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Chapter 2 ST 120
Legal Concepts, Risk Management, and Ethical Issue
| Question | Answer |
|---|---|
| Informed consent must be given only in person; it may never be given over telephone or telegraph lines. T or F | False |
| Written informed consent protects the patient in that it guarantees the patient is aware of ...... | His/ her condition, the proposed intervention. any risks involved in the procedure. |
| CAAHEP stands for...... | Commission on Accreditation of Allied Health Education Programs |
| The term advance directives can refer to a(n): a. DNP b. All of those are correct c. MSR d. Living will | d. living will |
| ______________ is a formal written accusation from a grand jury. | An indictment |
| Consent may be given in three formats. T or F | False |
| Prejury consists of: | Intentionally providing false testimony under oath. |
| Res ipsa loquitur means: | The things speaks for itself. |
| ___________________ is the legal right granted by a government agency in compliance with a statue that authorizes and over sees the activities of a profession. | Licensure |
| Assault is an intentional tort. T or F | True |
| A surgeon may never go beyond the conditions of an informed consent, even if unexpected conditions present themselves. T or F | False |
| A properly written informed consent does not have to contain the procedure to be performed if the patient in an unemancipated minor. T or F | False |
| The plaintiff in a criminal case is the person accused of the crime. T or F | False |
| Medical records must be written in: | Pen |
| The Occupational Safety and Health Administration (OSHA) defines informed consent as "agreement or permission accompanied by full notice about what is being consented to." T or F | False |
| The person who has the ultimate responsibility for securing written informed consent is the: | Surgeon |
| Prejury is the act of intentionally providing false testimony under oath. T or F | True |
| Surgical Technologists do not have to deal with questions of right or wrong. T or F | False |
| If a member of the surgical team leaves a patient who is dependent on the caregiver's presence, the caregiver can be held liable for abandonment. T or F | True |
| In health care, expressed consent in written form is the desired kind of consent. T or F | True |
| If a patient is injured by a fire caused by a pooled flammable prep solution such as alcohol, the hospital has full liability. T or F | False |
| If informed consent cannot be given, how many consulting physicians are needed for consent, not including the operative surgeon? | Two |
| An advance directive is a written instruction dealing with the right of an incapacitated patient to self-determination. T of F | True |
| To perform surgery without consent is to be liable for the charge of: | Battery |
| HIPAA means: | Healthcare Insurance Portability and Accountability Act |
| _____________________ is the actual act of harmful or unwanted contact with a person. | Battery |
| Because of new HIPAA regulations, patients' medical records must never report their discharge conditions. T or F | False |
| Under specific circumstances, the courts may give informed consent. T or F | True |
| Primum non nocere means: | Above all, do no harm |
| Surgical personnel can be held liable for the loss of a patient's personal property. T or F | True |
| Bioethics has no importance in the area of medicine. | False |
| Whose responsibility is it to ensure the right patient and the right site? | Everyone in the operating room (OR) |
| Hospitals must report child and elder abuse, but they do not have to report any known criminal acts. T or F | False |
| The general right and responsibilities of health care legislation are reflected in the: | Patient Care Partnership |
| To reduce the risk of incorrect drugs or the incorrect administration of drugs, all drugs should be labeled on the sterile field. T or F | True |
| Consent may NOT be given by a person who: | Is in an altered state of consciousness, has had a preoperative medication, is an unemancipated minor. |
| The omission or commission of an act that a reasonable and prudent individual would not do under the same conditions is called: | Negligence |
| Slander is an oral statement that damages a person's reputation. T or F | True |
| The obligation to disclose details for evaluation. Commonly used to mean "to be held responsible for" | Accountability |
| A voluntary statement of facts sworn to be true before an authority | Affidavit |
| A statement that one expects to be proven as true | Allegation |
| In good faith or innocently | Bona fide |
| All legal decisions reported on a given legal subject | Case Law |
| The first pleading filed by plantiff's attorney in a negligence action | Complaint |
| In criminal cases, the person accused of the crime, in civil matters, the person or organization being sued. | Defendant |
| A method of pretrial discovery in which questions are answered under oath | Deposition |
| Jurisdiction is given to federal courts in cases involving the interpretation and application of the U.S. Constitution, acts of Congress, and international issues | Federal Law |
| A court-appointed protector for a person incapable of making his or her own decisions | Guardian |
| An injury resulting from the activity of health care professionals | Iatrogenic injury |
| The formal written accusation from a grand jury | Indictment |
| A group of citizens that decides the outcome of a criminal or civil trial | Jury |
| The taking of another's property without consent | Larceny |
| The evolving set of principles based on court decisions | Law, Common |
| Any law prescribed by the action of a legislature | Law, Statutory |
| An obligation either to do or not do something | Liability |
| An obligation either to do or not do something that is the responsibility of the corporate body | Liability, cooperate |
| An individual's organization either to do or not do something | Liability, personal |
| Professional misconduct or lack of judgement that results in harm to another; professional negligence | Malpractice |
| Either the omission (not doing) or commission (doing) of an act that that a reasonable and prudent individual would not do under the same conditions; may be associated with the phrase "departure from the standard care" | Negligence |
| Reckless disregard for the safety of another; willful indifference | Negligence, criminal |
| Intentionally providing false testimony under oath | Prejury |
| A legal principle, created by a court decision, that provides an example or authority for judges deciding | Precedent |
| Description of expected conduct of a professional in a given circumstance, what a prudent caregiver would do in a similar circumstance | Standard of care |
| State statues, regulations, principles, and rules having the force of law | State law |
| A court order to appear and testify or produce required documents | Subpoena |
| A civil wrong; can be either intentional or unintentional | Tort |
| The presentation of evidence in a court of law in order to achieve a resolution or, in a criminal act, to determine a person's innocence or guilt | Trial |
| the one controlling or directing the employee has great responsibility than the one paying the employee. This doctrine could be applied to the surgeon and the "captain of the ship" doctrine | Doctrine of borrowed servant |
| A health care institution may be found negligent for failing to ensure that an acceptable level of patient care was provided. Potential employees & medical staff should be carefully screened and that the competent staff should be maintained & monitored. D | Doctrine of corporate negligence |
| The ability to reasonably anticipate that harm or injury may result because of certain acts or omissions. This doctrine could be applied to not applying a safety strap or a side rail being left down while transporting a patient | Doctrine of foreseeability |
| Each person is responsible for his/her own conduct, even though others might be liable as well. Doctrine could be applied 2 a surgeon delegating a task outside of ur scope of practice. surgeon is wrong to do this, but if u perform the task, u r liable. | Doctrine of personal liability |
| Persons should perform an action as would any reasonable person of ordinary prudence. | Doctrine of reasonably prudent person |
| "Above all do no harm" | Primum non nocere |
| "The thing speaks for itself;" harm obviously came from a given act or thing of which the defendant had sole control. Meaning? | Res Ipsa loquitur |
| "Let the master answer;" an employer is responsible for the actions of his/her employees | Respondeat superior |
| describes any civil wrong independent of a contract & provides a remedy in the form of an action for damages. | Tort Law |
| An act that causes another person to fear that he/she will be touched in an offensive, insulting, or physically injurious manner w/o consent or authority to do so. | Assualt |
| The actual act of harmful or unwarranted contact w/ a person, including contact w/o proper consent. | Battery |
| Slander (an oral statement) or libel ( a written statement) that damages a person's reputation or good name. | Defamation |
| The illegal detention of a person w/o consent or forcing a person to stay in an area by not allowing him or her to leave. | False imprisonment |
| Disparaging remarks made about a patient that result in emotional distress | Intentional infliction of emotional distress |
| The disclosure of private information concerning a patient or photographing a patient w/o his/her consent | Invasion of privacy |
| Dr. Smith obtains the surgical consent form from Mr. Valdez, 4 an open cholecystectomy procedure. When the preoperative nurse begins her evaluation of Mr. Valdez, he informs her that he does not speak English. This raises the concern over the validity of | Informed consent |
| Of the following safety measures the _____________________, would be the best intervention by the CST to prevent sharp injuries. | Establish a neutral zone. |
| Of the following action which is not an action associated w/ risk management? | Fire negligent employees |
| Alisha the CST involved in a colon resection has to leave to pick her daughter from school at 3pm. She knows that if she leaves w/o relief from another CST she could be charged with? | Abandonment |
| A patient was left alone unattended in the pre-op holding area. The patient fell from the stretcher and was injured. Place the hospital investigational steps in order from first to last. | Sentinel event, incident report, investigation from risk management. |
| Process whereby businesses, educational institutions and programs, and healthcare organizations are determined to meet standards and performance criteria as established by an accrediting agency | accreditation |
| Written instructions expressing the patient's wishes concerning the types and amount of medical treatment to be rendered in the event the patient can no longer make those types of decisions | advance directive |
| Guidelines, usually expressed in a series of statements, that provide ethical standards of conduct for a profession | Code of Ethics |
| process by which an agency or organization establishes a minimum knowledge base for a given healthcare profession and awards a credential to individuals who meet the minimum knowledge level | credentialing |
| Branch of philosophy dealing with good conduct and moral values | ethics |
| report of an irregular or adverse patient occurrence | incident report |
| a situation in which a patient gives voluntary permission to another party to perform the procedures that have been explained; includes the risks, benefits, possible complications and alternative treatment options | informed consent |
| Guides for ethical decision making that include the concern individuals have for the well-being of others, respect for individual autonomy, base justice, prevention of harm to others, and refusal to take unfair advantage | moral principles |
| Replacing the AHA's Patient's Bill of Rights, this plain-language brochure informs patients about what they should expect during their hospital stay with regard to their rights and responsibilities | Patient Care partnership |
| the efforts of a health care provider organization to collect and utilize data to decrease the chance of harm to patients or staff or damage to property | Risk Management |
| Established 1990, this act requires medical device users to report to the manufacturer and/or FDA incidents that reasonably suggest that there is a probability that a medical device has caused/contributed to death, serious injury/illness of a patient | Safe Medical Device Act |
| professional duty limits based on state and federal law and on an individual's education and experience | Scope of Practice |
| the basis for the practice of strict adherence to sterile technique by all surgical team members; involves a level of honesty and moral integrity that must be upheld | Surgical Conscience |
| recognition by an appropriate body that an individual has met a predetermined standard | Certification |
| Formal process by which qualified individuals are listed in a registry | Registration |
| Federal act that establishes privacy standards to protect patients' medical records and other health-related information | HIPPA |
| What are the four major components required to establish that a case of negligence has occurred? | Duty, deviation, direct cause, and damage |
| is the best weapon for reduction of medical errors; Ex- bar-coded medications, identification strips, handheld wireless devices, and computer drug order-entry systems | technology |
| refers to the permission being given for an action is a basic right | consent |
| manifested by action or inaction of silence that assumes consent has been authorized | implied consent |
| agreement or permission accompanied by full notice about what is being consented to (what cooperation) | The Joint Commission (TJC) |
| In the health care environment, there is considerable agreement over basic values and their applications for patient care. Basic values of Health Care practice include: | -Laws -Standards -Guidelines -Policies |
| A person should perform an action as would any reasonable person of ordinary prudence. | Doctrine of the Reasonably Prudent Person |
| Placing information into the patients medical record. | Documentation |
| Which organization recognizes patient safety as being an item of the highest priority and strongly urges individual hospitals and health care organizations to take all reasonable measures to prevent the retention of foreign bodies in the surgical wound | ACS (American College of Surgeons) |
| This issue, can cause added stress to the health care system and reduce the quality of care. Health care workers are asked to keep costs down, but to deliver the same quality of care. | Reduced Staffing |
| Oral statement that damages a person's reputation. | Slander |
| This issue, health care workers have rights. They should watch the number of hours worked. 2 shifts (7am - 3pm and 3pm-11pm) can lead to overworked. | Employee Rights |
| The failure of a device must be reported to who? | FDA |
| Managing Patient & Employee Injuries. Managing injuries involves two key components: | 1. The injury is immediately reported 2. The individual is rendered medical treatment if necessary |
| ________ involves examination of the benefits and risks of biotechnology, and offers a system that raises question about medical care that can lead to answers about what is right and what is wrong | bioethics |
| When an instrument is seen on X-ray within the abdominal cavity after a surgical procedure, we say that the doctrine of res ipsa loquitur applies, which means | the thing speaks for itself |
| The code by which we try to live is primum non nocere, which means | above all, do no harm |
| As the scrub, u along w/ circulator omitted the final count as she was on phone w/ surgeons answering service. Circumstances rushed u to next case. Patient later returned in shock 2 have a sponge removed from wound. What r u & the circulator charged w/? | Negligance |
| The physician asked for the wrong dosage of medication during the procedure. U mentally note that it is an unusual dose, but give it 2 him anyway, & the patient expires. The medical error resulted in harm 2 the patient. What type of negligence is this? | Malpractice |
| You are scrubbed in on a case, and during the case, the surgeon insulted you, and you left the room immediately. A bleeder occurred just after you left, and there was a delay in care because there wasn’t a scrub person in place. What are U charged w/? | abandonment |
| You made some written notes on the back of the chart when helping the circulator. In the notes, you made the statement that the patient was drunk. This later went to court. Written untrue statements may result in which charges? | Slander |
| You were talking in the elevator about the emergency patient who caused the wreck and stated that he was a redneck drug addict. The patient was actually a diabetic, and he was not drunk. You were overheard by a family member; what is the charge? | Libel |
| HIPAA is a federal act that protects | Personal information, or patient information, or patient confidentiality |
| A friend is admitted to the ER. You go online and check his chart to see what happened. Of what charges are you guilty? | Invasion of privacy and HIPAA violation |
| The time-out was omitted. consent form was incorrectly completed 4 the surgical procedure. patient did not want the surgery performed. patient made a mark w/ only 1 witness. What charges can b filed if informed consent is not appropriately obtained? | assault and battery |
| A special consent form would be required for which of the following situations during a hospital admission? | surgical procedure |
| Which type of legal action is MOST likely in cases involving tort law and operating room personnel? | civil |
| Which of the following surgical patients would be legally authorized to sign an informed surgical consent, based on medical practice acts and state law? | an emancipated 16-year-old minor |
| What is the term that describes a method of pretrial discovery in which a surgical team member might answer questions under oath? | deposition |
| The combined account of the interaction between the patient and the health care providers during a given incidence of illness or treatment. | Medical Record |
| Professional rules and standards of behavior that include principles such as impartiality, objectivity, duty of care, and confidentiality and disclosure | codes of conduct |
| According to the Joint Commission's definition regarding consent to surgical intervention, which party has "autonomy"? | patient |
| For which of the following processes are identification and reporting of unsafe conditions and hazards MOST critical? | risk management |
| Which of the following terms describes the principles such as benevolence, trustworthiness, and honesty for the care and well-being of others in society? | morals |
| Which of the following terms best describes the process of keeping thorough, accurate, and legal records of a patient's medical care? | documentation |
| Which of the following legal doctrines would MOST likely apply in the case of a wrong site surgery or retained foreign body? | res ipsa loquitur |
| The phrase "departure from the standard of care" BEST describes which of the following legal terms? | negligence |
| Which of the following legal terms is BEST described as "professional misconduct that results in harm to another"? | malpractice |
| Which of the following would NOT be considered an example of a potential ethical dilemma? | patient privacy |
| "Captain of the ship" doctrine holds the surgeon accountable for all actions of the operating room team in lawsuits. T or F | False |
| Errors in chart documentation should be erased to prevent confusion by subsequent caregivers. T or F | False |
| Which of the following terms describes the system of principles that become standards of conduct for professionals? | ethics |
| The broad objectives of the Health Insurance Portability and Accountability Act (HIPAA) include all of the following EXCEPT: | eliminate medical errors |
| Which part of the patient's medical record documentation would contain pre-op and post-op diagnoses, positioning, skin prep, start and stop times, counts, and dressings? | intraoperative record |
| If a patient suffered a burn as a result of improper application of the ESU dispersive (grounding) pad, the individual team member responsible may be found guilty in a lawsuit of which of the following? | negligence |
| Which of the following terms meets the following definition: a voluntary and informed act in which one party gives permission to another party to "touch"? | consent |
| The legal term that identifies the knowledge and skills required for a profession and describes a health care provider's core accountability, based on education, experience, and credentialing is: | scope of practice |
| In 2004, which of the following agencies created the "Do Not Use" abbreviation list? | the joint commission |
| The most common types of patient-care errors committed by operating room personnel, including negligence and malpractice, are categorized as: | unintentional torts |
| What is the name of the type of report sent to risk management in an effort to decrease the chance of harm to patients or staff or damage to hospital property? | sentintal report |
| In a common adage, what is the "best medicine" in health care? | prevention |
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