ch 2/3 delmar

Card Set Information

ch 2/3 delmar
2011-09-22 22:12:39
surg tech

standard of conduct and the surgical patient
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  1. accountability
    obligation to disclose details for evaluation; "to be held responsible for"
  2. affidavit
    voluntary statement of facts sworn to be true before an authority
  3. allegation
    statement one expects to prove true
  4. bona fide
    in good faith or innocently
  5. case law
    all legal decisions reported on a given legal subject
  6. complaint
    first pleading filed by plaintiff's attorney in a negligence action
  7. defendant
    • in criminal cases, person accused of crime;
    • in civil cases, the person or organization that is being sued
  8. deposition
    a method of pretrail discovery in whic questions are answered under oath
  9. federal law
    jurisdiction is given to federal courts in cases involving the interpretationand application of the US constitution, acts of congress, and treaties
  10. guardian
    court-appointed protector for anindividual incapable of making his or her own decisions
  11. iatrogenic injury
    an injury resulting from the activity of health care professionals
  12. indictment
    formal written accusation fom a grand jury
  13. jury
    a group of citizens who decide the outcome of a criminal or cival trial
  14. larceny
    taking another's property wthout consent
  15. common law
    principles that have evolved an continue to evolve on the basis of court decisions
  16. statutory law
    an law prescribed by the action of a legislature
  17. liability
    obligation to do or not to do something; also an obligation potentially or actually incurred as a result of negligent act
  18. corporate liability
    an obligation to do or not to do something that falls on the corporate body
  19. personal liability
    an obligation to do ornot to do something that falls on the individual
  20. malpractice
    professional misconduct that results in harm to another; negligence of a professional
  21. negligence
    omission (not doing) or commission (doing) of an act that a reasonable and prudnt individual would not do under the same conditins; may be associated with the phrase "departue from the standard of care"
  22. criminal negligence
    reckless disregard for the safety of another; willful indifference
  23. perjury
    intentionally providing false testimony under oath
  24. plaintiff
    the person who initiates a lawsuit
  25. precedent
    legal principle, created by a court decision, which provides an example or authority for judges deciding similar issues later
  26. standard of care
    description of conduct that is expected of an individual or professional in a given circumstance
  27. state law
    state statutes, regulations, and principles and rules having the force of law
  28. subpoena
    court order to appear and testify or produce required documents
  29. tort
    a civil wrong; intentional or unintentional
  30. aeger primo
    • "the patent first"
    • motto of the AST
  31. doctrine of borrowed servant
    • the one controlling or direction the employee has greater responsibility than the one paying the employee.
    • (surgeon)
  32. doctrine ound corporate negligence
    a health instituition may be found negligent for failing to ensure that an acceptable level of pt. care was provided
  33. doctrine of foreseeablility
    is the ability to see or know in advance; the ability to reasonably anticipate that harm or injury may result because of certain acts or omissions
  34. doctrine of personal liability
    each persn is resposible for his or her own conduct, even though others may be liable as well
  35. doctrine of the reasonably prudent person
    a person should perform an action as would any reasonable person of ordinary prudene
  36. primum non nocere
    "above all, do no harm"
  37. res ipsa loquitur
    • "the thing speaks for itself"
    • harm came from a given act or thing of which the defendant had sole control
  38. respondeat superior
    "let master answer" employer is responsible for th actions of hs or her employees
  39. tort law
    • evolved in the middle ages
    • any civil wrong independant of a contract
  40. assault
    an act that causes another person to fear that he or sh will be touched in an offensive, insulting, or physically injurious manner without consent or authority to do so
  41. battery
    actual act of hrmful or unwarranted contact with a person, including contact without proper consent
  42. defamation
    • oral statement (slandar)
    • written statement (libel)
  43. false imprisonment
    illegal detention of a person without consent, or forcing a person to stay and not allowing them to leave
  44. intentional infliction of emotional distress
    disparaging remarks made about a patient that result in emotional distress
  45. invasion of privacy
    disclosure of private information concerning a patient or photographing a patient without consent
  46. unintentional torts
    most common types of ptient indiscretions committed by operating room personnel, and include negligence an malpractice
  47. patient misidentification
    check and cross-check procedures should be in place to prevent pt misidentification
  48. who checks pt ID
    • transportation
    • preop
    • circulator and anesthesia
    • surgeon
  49. performing an incorrect procedure (often related to limbs)
    must take great precautions to prevent the removal of the wrong body part or to prevent performing any surgical procedure on the wrong site or side
  50. "time out"
    • period involving all members of the surgical team should take place immediately before starting the procedure
    • to finalize the correct pt, procedure,and when applicable, implant placement is correct
  51. foreign bodies let in pts secondary to incorrect sponge/instrument counts
    circulator and STSR must count; before the procedure begins and at the time that wound closure begins
  52. patient burns
    • hot instruments
    • improper placement of dispersive electrode
    • malfunctioning of the ESU
    • improper use of lasers
    • pooled flammable prep solutions
    • flammable anesthesia gases
    • irrigation fluid that is too hot
  53. falls or positioning errors resulting in pt injury
    • unattended pts can fall from a stretcher that has is side rails down
    • a safety strap should be applied
    • EACH member of the surgical team can be charged with negligence if an injury occurs due to improper positioning
  54. improper handling, identification, or loss of specimens
    occurs if speciemn is lost, improperly perpared or "fixed" for analysis, or inaccurately labeled
  55. incorrect drugs or incorrect administration
    • all medications and solutions on the sterile setup should be reduce risk of incorrect administrationor use of an incorrect drug
    • when passing medication to surgeon surg tech must announce the name and strength of medication
    • surgial team share equal responsibility for transfer of a drug to the sterile field
  56. harm secondary to use of defective equipment/instrument
    • malfuctioning equipment and instrumenation can cause injury to a surgical patient
    • many facilitieshave biomedical engineering departments that maintain surgical equipment
  57. liability for malfunctioning equipment and instrumentation may lie...
    with the institution if it can be proven that the equipment was not propery maintained and tested
  58. loss of or damage to patients property
    a pt occasionally arrives at the surgical services department with personal property or prostheses, such as dentures, hearing aids, or glasses.
  59. harm secondary to a major break in sterile tech.
    the surg tech through the application of a strong surgical conscience, should apply all principles of asepsis and must rport any breaks that may occur to reduce the risk of postop infections
  60. exceeding authority or accepted functions; violaton of hospital policy
    the surg tech should be aware of state medical practice acts, hospital policies, and scope of practice limitations
  61. abandonment of a patient
    • if a member of the surgical team leaves a patient who is dependent on their presence as a caregiver, then the caregiver can be held liable for abandonment
    • a confusted pt could fall from an operating table or transportation stretcher or could suffer a seizure or cardiac arrest
  62. prevention is...
    • trully the best medicine
    • a vigilant surgical conscience should prevent every one of the incidents
  63. consent
    a term that refers topermission being given for an action
  64. to perform surgery without consent can be the ...
    commission of battery
  65. express consent
    direct verbal or written statement granting permission for treatment
  66. implied consent
    in which circumstances exist that would lead a reasonable health-care provider to believe that the person, or pt had given consent although no direct or verbally expressed words of consent had been given
  67. the joint commission describes informed consent as..
    "agreement or permission accompanied by full notice about what is being consented to"
  68. the joint commission says that informed consent refers to....
    "the requirement that a pt be apprised of the nature and risks of a medical procedure..."
  69. 2 catagories of consent used in the hospital setting
    • general-all routine services
    • special-consent for special procedures
  70. the responsibilty for securing written, informed surgical consent belongs to..
    • the surgeon
    • the surgeon will discuss the condition, proposed treatment, risks, and alternatives with the pt and possibly family
  71. physician's responsibility fo securing an informed consent requires :
    • understandable language
    • no coercion orintimidation of the pt
    • surgical procedure or treatment must be explained
    • potential complications must be explained
    • potential risks must be explained
    • alternative therapies and their risks and benefits must be explaed
  72. written consent should contain:
    • pt's legal name
    • surgeon's name
    • procedure to be performed, incuding side risks of anesthesia and procedure including complications
    • pt's legal signature
    • signature of witness(es)
    • date and time of signatures
  73. planned procedure, pt must :
    • be of legal age or emancipated minor
    • mentally alert
    • legally competent
    • not under influence of drugs
  74. non-emergency (informed consent) may be given by:
    • competent adult speaking for themselves
    • parent or legal guardian of minor
    • guardian in the case of physical inability or legal incompetence
    • temporary guardian
    • hospital administrator
    • the courts
  75. emergency (informed consent) may be given by:
    • telephone
    • fax
    • agrement of 2 non operating physicians
    • adminitrative consent
  76. extension doctrine (blanket consent)
    surgeon may be liable for assault and battery unless it can be proven that good judgment was used when unexpected conditions were encountered
  77. prior to surgery
    pt must have: history and physical record, medical record and informed consent
  78. errors are to be marked through with a
    single line and initials and correction made and legal signiture
  79. incident reports
    are channelled o the risk management department
  80. moral principles
    • guides for ethical decision making
    • principles that we try to instill in ur children (honesty, trust, benevolence)
  81. bioethics
    • study of ehtical implications of biological research and applications
    • envolves examination of the the benefits and the risks of biotechnology
  82. american hospital association (AHA) pt's bill of rights
    • open and honest
    • mutual respect
    • collaboration between pt's and heath care
    • foundatio for respecting the rights and role in health care decision making
    • must be sensitive to cultural, racial,age,gender,religious
  83. pt care partnership (contains plainer language that informs te pt about what to expect during hospital stay:
    • high quality hosp care
    • a clean and safe environment
    • involvement in the pt's care
    • protection of pt privacy
    • help when leaving
    • help with billand insurance clains
  84. somethings that may create personal or vocational discomfort:
    • elective sterilization
    • various fertilization procedures
    • elective abortion
    • human experimentaion
    • animal experimentation
    • organ donation/transplant
    • quality versus quantity of life
    • substance abuse
    • gender reassignment
    • care of ppl with HIV
    • newborns with disability
    • good samaritan law
    • assisted suicide
    • genetic engineering
    • refusal of treatment
    • termination of care and right to die
  85. AST established code of ethics:
    10 (surgical conscience)
  86. scope of practice
    term that identifies the knowledge and skills required for the profession in order to provide effective and reliable services
  87. professional scopes of practice:
    • federal law
    • federal agencies
    • state law and regulations
    • legal precedent
    • hospital policy
    • professional organizations
  88. registration
    formal process by which qualified individuals are listed in a registry
  89. certification
    recognition by an appropriate body that an individual has met a predetermined standard
  90. licensure
    legal right granted by a government agency in compliance with a statute that auhorizes and oversees the activities of a profession
  91. accreditation
    contributes to the protection of the public by assessing educational prgrams fo their quality and effectiveness
  92. core curriculam
    sets standard in curiculum quality
  93. risk management objectives:
    • minimize risks to pts and hosp employess
    • avoid or controlfinancial loss
    • identify actual or potential causes ofpt and employee accidents
    • implement programs, policies, and prodedures toeliminate or reduce occurances
    • collect and utilize data to decrease harm to pts an staff or damage property
  94. an emphasis has also been placed on the reduction of medical errors such as..
    AST, Joint commison, CSPS, and more
  95. neutral zone (pass zone or no touch)
    • is used for placement of sharps during the surgical procedure
    • creation of this zone reduces potential injury
  96. physical need
    any need or activity related to genetics , physiology, or anatomy
  97. psychological need
    any need or activity related tothe identification and understanding of oneself
  98. social need
    any need or activity related to one's identification or interaction with another individual or group
  99. spiritual need
    any needor activity related to the identification and understanding of one's place in an organized universe
  100. maslow's hierchy of needs
    means of prioritizing needs effective for basic understanding of individuals and for quick recognition of patient cocerns
  101. factors of surgical interventions
    • genetic malformation
    • trauma
    • disease
    • choleystitis(gallbladder infection)
    • cheiloschisis (cleft lift)
  102. dr hans selye defines stress as
    a "nonspecific response of the body to a demand"
  103. 2 types of stress
    • eustress-good
    • distress-bad
  104. coping mechanisms
    • denial
    • rationalization
    • regression
    • repression
  105. 3 types of death
    • cardiac-irreversible loss of cardiac and respiratory functions
    • higher brain-irreversible loss of higher brain function
    • whole-brain-irreversible loss of all functions of entire brain
  106. 5 stages of grief
    • denial
    • anger
    • bargaining
    • depression
    • acceptance
  107. gernal catagories of death
    • accidental-caused by nature, moter vehicles, homicides
    • terminal-suffering from a incurable disease
    • prolonged(chonic)-long lasting 4-6 weeks or lifelong
    • sudden-any death without warning
  108. palliative
    provide the pt with symptom relief, avoidance of symptoms, relief from conditions secondary to the progressive local disease
  109. therapeutic
    used to treat or manage disease
  110. life support
    preserve pt's life
  111. 2 types of euthanasia
    • passive-physician does nothing to preserve life
    • active-actions to speed up dying
  112. advance directives
    refers to 2 legal documents
  113. physiological needs
    basic needs: water, food and temp
  114. safety needs
    needs to refered to safe enviornment
  115. love and belonging
    basic social needs
  116. esteem needs
    pos evaluation of oneself and others
  117. self actualization
    need to fulfill whatone believes is one's purpose
  118. the nature of surgery requires that the surgical team concentrate on :
    • physilogical needs first
    • followed by environmetal
    • then affective
    • then self esteem
    • and self actualization