Patient Centered Care Unit 1

standard of care

ATs have a legal obligation to provide a certain level of care

how courts determine the appropriate level of care

legal standard established to protect others against unreasonable risk of harm

legal standard to protect against unreasonable risk of harm

publicized statements, specific situation, NATA position statements

NATA position statements

many statements regarding the appropriate care for ATs, must abide by these and follow best practice

liability

ATs have a legal oblication to provide a certain standard of care

negligence

failure to provide the standard of care that is expected of an AT or when an ATs actions fall below the legal standard established to protect others against unreasonable risk of harm

malpractice

a type of professional negligance that an AT may be accused of if they are negligent while working

4 facets of negligence

duty, breach, harm, cause

duty

the AT must have this to provide services, at a certain standard of care

breach

the AT did this with his/her duty, the standard of care wasn’t followed, they committed an act of omission or commission

omission

the AT didn’t perform an act that he/she should have

commission

the AT perfermed an act they should not have

harm

this was caused and may have led to damage

cause

the ATs omission or commission caused harm, if the AT was removed from the scenario would the harm be the same

tort

wrongful act causes injury or harm, usually intentional, can include invasion of privacy, emotional injury/harm, negligance

tort law

a lawsuit seeking civil remedies (damages)

contract law

a lawsuit seeking civil remedies after a breach of duty

criminal law

a lawsuit seeking criminal charges and punishable by the state

nonfeasance

didn’t do something when the AT had the legal duty to do it/act, act of omission

misfeance

mistake, did something incorrect/wrong, improper performance, inadequate/improper care, act of commission

malfeasance

intentionally acted in wrongful or illegal manner, commits an act that isn’t the ATs duty/role to perform, act of commission

doctorine of assumption of risk

places responsibility on patient for understanding the risks associated with their job/sport/etc., must inform and educate about potential risks and dangers, informational letter and consent form

failure to warn doctorine

a patient cant assume a risk if he/she is not made aware of the risk

doctorine of informed consent

a patient cannot consent to a treatment and the risks if he/she wasn’t informed about the treament and treatment risks, always document this

5 keys of informed consent

disclosure, understanding, competancy, voluntary, assent

disclosure

the AT must provide enough information to the patient so that they can make an informed decision

understanding

the AT must ensure that the patient understands the information being presented

competency

the patient must have the cognitive ability to process and reason (and understand the consequences of their decision)

voluntary

the patient must consent voluntarily

assent

the AT must ensure that the patient provides a positive response to proceed forward with the treatment, could be verbal in low-risk situations but should be written in high-risk situations

contributory negligence

the actions of the plaintiff contributed to the harm, if the defense is successful the plaintiff can’t be awarded a financial award, not used much today

comparative negligence

the actions of the plaintiff contributed to the harm, if the defense is successful the plaintiff can be awarded based on the level of responsibility, usually percent based and varies state to state, current and basically replaced contributory

governmental/sovereign immunity

government employee, actions can’t be intentional, not universal and has been eroded with time

statue of limitations

length of time allowed between act and legal action (varies by state/jurisdiction/offense/etc.)

product liabilty

product is defective/flawed, packing is mislabled or misleading

good samaratin law

emergency situations only, protects an individual from legal action while caring for a person during an emergency, need to be certain of role and responsibility (working/hired/contracted vs. volunteer)

licensure

most restrictive, a government agency (state) agrees to police or regulate the practice of a profession, you must hold a license to practice a profession within a state that has licensure laws for that profession, practice act and title act

practice act

more restrictive, regulates the actual practice of the profession and establishes guidelines to direct practice, restricts non-licensed individuals from using the title “AT”, restricts non-licensed individuals from performing “AT” duties

title act

regulates who may carry a title or hold themselves out as a health care professional, restricts non-licensed individuals from using the title “AT”

state practice act

further defines one’s scope of practice in a particular state, protects the public by regulating the individuals that practice AT, rationale

certification

an individual has met a certain minimum standard or level of competence (usually an exam), they are recognized as having the required knowledge and skills to practice in a profession, state certification, BOC certification, etc., restricts non-certified individuals from using the title AT but doesn’t restrict them from performing AT duties

registration

an individual registers themselves with the state and the state recognizes their profession

guest statue

no person riding in an auto as a guest has any right of action against the driver or any person liable if they willingly volunteered

BOC standards of professional practice

board of certifcation inc., certifying ATs since 1969, was originally part of the NATA but seperated in 1989, confers the ATC credential, outlines the practice standards and describes the code of professional responsibility

practice standards

establish essential practice expectations for all ATs, compliance is mandatory, intended to: help the public understand what to expect from an AT, help the AT in evaluating the quality of patient care, help the AT understand the duties and obligation imposed by the ATC credential

code of professional responsibility

describes the professional manner code than an AT must uphold, code is mandatory, intended to: help the AT understand the professional responsible manner in which they must act

ethics

reflect the values of a certain group and identifies the right and wrong behavior expected

metaethics

the study of origin of ethical thought, why do people make decisions and choice that follow moral values?

normative ethics

the principles or moral criteria upon which individuals make decisions, what is right or wrong?, what is the appropriate or correct action or behavior?

applied ethics

specific, controversial, moral issues that are current and often emotional

virtue theories

the decision maker chooses action based upon his/her own character or virtue, plato and aristotle

platos 4 virtues

wisdom, courage, temperance, justice

aristotle

each virtue and vise is on a continum, virtues can be vices if take to the extreme

duty theories

duties or obligations exist without regard for consequences, duty to self, others, and god

consequentialist theories

letting the consequences of a decision determine the appropriateness of that decision

NATA’s code of ethics

outlines the ehtical behaviors expected, maintains high standards and professionalism, the law prevails if there is conflict between the code of ethics and the law

conflict of interest

exploiting a patient, influencing the score or outcome of a game/eventm financial gain through gambling ona game/event, duties/roles (ex: coach and AT), etc.

role fidelity

stay within your scope of practice, refer to other practioners when necessary

beneficence/nomraleficience

always do whats best for the patient, do not harm your patients

veracity

truthfulness at all times, with all individuals

autonomy

respect for the patient as an individual, capable of making their own medical decisions

duty of confidentiality

prohibits ATs from disclosing information about a patient to unauthorized individuals

patient rights

confientiality and hipaa compliance, informed consent, boundaries, and safe quality healthcare

HIPAA

health insurance portability and accountability act, regulates how/when private health info can be shared, regulates the transmission of private health information, NPP, authorization for release of medical information

notice of privacy practice (NPP)

must provide patients with a clear explanation of how health info will be used and shared

authorization for release of medical information

must be signed and on file to share medical info with others

FERPA

family educational rights and privacy act, AKA the buckley amendment, protects the privacy of student records (right to inspect and review educational records, right to seek ammendments to educational records, right to limit disclosure to educational records)

breach of confidentiality

mandatory reporting, the harm in maintaining confientiality is greater than the harm brought about by disclosing confidential info, concern for the safety of self or other specific people or concern for the public welfare, your position requires it

OSHA

Occupational Safety amd Health Administration, focus is to create a safe work environment

big one

bloodborne pathogens, safety, infection control, universal precautions

medications

check local state and federal regulations, proper tracking and documentation is necessary, must be stored securely and at proper temp, must be monitored

prescribing

writing/giving a prescription

dispensing

preparing, labeling, or providing multiple doses for future use

administering

giving a single dose for immediate use

prescription medications

ATs cant prescribe or dispense, may be able to administer in emergencies

OTC medications

ATs can administer one dose at a time, may be able to dispense, must provide written or verbal instructions