of care by a ____________should be respected in keeping with ethics guidance.
trainee
What are the 3 elements of informed medical decision making? (abbreviated)
1) Pt is acting voluntarily
2) Pt’s choice must be adequately informed
3) Adequate decision-making capacity
You should differentiate _____________________ from decision making processes when it comes to competence
memory deficits
Assessing Capacity: List the 4 parts
1) Understanding
2) Appreciation
3) Reasoning
4) Expressing a choice
Assessing Capacity; define:
1) Understanding
2) Appreciation
3) Reasoning
4) Expressing a choice
1) Understanding: comprehending information
2) Appreciation: recognize that the information applies to oneself; i.e. might understand a procedure but not know “I need this”
3) Reasoning: ability to apply logic, weigh merits & consequences of various choices
4) Expressing a choice: verbally or otherwise; must distinguish between refusal & inability to express
True or false: Expressing a choice has to be verbal
False
Define assent
-Agreement from minor child for medical procedures (age 7, 9, 14)
-Age varies by state, procedure
A patient has the right to refuse your
treatment suggestion; however, you also have the right to do what?
Document
True or false: While PAs are not expected to ignore their own personal values, scientific or ethical standards, or the law, they should not allow their personal beliefs to restrict patient access to care.
True
2 Broadest Categories of Health Care Systems are what?
Outpatient and inpatient
List 3 types of Non-hospital Inpatient Facilities
1) Skilled Nursing Facilities
2) Long-term Acute Care Hospitals
3) Inpatient Rehab Facilities
True or false: Medicare does not cover nursing homes
True
Patient Self-Determination Act
Passed in 1990 requires what?
1) Health care facilities to provide patient with a written summary that includes rights to make health care decisions and the hospital’s policies regarding advance directives
2) Upon admission to a hospital the patient must be asked if they have an advance directive
3) Cannot discriminate against any patient based on advance directive
List the 2 categories of advance directives
1) Instructive directives: Living will
2) Proxy directives: Durable Power of Attorney for Health Care
Appointment of Health Care Agent/Proxy allows for what?
Lets you name someone, called an agent/proxy, to make decisions about your medical care
True or false: You may revoke the designation of your agent only by a signed writing or by personally informing your supervising health care provider.
True
There are multiple uses for the term _________, including the philosophy of care for the dying
Hospice
What is the difference between an advance directive and a POLST?
a) They are the same thing
b) One is kept in a safe, one is portable
c) An advance directive is a legal document; a POLST is not a legal document
d) An advance directive describes the pts general treatment preferences; a POLST is an enforceable medical order that is specific
d) An advance directive describes the pts general treatment preferences; a POLST is an enforceable medical order that is specific
Hospice is appropriate when what 2 conditions are met?
1) Patients are entering the last weeks to months of lifeand
2) They want to forego disease-modifying therapies with curative/life-prolonging intent
