Legal Concepts, Risk Management, & Ethical IssuesST210Concorde Career College
Identify and develop group behaviors appropriate to the educational process and the work environment including an awareness of cultural perspectivesIdentify and develop leadership and problem solving skills that apply to the educational process and the work environment
Identify and develop team building and networking skills that apply to the educational process and the work environment.Identify affective behaviors and integrate positive examples into professional practiceAnalyze the critical thinking process and apply critical thinking skills to the educational process and surgical case management
Evaluate positive employability characteristics and begin to develop those qualitiesDevelop an education to employment strategy that includes employment trends and opportunities for the surgical technologistAnalyze the Patients Bill of Rights (American Hospital Association AHA) as it pertains to the surgical patient
Identify ethical situations that healthcare workers may face and apply the principles of moral problem solving to ethical decision makingUnderstand basic legal terminology and apply major legal concepts to the responsibilities of surgical case managementUnderstand the legal risks and responsibilities of the surgical team members and the consequences that may apply when those responsibilities are not met
Describe the role of the risk management department of the healthcare facilityIdentify errors that may occur in the surgical environment and list methods for preventionList the benefits of professional liability coverage
TermsAbandonmentAccountabilityAffidavitAllegationBona fide Case lawComplaintDefendantDepositionFederal lawDefamationGuardian Iatrogenic injuryIndictmentJuryLarcenyStatutory lawCommon lawLiabilityCorporate liabilityPersonal liabilityMalpractice
TermsNegligenceCriminal negligencePerjuryPlaintiffPrecedentStandard of careState lawSubpoena Tort Aeger PrimoTort LawPatients Bill of Rights
Doctrine of borrowed servantDoctrine of corporate negligenceDoctrine of foreseeabilityDoctrine of personal liabilityDoctrine of the reasonably prudent personPrimum non nocereRes ipsa loquiturRespondeat superior
TortsA civil wrong not arising out of a contract or statuteProvides a remedy in the form of an action for damages.IntentionalUnintentionalOR staff: civil actions, not criminal
TortsIntentional AssaultBatteryDefamationFalse imprisonmentIntentional infliction of emotional distressInvasion of privacyIntentional infliction of emotional distressRequires proof of the willful action of three elements
TortsUnintentionalMalpractice the term used to describe the behavior of a professional persons wrongful conductNegligence a breach of duty omission or commission of an act that a reasonable and prudent individual would do under the same conditionsDeparture from the standard of care the defendant had a duty to the plaintiff; that duty was breached by failing to confirm to the required standard of conduct.
Unintentional Tort- Negligence - MalpracticeIf an individual engages in an activity requiring special skills, education, or experience (like working in an OR), the standard by which their conduct is measured is the conduct of a reasonably skilled, competent and experienced person who is a qualified member of the group authorized to engage in that activity
O.R. Incidents Patient Misidentification Incorrect procedureForeign Bodies left in patientsBurnsPositioningImproper handling of specimensDrug errors
Defective equipment or instrumentationLoss of patients propertyMajor breaks in sterile techniqueExceeding scope of practice or hospital policyAbandonment
Universal Protocol: Surgical/Invasive Procedure Time-Out Verification Purpose: To promote patient safety and prevent risk of wrong site, wrong procedure, wrong person surgery, this policy defines the Universal Protocol requirements for patient identification verification and the Time-Out procedure to be conducted before any invasive or surgical procedure that exposes patients to more than minimal risk, including procedures done in settings other than the operating room.
Universal Protocol: Surgical/Invasive Procedure Time-Out VerificationPolicy: Patient identification verification and conducting a Time-Out is required prior to all invasive/surgical procedures that involve puncture or incision of the skin, or insertion of an instrument or a foreign material into the body.
Universal Protocol: Surgical/Invasive Procedure Time-Out VerificationProcedure: The RN is responsible to complete and document on the Surgical/Invasive Procedure Time-Out Verification Checklist that verification of patient identification and the required elements of the Time-Out have been conducted immediately prior to the invasive or surgical procedure according to the following guidelines:
Universal Protocol: Surgical/Invasive Procedure Time-Out VerificationSurgical/Invasive Procedures Included: Surgical/invasive procedures falling within the scope of these guidelines include, but are not limited to: biopsies, percutaneous aspirations, cardioversions, cardiac and vascular catheterizations, pericardiocentesis, Trans-esophageal echos, endoscopies, thoracentesis, chest tube insertions, paracentesis, lumbar punctures, bone marrow aspirations, closed reductions or manipulations of extremities, circumcisions, incisions and drainage of wounds, etc.
Universal Protocol: Surgical/Invasive Procedure Time-Out VerificationInitial Patient Identification Verification: The RN assigned to the care of the patient is to verify patient identification elements as listed on the Surgical/Invasive Procedure Time-Out Checklist prior to any invasive or surgical procedure
Universal Protocol: Surgical/Invasive Procedure Time-Out VerificationRe-verification of Patient Identification: Re-verification of identification elements is required if the patient is relocated to a different setting or staff changes occur prior to the invasive/surgical Time-Out; the RN assuming the care of the patient must re-verify the patient identification
Universal Protocol: Surgical/Invasive Procedure Time-Out VerificationSite Marking Requirements: Marking of the site immediately prior to the procedure is required for procedures involving left/right distinction, multiple structures (such as fingers, toes, kidneys), or multiple levels (as in spinal procedures)
Universal Protocol: Surgical/Invasive Procedure Time-Out VerificationSite Marking Exemptions: Site marking is not required for single organ cases or interventional procedures for which the insertion site is not predetermined. Also exempt are cases in which the physician performing the procedure is in continuous attendance with the patient from the time of the decision to do the procedure (consent is obtained from the patient) through the performance of the procedure. For those procedures in which site marking is not required, the other requirements for patient identification verification and Time-Out still apply.
Universal Protocol: Surgical/Invasive Procedure Time-Out VerificationEmergency Situations: In most cases, when invasive procedures are performed under emergency or urgent conditions, the physician performing the procedure will be in continuous attendance of the patient from the point of decision to do the procedure. Under those circumstances, marking the site would not be necessary, although the Time-Out to verify correct patient, procedure, and site would still be appropriate (unless it is such an emergency that even the Time-Out would add more risk than benefit).
Time-Out Procedure: A Time-Out procedure must be conducted in the location where the procedure will be performed, immediately before the start of any invasive procedure or surgical incision. The Time-Out procedure will be initiated by the RN and requires the active participation of all team members involved in the procedure to verify each of the following elements: Patients name and date of birth Correct side/site, including marking, if applicable Correct procedure Correct patient position Correct radiograph data, if applicable Special equipment/implants/requirements available, if applicable
The Time-Out Procedure is to be conducted in a fail-safe mode; the surgical/invasive procedure is not started until any questions/issues are resolved. Required Time-Out Documentation: The RN is responsible to initiate and document the Time-Out procedure. The RN is to document the required elements of the Time-Out procedure by initialing in the spaces provided by each element of the Time-Out, writing in the names of all team members participating in the Time-Out, and signing on the signature line designated RN Signature completing Time-Out Checklist.
ConsentConsists of at least two parties One being the recipient of the action; Second being the one to perform the action.Voluntary and informed act in which one party gives permission to the other party to touch Battery: nonconsensual touchingSurgical procedures require an Informed Consent (certain situations do not)
Who Can Give Consent?Competent adultParent of legal guardian of a minorHospital administratorCourts
Consent cont.Two formats for Consent
Express direct verbal or written permission (preferred by healthcare facilities in written form)
Implied manifested by action or inaction of silence, which presumes consent has been given
Informed consentThe Join