CORE Patient Care

CORE Patient Care

Patient Interactions and Management

Ethical and Legal Aspects

Ethics, Legal Considerations, and Professionalism

  • Copyright © 2017 by Elsevier, Inc. All rights reserved.

Learning Objectives

  • Discuss Reasons for Studying Professional Behavior

    • Importance for limited x-ray machine operators

  • Apply Ethical Concepts

    • Typical situations in healthcare

  • Explain Confidentiality Rationale

    • Importance and precautions for maintaining confidentiality

  • Demonstrate Respect for Patient Rights

    • Responsibilities of the limited operator

  • List Misconduct and Malpractice Acts

    • Circumstances causing patient litigation

  • List Self-Care Aspects

    • Responsible behavior by the limited operator

  • Demonstrate Effective Communication Skills

    • Including listening, nonverbal communication, and statement validation

  • Suggest Positive Communication Strategies

    • For patients with impairments and from diverse cultures

  • Demonstrate Professional Skills in Communication

    • Handling messages via various media (paper, voicemail, fax)

  • Demonstrate Use of Patient Charts

    • Recording information and essential characteristics of good medical records

  • Explain Radiographic Image Maintenance Requirements

    • Procedures for lending them

Professionalism Defined

  • Definition:

    • Application of specialized knowledge for the benefit of others.

  • Professional Organizations:

    • Set standards for professional behavior.

    • Establish and maintain educational requirements.

    • Determine qualifications for practice within the profession.

Morals, Values, and Ethics

  • Morals:

    • Right actions based on religious teachings.

  • Values:

    • Priority placed on various moral concepts.

  • Ethics:

    • Rules that apply values and moral standards to actions.

    • Professional ethics define appropriate behavior for specific professions.

Code of Ethics for Radiography

  • ARRT Code of Ethics Requirements:

    • Practice ethical conduct appropriate to the profession and protect patient rights to quality care.

    • Render services without prejudice or bias.

    • Use care and discretion in decision-making and accept responsibility for those decisions.

    • Adhere to accepted practices and protect self, patients, and staff from unnecessary radiation exposure.

    • Respect confidentiality of communications and patient privacy.

    • Strive to improve knowledge and skills continually.

Patient Rights

  • American Hospital Association (AHA):

    • 1973 A Patient’s Bill of Rights:

    • Defines the expectations and rights of patients.

    • 2003 Patient Care Partnership:

    • Informs patients about rights and responsibilities during hospital stays.

Informed Consent

  • Types:

    • Written, Oral, and Implied consent.

    • Must be obtained for experimental procedures and those with significant risk.

    • Signed consent verifies understanding of procedure and associated risks.

  • Validity Requirements:

    • Patient must be of legal age or consent signed by a guardian.

    • Patient must be of sound mind and give consent freely.

    • Patient must be adequately informed.

    • Conditions explained by the performing physician.

Patient Data Privacy and Confidentiality

  • Rights:

    • Right to refuse release of records unless legally mandated or required by third parties.

    • Health Insurance Portability and Accountability Act (HIPAA):

    • Regulates release and disclosure of medical information.

    • Grants patients the right to:

      • View and obtain copies of medical info.

      • Amend medical records.

      • Request restrictions on use and disclosure of information.

      • File complaints regarding HIPAA violations.

Extent of Care

  • Advanced Directives and DNR Orders:

    • Patients can formulate advanced directives regarding their care.

  • Health Care Proxy:

    • Appointed individual to make healthcare decisions on behalf of a patient unable to do so.

  • Advanced Directive:

    • Legal instructions guiding medical care in case of incapacity.

    • Includes living wills focusing on life-sustaining measures and end-of-life treatments.

Research Participation Rights

  • Rights to refuse participation in research or treatment, with informed consequences.

Considerate and Respectful Care

  • All patients treated with dignity.

Access to Information

  • Patients should have answers regarding their procedures and examinations.

Refusal of Treatment or Examination

  • Patients retain the right to refuse even after consent.

Legal Considerations

  • Beneficence:

    • Actions that promote the well-being of others, particularly in medicine.

Patient Verification

  • **Verification Checks:

    • Name, ID number, date of birth, and additional identifiers (phone, social security number, address).

Legal Terminology

  • Tort:

    • Civil wrong committed against person or property.

  • Categories:

    • Intentional Misconduct:

    • Assault, Battery, False Imprisonment, Invasion of Privacy, Libel, Slander.

    • Negligence:

    • Omission of reasonable care; Malpractice defined as professional negligence.

Reducing Negligence Risk

  • Maintain professional competence.

  • Comply with workplace policies.

  • Proper charting and communication.

  • Maintaining confidentiality and courtesy towards patients and coworkers.

Legal Doctrines

  • Respondeat Superior:

    • Employer liability for employee negligence.

  • Res Ipsa Loquitor:

    • Injury evidently caused by negligence when specifics are unproven.

Patient Communication

  • Electronic Data Manipulation:

    • Process indicators, algorithms, brightness, contrast adjustments, anatomy cropping.

Interpersonal Communication Components

Professional Behavior

  • Self-Care Practices:

    • Neat appearance, positive attitude, teamwork, empathetic patient care, environmental maintenance, continued education.

Professional Communication Guidelines

  • Nonverbal:

    • Eye contact, gestures, and appropriate touch.

  • Verbal/Written:

    • Clear speech using comprehensible language.

Effective Listening Techniques

  • Focus on the speaker without interruption.

  • Validating messages for accuracy.

Patient Interaction Strategies

  • Address patients by surname, provide opportunities for choice, and clear instruction.

Communication Challenges

  • Language Barriers:

    • Use interpreters as necessary.

  • Age and Impairments:

    • Adjust communication style for age and sensory impairments.

Emotional and Cultural Considerations

  • Adjust verbal communication based on emotional states and acceptance of conditions.

  • Respect cultural differences in communication styles.

Patient Education Strategies

  • Use written materials, step reviews, purpose explanations, and confirm understanding through questions.

Professional Communication with Co-Workers

  • Discuss patient information strictly on a need-to-know basis, ensure accurate and prompt message relaying, and maintain confidentiality with faxes.

Radiographic Images and Medical Records

  • Radiographic images are owned by the facility, retained for 5 to 7 years by state law, and can be loaned with proper documentation.