Chapter 3 Surgical Technology principles

statutes and liability

What kind of laws is a surgical technologist mainly concerned with?

Federal law

The Health Insurance Portability and Accountability Act of (HIPPA) 1966 and laws concerning Medicare insurance fall under what types of law?

State law

Practice acts fall under what types of law?

practice acts

What are state laws that establish and regulate the conditions under which professionals may practice, including licensure, registration, educational requirements, scope of duties, and functions?

administrate law

What is the branch of law that deals with federal and state agencies?

regulations

What are the names of the laws enforced by federal and state agencies?

administrate law, regulations

The Occupational Safety and Health Administration falls under what type of law? What would there laws be called?

OSHA

What agency enforces regulations that reduce employee injury in the workplace?

It is punishable by a fine and loss of accreditation

Is violation of a regulation punishable? If so by what?

civil laws

What laws protect the rights of individuals?

tort

Actions that result in physical or psychological harm or injury is referred to as what?

civil

In what court are tort cases handled?

True

A tort is classified as both intentional or as a result of negligence. True/False

negligence tort

What kind of tort is unintentional?

negligence

__ is the most common cause of injury in the health care setting.

intentional

Batter, assault, invasion of privacy, false imprisonment, and defamation are all examples of what type of tort?

slander

Defamation are the deliberate efforts to erode the reputation of another person. If actions are verbal it is considered what?

libel

If a defamation is a written statement it is known as what?

medical malpractice

Operating on the wrong patient or wrong side is an example of what?

civil law

medical malpractice falls under what law?

medical malpractice

This is defined by TJC as “improver or unethical conduct or unreasonable lack of skill by a holder of a professional or official position.” What is it?

criminal law

What are state and federal laws that make specific behaviors illegal known as?

accuser

In civil the law the ___ is the individual that was harmed, where in criminal law it is the person who committed an action with harm.

criminal law

Homicide, theft, robbery and sex crimes are all examples of what type of law?

common law

What law is a branch of law that applies previous legal decision to a case currently being judged?

doctrines

Legal __ are the legal principles or rules that have been established through legal precedents.

“Let the master respond”

What does repondeat superior mean?

“The thing speaks for itself”

What does Res ipsa loquitur mean?

“First, do no harm”

What does Primum non nocere mean?

foreseeability

This concept is embodied in the laws regarding negligence in which a health professional should be able to predict specific risks associated with their duties that could injure a patient and take the appropriate precautions to prevent such harm. What doctrine is it?

practice standards

These are not exactly laws but they are guidelines. They are considered “laws” that protect society from harm. What are they?

evidence

Professional standards should be based off of ___ derived from recent peer-reviewed scientific data or research.

Position statement

These are public declarations of the organization’s opinion on issue related to professional practice and policy. What is it?

Code of conduct

This is an organization’s rules or guidelines for the *behavior* of its members. If violation occurs, there is not legal consequence but there my be disciplinary action by the organization itself. What is it?

code of conduct

“To follow principles of asepsis” is an example of what?

Certification

This is validation that an individual has met the requirements needed to practice a particular profession. This is not required by law. What documentation is this?

Licensure

This is a legal requirement for certain professions. These are issued by the state in which a professional intends to work. What documentation is this?

Registration

This is an administrative process carried out for publics protections. The state government maintains an official record of the health professional’s statistics, address, and place of employment. What documentation is this?

plaintiff

When a civil lawsuit is brought into action because of negligence, the person bringing the suit, also referred to as the __ seeks something for compensate the injury caused by negligence

Damages

What is the plaintiff seeking in a lawsuit? It is also known as money.

retained foreign object

This is an instrument, sponge, needle, or instrument fragment unintentionally left inside the patient.

the scrub and circulator

Who is responsible for the surgical count?

Burns

These are the the most frequent cause of injury in the operating room. They are a common act of negligence. What is it?

Falls

These are a common act of negligence are the leading cause of death in hospitalized people older than 65 years old. What is it?

incorrect patient positioning

This is a common action of negligence that involves consequences such as the overextension of limbs, pressure on bony prominences, loss of circulation as a result of poor or improperly placed padding and restricted ventilation.

operating on the wrong patient or wrong site

This a an act of negligence that is so grave that TJC requires surgical teams to comply with universal protocol or TIMEOUT as verification.

incorrect identification or loss of a specimen

This is an act of negligence that results in misdiagnosis or delay of appropriate treatment.

medication errors

This is an act of negligence that results in the wrong drug being transferred or administered, or the wrong strength mixed at the sterile field due to miscalculation or other error.

abandonment

This a common act of negligence where a health care professional neglects a patient or leaves a patient unattended.

False

A staff member is able to leave the workplace without notifying anyone and is not known as abandonment. True or False?

miscommunication or failure to do so

This is an act of negligence that occurs when a member of a team fails to pass on vital information that requires action. It can also be cause by distractions in the operating room.

loss or damage to the patient’s property

This is an act of negligence that occurs when a patient’s items or lost or damage when they are removed from them.

Delegation

This is the transfer of duty to perform a task from one person to another. What is it?

False, they should be legally allowed

The delegee doesn’t have to be legally allowed to perform the task. True or False?

False, the accountability will rest of both the delegee and the person delegating the task.

Legal accountability will rest on just the delegee. True or False.

False, they must have received the appropriate amount of training

The delegee must have received the minimum amount of training to perform the task. True or False?

This is true

The delegee must the competent and able at the time of the delegation to perform the task, True or False?

agccountability

This means taking responsibility for one’s actions including professional duties.

abuse

The OR is a unique environment that has traditionally embraced hierarchy and authoritarian practices that normalize ___.

bullying

This is the most common abusive and potentially destructive behavior in healthcare. TJC define it as verbal abuse or nonverbal actions, intimidation or humiliation, and sabotage. What is it?

five

TJC recognizes how many categories of violence occurring in the workplace?

violence

Threat to personal standing such as name calling, insult and teasing is an example of what?

*Hazing*

This is a type of bullying that is inflicted on student doctors, nurses, and surgical technologists who are new in the profession. These are acts intended to humiliate and embarrass the victim. What is it?

Horizontal abuse

This take placed among staff members of equal rank and position.

sexual harassment

This is defined *legally* by the US Equal Employment and Opportunities Commission. This is considered illegal and should be documented and reported by the victim.

False, the victim should report the abuse those above the predator’s administrative level or up the chain of command

If a predator of sexual harassment is a superior, the victim should confront them about it personally. True or False?

They are afraid of losing their jobs or fear retaliation from the abuser.

Why do some victims not report sexual abuse?

disruptive behavior

The American Medical Association in its Code of Medical Ethics, define this as “any abusive conduct, including sexual or other forms of harassment, or other forms of verbal or nonverbal conduct that harms or intimidates others to the extent that quality of care of patient safety could be compromised.” What is it?

False, the impact on patients is also severe

Abusive behaviors such as bullying only negatively affects the victim in the workplace. True or False?

sentinel

Sexual harassment and bullying are considered ___ events.

Management

Professional organization, psychologists and others have suggests that workplace bullying and other types of abuse are a reporting, identification and ___ problem.

Leadership Standard

In 2009 TJC released a mandatory ___ that requires action by the heath care facility and its managers.

adverse

Incidents are also called ___ events.

the operating room supervisor

Who do you report an incident to first?

*Internal*

__ report is required for all incidents that involve injury and many other events may result in harm or injury.

yes, True

The purpose of a report is only to report it not to make judgement about it. True or False.

False, they are never placed in the patient’s chart but a description of the event is reported in progress notes

Reports are always placed in the patient’s chart. True or False?

sentinel event

This is defined by TJC as a *Patient Safety Event* or as an event that was “not related to the natural course of the 'patient’s illness or underlying condition,” and results in death, permanent harm, or severe temporary harm and intervention required to sustain life.

TJC

Who are sentinel events ultimately reported to?

how

A report must include who, where, when and ___.

whistleblowing

This refers to a policy in which institutions encourage their employees to report acts of misconduct or suspected negligence. What is it?

risk management

This is a process used to prevent adverse events in the perioperative environment and other health care setting. What is it?

Yes

Are medical records protected by law, yes or no?

protected health information

Within the HIPPAA act is a privacy rule that protects the confidentiality of an individual’s health information. This is also known as what?

False, photographs of the medical or surgical facility may not be made without express written permission by the facility manager.

You only need permission from the patient to record or take pictures of them but you do not need permission to take photographs of the medial facility. True or False?

strikethrough through the error

When you make an error on a written medical record, what is the only correction for the error?

black

What is the only color of ink that is acceptable?

patient’s medical record

This is the sum of all encounters with the health care system, including reports, assessments, and investigations, surgical procedure records, nursing notes, anesthesia records, counts records, and dates of admission and discharge. What is it?

informed consent

This is a process in which the risks, benefits, and alternatives of the surgery or treatment are communicated to the patient, who must sign the form. What is it?

True True

All invasive procedure require informed consent, including blood transfusions and administration of anesthesia. True or False?

legal guardian

If a patient is a minor, who signs for them?

The patient would make an x which is followed by the witness’s signature and the words "patient’s mark.”

If a patient is illiterate how are forms signs and who signs?

legal guardian, agency representative, or court representative

If a patient is mentally, incompetent or incapacitated, who signs for them?

Consent is not necessary, the decision is made by the attending physician

If there is an emergency situation, who signs for a patient when there is no representative or they cannot do so?

witness

By law, any adult such as a legal guardian, spouse, or agency representative can be a ___ during patient signatures.

intraoperative record

a specific document about the surgical procedure and include information on the patient assessment, as well as technical information about the equipment devices, drains, and implants used during the procedure. All perioperative personnel who participated in the procedure must all be included. What document is this?

anesthesia record

This is a document of the intraoperative anesthesia process including the type, drugs and solutions used, methods, and any complications that occurred during surgery. What document is this?

patient charges

This is a document that has an appropriate form in the patient charge that states the service or equipment and appropriate charge.

birth/death certificate

This document is a legal record issued by the county or state where the event occurred. The information required for this document is obtained by the health facility and then submitted to the vital records office of the county or state. What document is this?

specimen and pathology records

This is a document that provides a description of the patient’s tissue, its origin, time of recovery and any special identifiers. What document is this?