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Ethics
Clinical exam 2 - prof aspects of practice
| Question | Answer |
|---|---|
| What we are ALLOWED to do is (slide 1-4): | Scope of practice |
| What we MUST do is (slide 1-4): | Standards of care |
| What we SHOULD do is (slide 1-4): | Ethics |
| 3 levels of statements defining what we do are: | clinical practice standards (highest), clinical practice guidelines, position statements |
| Clinical practice standards are (slide 5-2): | rules or minimum req'mnts for clinical practice of the professional; represent behaviors that MUST BE EXERCISED BY THE PRUDENT CLINICIAN UNDER SIMILAR CIRCUMSTANCES. Allows for little variation. Measures against which your practice may be judged in court |
| Clinical practice guidelines are (slide 5-3): | official policy statements of a professional association that assist the CRNA to understand indications for & the methods to perform clinical procedures. A tool, not a rule |
| Position statements are (slide 5-4): | documents that recommend clinical practice or reflect emerging trends that may notify the practitioner abt generic issues that impact practice |
| What is standard 1 (slide 6-1)? | perform & document a thorough pre-anesthesia assessment & evaluation |
| What is standard 2 (slide 6-2)? | obtain & document informed consent for the planned ANESTHETIC intervention from the pt or legal guardian, or verify that informed consent has been obtained & documented by a qualified professional |
| What is standard 3 (slide 6-3)? | formulate a pt-specific plan for anesthesia care (which is based on comprehensive pt assessment, problem analysis, anticipated surgical or therapeutic procedure, pt & surgeon preference, & current anesthesia principles) |
| What is standard 4 (slide 6-4)? | implement & adjust plan based on pt's physiologic response. Continuously assess pt's response to anesthetic, surgical intervention or procedure. Intervene as req'd to maintain the pt in satisfactory physiologic condition |
| Sources of standards of care are (slide 4-4): | State & federal = JCAHO, office surgery regulatory agencies, board of nsg or DPH, FDA, Medicare, Medicaid. Insurers mandates (who may perform anesthesia & insert invasive lines) Personal standards |
| What is standard 5 (slide 7-1)? | Monitor, eval, & document pt's physiologic condition as approp for type of anesthesia & specific pt needs. Alarms should be on & audible. CRNA should continuously tend to pt until responsibility of care has been accepted by another anesthesia professional |
| What is standard 6 (slide 8-3)? | document pertinent anesthesia-related info on the pt's medical record in an accurate, complete, legible & timely manner |
| What is standard 7 (slide 8-4)? | eval pt's status & determine when it is safe to transfer responsibility of care. Accurately report pt's condition, incl all essential info, & transfer responsibility of care to another qualified provider for continuity of care & pt safety |
| What is standard 8 (slide 9-2)? | Adhere to approp SAFETY PRECAUTIONS to minimize fire, explosion, electrical shock, & equip malfxn risks. Ensure necessary equip was checked for proper fxn; document compliance. Anesthesia machine ability to detect DISCONNECTION. Monitor OXYGEN ANALYZER |
| What is standard 9 (slide 9-3)? | verify infection control policies & procedures for personnel & equip exist w/in practice setting. Adhere to infection control policies & procedures to minimize risk of infection to pt, CRNA, & other healthcare providers |
| What is standard 10 (slide 9-4)? | participate in ongoing review & eval of anesthesia care to assess quality & appropriateness |
| What is standard 11 (slide 9-4)? | respect & maintain basic rights of pts |
| What are the 4 codes of ethics (p 10 & 11)? | responsibility to pts, competence, responsibilities as a professional (responsible & accountable for the services they render & the actions they take), responsibility to society |
| What are the 5 steps in the decision making model (slide 4-1)? | Is the act/task permitted/prohibited by laws & regulations? Is the skill for APRN w/i scope & standards of certifying body? Is the act taught in adv practice education prgm? Does employer allow you to perform act? Currently competent in the act? |
| Details of oxygenation standards in standard 5 are (slide 7-2): | continuously monitor oxygenation by clinical observation & pulse ox. If indicated, continually monitor oxygenation by ABG analysis |
| Details of ventilation standards in standard 5 are (slide 7-3): | cont monitor ventilation, verify intubation of trachea or placement of other artificial airway device by auscultation, chest excursion, confirmation of EtCO2. Cont monitor EtCO2. |
| Details of cardiovascular standards in standard 5 are (slide 7-4): | continuously monitor CV status via EKG. Auscultate heart sounds as needed. Eval & document BP & HR at least every 5 min |
| Details of thermoregulation standards in standard 5 are (slide 7-4): | when clinically significant changes in body temp are intended, anticipated, or suspected, monitor body temp in order to facilitate maintenance of normothermia |
| Details of neuromuscular standards in standard 5 are (slide 8-1): | when NMBA are administered monitor neuromuscular response to assess depth of blockade & degree of recovery |
| Details of positioning standards in standard 5 are (slide 7-4): | monitor & assess pt positioning & protective measures, except for those aspects that are performed exclusively by one or more other providers |
Created by:
Thommy413
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