chap 2 E2

Accountability

The obligation to disclose details for evaluation; commonly used for “to be held responsible”

Affidavit

Voluntary statement of facts sworn to be true before an authority

Assault

Intentional act intended to make another person fearful; “the threat”

Battery

Intentional nonconsensual touching; “the touch”

Defamation

Injury to an individuals reputation or character caused by false statements to a third party (inclusive of libel and slander)

Iatrogenic Injury

An injury resulting from the activity of a health care professional

Liability

An obligation to do or not to do something; also an obligation potentially or actually incurred as a result of a negligent act

Malpractice

Professional misconduct that results in harm to another; negligence of a professional

Negligence

The omission (not doing) or commission (the doing) of an act that a reasonable and prudent person would not do under the same conditions; a departure from the “standard of care”

Standard of care

Description of conduct that is expected of an individual or professional in a given circumstance

Primum non nocere

Above all do no harm

Res ipsa loquitur

The thing speaks for itself

Respondeat superior

Let the master answer; employee is responsible for employees

Aegar primo

The patient first (motto of AST)

What are intentional torts?

Assault, battery, defamation, false imprisonment, intentional infliction of emotional distress; requires proof of the willful action on behalf of the defendant

What are unintentional torts?

In spite of best effort, a mistake is made; malpractice, negligence; OR errors and incidents

What are the concepts involved with patient identification?

All patients must be identified three times before procedure; ID bracelet to chart, admission to holding, transfer to OR, arrival to OR

What are the policies and criteria used to assure the correct procedures is being performed?

Patient or surgeon/patient mark the operation site; x-ray/CT/MRI should be checked by surgeon to confirm operation site; time out policy

Time out Policy

All members of the surgical team should take place immediately before the procedure; all members in the OR must agree with : correct patient, site/side, procedure, implants (if available)

What is the purpose of surgical counts?

If a foreign body is left behind; circulator and STSR

What items are counted?

Instruments, sponges (lap-5, 4×4 - 10, kittners - 5, etc), suture needles, hypodermic needles, electrocautery pencil (the tip), blades

How to prevent falls and positioning injuries?

A safety strap needs to be applied as soon as the patient is moved to OR table; never leave patient unattended; injuries - nerve damage or vascular injury

What are the charges involved with improper positioning?

Negligence for improper transfer or positioning of patient

Who is ultimately responsible for patient positioning?

Surgeon

How are the patient’s personal items handled in the OR? And by whom?

Any property should be removed by the holding nurse or circulator nurse and placed in a protective container and properly labeled

What are the repercussions of improper handling of a specimen?

It could result in lack of diagnosis, may require another procedure; be sure to label; frozen vs permanent

What is the purpose of the biological testing/ indicatiors?

The only method that assures the sterility of items

How are OR mistakes avoided?

By the Time Out policy

The JCAHO?

Informed consent as an agreement for permission accompanied by full notice about what is being consented to

Consent?

Refers to permission being given for action; proper consent requires the party granting permission has capability and authority to do so

What are the formats of consent?

Express and implied

Express consent?

Direct verbal or written statement granting premission for treatment

Implied consent?

Manifested by some action or inaction of silence which raises a procession that consult has been authorized

Requirements of consent?

Patients full legal name, maiden name, surgeons legal name, specific procedure, patients legal signature, signature of witness, date and time of signatures

Types of consent?

General and special

General consent?

Authorizes surgeon to render treatment or preforms procedure as the surgeon deans advisable

Special consent?

Procedures which entails higher than normal risk; surgery