Introduction to sonography Chapter 7- In depth notes

An adequate appreciation of medical law and everyday practice of professional ethics will nearly

Guarantee your prudent and consistent care of patients.

If you take measures to understand _____ _____ and follow your ______ ____ ________ , you will not need to fear repercussions of legal action in the workplace

Medical law

Scope of practice

What do physicians usually practice?

"Defense medicine" for the fear of being sued

(Testing for the worst-case scenario so they do not risk missing something)

What does defensive medicine result in

Numerous unnecessary tests and procedures in order to prevent lawsuit claims that he or she could have done more.

What is another reason that physicians may choose not to order an effective test

Because of a high risk of complications.

(This is why the first thing they tend to do is order an ultrasound because we do not deal with radiation so they do not have to worry about radiation exposure or allergic reaction to contrast, etc)

What is the rule to know about ethics vs laws

While ethics are standards we should follow, laws are rules we must follow

What are the two basic types of laws

Common law

Statutory law

What is common law

The oldest law, it is ever evolving

What is statutory law

Includes statutes enacted by federal, state, or local governments. There are several classifications.

What is Administrative Law and what does it include?

This addresses statutes enacted regarding the power of agencies to regulate and enforce laws.

This includes ensuring licensure and practice regulations.

What does OSHA stand for

The Occupational Safety and Health Administration

What is OSHA and example of

An agency that establishes and enforces employee health and safety standards.

What is criminal law

This includes crimes against the state or society

Criminal acts include what?

Felonies and misdemeanors

What are criminal cases brought to suit by?

The government against a person or group of people charged with a crime

What are the three stages to a lawsuit

Pleading phase, discovery phase, and the trial

What is used as a part of clinical training?

Criminal background checks

What is a civil law

This involves crime against an individual, including slander, libel, trespassing, and contract violation.

(CIVIL LAW INCULDES TORT LAW)

What is a tort law

A wrong committed against a person or property, which may result in physical injury, damage to personal property, or deprivation of liberty or freedom

What can a tort law can be the result of (2)

Negligence or intentional misconduct.

Tort laws can be..

Intentional or unintentional

What are things that can be intentional

Assault

Battery

False imprisonment

Invasion of privacy

Defamation of character

What are two types of defamation of character

Slander and libel

What is the one example of an unintentional tort

Negligence

What are the 3 types of negligence

1) Professional negligence (malpractice)

2) Statutory Negligence

3) Criminal Negligence

What is a example of intentional torts

If a patient feels you intentionally did something that resulted in his or her injury, he or she may file a civil lawsuit

What is assault

All that is required for an assault is for the patient to fear that he or she will be hurt

What is battery

The unlawful touching of a person without his or her consent, even if the act is performed for his or her benefit.

What must be provided for all sonographic procedures

Consent

When does false imprisonment occur

when a medical professional confines a patient against his or her will

What should you never use without a physician's order

Immobilization devices

(Can result in false imprisonment charges)

Defamation of character can take the form of

slander or libel

In defamation of character damages must be

Verifiable in order for a legal complaint to be established.

What is embezzlement

is the illegal appropriation of funds in your care.

What is a invasion of privacy

is the interference of a person's right to be left alone

What is fraud

any attempt to deceive someone, including making false promises to patients.

What are unintentional torts

These are acts that are not intentionally committed but result in injury to a person.

When does negligence occur

when one has a duty to provide reasonable care and fails to do so regardless of intentions.

What are the "four D's" that must be proven for a case

duty

derelict

direct cause

damages

A sonographer what do you have the obligation to do

to perform your professional duties according to the accepted standard of care.

Malpractice is essentially what

professional negligence

What should sonographer do to avoid legal concerns

Perform within their scope of practice

(3) The sonographer's scope of practice includes the obligation to:

Perform patient assessments

- Acquire and analyze data obtained using ultrasound and related diagnostic technologies

- Provide a summary of findings to the physician to aid in patient diagnosis and management

- Use independent judgment and systematic problem-solving methods to produce high-quality diagnostic information and optimize patient care

A sonographer should never act as a what

diagnostician

Some sonographic procedures may require use of a _________

chaperone

Some sonographers purchase an

individual professional liability insurance to guard against malpractice claims

As a working sonographer it is your responsibility to

to understand the scope of coverage of these plans

Tips for Preventing Medical Malpractice

1) Treat each person equally.

2) Explain procedures precisely and obtain the patient's permission.

3) Communicate effectively with your patient throughout the procedure.

4) Be familiar with your healthcare facility's protocols, policies, and procedures.

5) Always practice within the sonographer's scope of practice. 6) Never independently perform procedures that you have not been trained to perform.

7) Ask for help.

8) Never offer medical advice to patients.

9) Never provide diagnostic information to a patient.

10) Keep accurate medical records and documents.

11) Comply with all state and federal regulations, including HIPAA.

Tips for Preventing Medical Malpractice

1) Keep your work environment safe for patients and perform quality assurance.

2) Practice universal precautions.

Maintain patient confidentiality.

3) Secure informed consent.

4) Obtain a chaperone when needed.

5) Never leave an incoherent or unconscious patient unattended.

6) Learn what legal protection your employer provides.

7) Practice ALARA (as low as reasonably achievable).

8) Properly label images and identify any alterations that are made to the standard protocol.

9) Maintain continuing medical education and be informed about the changing medical environment.

10) Recognize the signs and symptoms of an emergency.

Good

What does HIPPA stand for

Health Insurance Portability and Accountability Act of 1996

What is the "Good Samaritan Laws"

include protection for people who provide emergency to a stranger from civil or criminal liability as long as

Examples of the good Samaritans laws

1) The care is given in good faith

2) The provider acts within his or her scope of practice

3) The provider uses due care under the circumstances

4) The provider does not bill for the service

It is important to remember that the Good Samaritan laws..

Do not generally apply to hospital or clinical settings

Patient rights

the legal rights of the patient, the protection of individual rights, and the rights of the healthcare employee

An underlying theme of the Patient Care Partnership is that of ________

Consent

What are the two types of consent

Informed consent

Implied consent

Informed consent example

Giving the patient a paper to sign before producer with risks etc

Implied consent example

this type of consent can be VERBAL or NONVERBAL

example - Patient laying back onto the table to get their scan

What is important to remember during a patient examination

Patients can refuse an examination for any reason at any time

If a patient refuses what should the sonographer do

the sonographer should refer the patient to his or her physician for further guidance

What happens if you continue to scan after the patient has refused

If the sonographer continues with a refused exam, he or she can be held liable for assault and battery.

What does HIPPA require (4)

1) Standardization of electronic medical records, administrative data, and financial data

2) Establishment of unique health identifiers

3) Security standards to protect patient confidentiality

4) Statutory duty to report

HIPPA legislation Administrative Simplification (5)

1) National Identifier

2) Enforcement

3) Privacy rule

4) Security rule

5) Transactions & Code Sets

Advance directives can be established

for patients who do not desire for life to be maintained by mechanical means

4 Legal documents that can contain information regarding advance directives: (End of life issues)

1) Living will

2) Durable power of attorney

3) Do not resuscitate order (DNR)

4) Healthcare advanced directive

Living will

This expresses the patient's wishes concerning future medical care

Durable power of attorney for healthcare

This appoints an agent to act on the patient's behalf should the patient lose the ability to make decisions

Healthcare advance directive

This is the combination of the first two documents.

Do not resuscitate order (DNR)

This is a written physician's order instructing healthcare workers to not perform CPR.

*Note that this does not always mean CPR - the pateint could say they do not want medications but their DO want CPR, etc, etc..

Images obtained via sonogram are..

legal documents that become a permanent part of the patient's medical history

(2) Information gathered from images can be used to construct a legal argument so..

1) Evaluate your images with this in mind

2) Always document when and why an examination may not be optimal.

You may be asked to complete an _____ _______ or to report patient safety concerns.

incident report

example - A patient falls

Laws change, and so the sonographer must be..

a professional who is attentive to changes and proficient at providing patient care effectively but within the legal scope of practice.

Patients have an implicit right to a sonographer who is..

fully informed and who practices within the established standards of the profession.

If you ever encounter questions that concern the legal aspects of your profession, or if you are asked to perform tasks with which you are uncomfortable, never hesitate to..

Ask for help

*Note that: The watcher does not have to be another sonographer, it could be a receptionist, volunteer, etc