week 7: medical orders and boundaries

Who can give an order for medical care?

Members of the College of Physicians and Surgeons of Ontario, Royal College of Dental Surgeons of Ontario, College of Midwives of Ontario, and College of Nurses of Ontario (if RN EC certified).

What constitutes a valid medical order?

Authority to undertake an intervention, details of the intervention, who the order is for, who the prescriber is, when the order is given, when and how to carry it out.

What is a direct order?

An order authorized by an individual prescriber at the time of care delivery for a specific patient and treatment.

What is a medical directive?

An order authorized in advance for a specified range of patients meeting specific conditions.

What are the essential components of a medical directive?

Must be written, approved by the Medical Advisory Committee, and must maintain the integrity of a direct order.

What is an example of an order set in respiratory therapy?

Authorizing respiratory therapists to adjust ventilator settings in ICU as per respective directives.

What are the requirements for a valid medication order?

Includes drug name, dose, maximum frequency, mode of administration, prescriber, patient information, date/time.

What is electronic ordering in healthcare?

Medical orders transmitted via an electronic format, such as electronic medical records.

What is required for an order for a diagnostic test?

Prescriber, patient/client information, date/time, test required, specific conditions of the test.

What information must be included in an order for assisted ventilation?

Prescriber, patient/client information, date/time, ventilatory mode and parameters, oxygen % and specific conditions.

When can mechanical ventilation be carried out by RTs?

Once the need is established and a valid order is in place, following RT standards of practice.

What are verbal orders in medical care?

Orders that must meet requirements and be transcribed ASAP, received directly from the prescriber.

What are re-orders in medical care?

Must be specific and include all conditions; vague orders like 'Ventolin' are unacceptable.

What are automatic discontinue orders?

Require a specific order to discontinue therapy unless the original order has an 'automatic discontinue' clause.

What are the responsibilities of a respiratory therapist?

Adhere to professional and personal scope of practice, ensure the order is in the patient's best interest, follow relevant legislation.

What does delegation of controlled acts involve?

Transfer of legal authority to perform a controlled act to someone not authorized to do so.

What controlled acts are RTs authorized to accept delegation for?

Diagnosis communication, applying energy forms (with exceptions), and certain drug dispensing.

What is required for a delegation process?

Planning, education, training, ensuring safety and competency of the healthcare professionals involved.

What significant change occurred regarding ultrasound delegation for RTs?

RTs now require delegation to use ultrasound in practice following regulation changes.

What does POCUS stand for in respiratory therapy?

Point of Care Ultrasound, used for various assessments and procedures.

What are the RHPA exceptions that allow for performing controlled acts?

First aid in emergencies, supervised acts during training, spiritual means of treatment, and assisting household members.

What are boundary violations in healthcare?

Harmful or exploitative behaviors, such as sexual contact, excessive self-disclosure, or disregarding patient privacy.

What identifies professionalism in healthcare?

Behaviors expected of healthcare professionals, compliance with moral, ethical, and legal standards.

What is the significance of boundary crossing?

Engaging with patients in ways that blur professional limits, requiring careful navigation to avoid implications.

How should health professionals handle conflict?

Recognize it as normal, avoid personalization and focus on resolution for positive outcomes.

What should healthcare professionals maintain regarding colleagues?

Support and refrain from maligning a colleague's reputation.

Who can give an order for medical care?

Members of the College of Physicians and Surgeons of Ontario, Royal College of Dental Surgeons of Ontario, College of Midwives of Ontario, and College of Nurses of Ontario (if RN EC certified).

What constitutes a valid medical order?

Authority to undertake an intervention, details of the intervention, who the order is for, who the prescriber is, when the order is given, when and how to carry it out.

What is a direct order?

An order authorized by an individual prescriber at the time of care delivery for a specific patient and treatment.

What is a medical directive?

An order authorized in advance for a specified range of patients meeting specific conditions.

What are the essential components of a medical directive?

Must be written, approved by the Medical Advisory Committee, and must maintain the integrity of a direct order.

What is an example of an order set in respiratory therapy?

Authorizing respiratory therapists to adjust ventilator settings in ICU as per respective directives.

What are the requirements for a valid medication order?

Includes drug name, dose, maximum frequency, mode of administration, prescriber, patient information, date/time.

What is electronic ordering in healthcare?

Medical orders transmitted via an electronic format, such as electronic medical records.

What is required for an order for a diagnostic test?

Prescriber, patient/client information, date/time, test required, specific conditions of the test.

What information must be included in an order for assisted ventilation?

Prescriber, patient/client information, date/time, ventilatory mode and parameters, oxygen % and specific conditions.

When can mechanical ventilation be carried out by RTs?

Once the need is established and a valid order is in place, following RT standards of practice.

What are verbal orders in medical care?

Orders that must meet requirements and be transcribed ASAP, received directly from the prescriber.

What are re-orders in medical care?

Must be specific and include all conditions; vague orders like 'Ventolin' are unacceptable.

What are automatic discontinue orders?

Require a specific order to discontinue therapy unless the original order has an 'automatic discontinue' clause.

What are the responsibilities of a respiratory therapist?

Adhere to professional and personal scope of practice, ensure the order is in the patient's best interest, follow relevant legislation.

What does delegation of controlled acts involve?

Transfer of legal authority to perform a controlled act to someone not authorized to do so.

What controlled acts are RTs authorized to accept delegation for?

Diagnosis communication, applying energy forms (with exceptions), and certain drug dispensing.

What is required for a delegation process?

Planning, education, training, ensuring safety and competency of the healthcare professionals involved.

What significant change occurred regarding ultrasound delegation for RTs?

RTs now require delegation to use ultrasound in practice following regulation changes.

What does POCUS stand for in respiratory therapy?

Point of Care Ultrasound, used for various assessments and procedures.

What are the RHPA exceptions that allow for performing controlled acts?

First aid in emergencies, supervised acts during training, spiritual means of treatment, and assisting household members.

What are boundary violations in healthcare?

Harmful or exploitative behaviors, such as sexual contact, excessive self-disclosure, or disregarding patient privacy.

What identifies professionalism in healthcare?

Behaviors expected of healthcare professionals, compliance with moral, ethical, and legal standards.

What is the significance of boundary crossing?

Engaging with patients in ways that blur professional limits, requiring careful navigation to avoid implications.

How should health professionals handle conflict?

Recognize it as normal, avoid personalization and focus on resolution for positive outcomes.

What should healthcare professionals maintain regarding colleagues?

Support and refrain from maligning a colleague's reputation.