Law, Ethics and Professionalism Final Exam 20.. PDF

Law, Ethics and Professionalism Lesson 1.1 Law set of rules and regulations by authority that community should follow body of the law; controls actions between individuals and government covers 3;...

Law, Ethics and Professionalism Lesson 1.1 Law set of rules and regulations by authority that community should follow body of the law; controls actions between individuals and government covers 3; 1. Constitutional: dervies from the consitution of the country 2. Administrative: body of the law, like trade, economy, public service & enviromental issue General Law 3. Criminal: body that concerns with maintaining justice, public order and safety such as; abuse, death, physical & financial & mental harm, (if it’s offensive or by intention) Felony: big crimes & punished by death Misdemeanor: not as serious, punished by fines organizes the rights and duties between private individuals and organizations; includes civil law 1. Civil Law: verbal abuse, bullying, joking, divorce, child support libel: to the person in public to ruin reputation Private Law slander: in private not publicly Plantiff: complained in court Respondent: did the action tort: physical harm, makes the other party suffer a loss contract: binding agreement 1. Constitution: branches of government ‫المجلس الوطني‬ 2. Legislative Enactment: federal & local authorities ‫ديوان‬ Sources of law 3. Judicial Decisions: case/court law ‫محاكم‬ 4. Treaties: world grouping such as WHO 5. Religious: islamic sharia ‫دار االفتاء‬ 1. Quran Sources of 2. Sunnah: verbal prophet teaching Islamic Sharia 3. Ijma: agreement on a case by religious scholars Law 4. Qiyas: comparing cases process of applying the law Legal System 1. common law system: not applied in UAE, from judicial decisions 2. civil law system: applied by UAE, from legislatives Meera Rashid Alawadhi Lesson 1.2 1. Federal Government: (FSC) Supreme council: includes the 7 rulers, control legislative and executive powers UAE President & Vice President: chosen by supreme council Types Of Council of ministries:‫ وزارات‬, consists of prime minister, controls Governments executive powers (FNC) National Council: 40 members, ‫المجلس الوطني االتحادي‬ Judiciary 2. Local Government 1. The federal Judiciary: by federal Supreme Court (highest) SHJ, AJ, FUJ,UAQ follow it, ministry of justice Judicial System 2. local judicial department: local government level *Abu Dhabi judicial department, Dubai court, Ras Alkhaima Court - from each emirate seperately 152 articles adopted in july 1996 The UAE describe the main rules of political and constitutional organization Constitution main purpose of federal establishment explain the federal authorities 1. Court of first instance: first degree, includes federal and local, hears all lawsuits System of 2. Court of appeal: second degree, includes federal and local courts 3. Federal Supreme Court 3. Court of Cassation(Local): highest judicial body Judicial Circuit: branches of court 1. Labour court: private sector employers/employers against each other Court Circuit 2. Personal Status court: family cases 3. Civil Court: financial rights and mortgages and public rights 4. Commercial Court: contracts and commitments 5. Criminal Court: federal or local prosecution in each emirate Sharia works with criminal and civil court and particularly within Legal System personal status court Lesson 1.3 wrong committed to a person or property 1. Intentional Misconduct (Willful): criminal act; assault (threat of harm & violation of mental peace) battery (touching someone & violation of physical integrity) false imprisonment (preventing or forcing something without having the right) defamation of character (harm reputation include slander: oral & Tort libel: written) invasion of privacy (public disclosure of patient information & breaching the confidentiality) infliction of mental distress (painful emotions to someone) fraud (lying to gain something) 2. Unintentional (accidental): not intented but committed without considering the consequences Negligence (failure to provide expected care due to not caring) commision (doing the wrong act) omission (not even doing the act) malpractice (failure to apply skills) The 3 acts: Malfeasance ‫ & مخالف‬Misfeasance ‫& سوء تصرف‬ Nonfeasance ‫عدم تصرف‬ Negligence Four elements: (all must be present in order to cover damages of (unintentional) plaintiff) 1. duty of care: (what you must do) maintain license, health, skills & attending courses, checking equipment, respecting patient 2. breach of duty: (failed to perform with care) 3. causation: legal obligation to patient and breached care 4. injury damages: economic loss (medical expense) noneconomic (physical injury) Lesson 1.4 Paramedics 1. Civil Law: malpractice or tort of negligence Law 2. Criminal Law: wrong medication or not giving medication Liability: state of being legally responsible for something the constitution: right to take legal action against paramedic civil lawsuit: called a tort Civil Lawsuit civil lawsuit that affect a paramedic: 1. Emergency vehicle crash: we have to take care of driving 2. Dispatch and transport issues: delay in transport 3. The quality of medical care: negatively treating patient Criminal criminal prosecution: action taken by the government Lawsuit prosecution needs prove the intent to cause harm 1. ignorance of technical matter 2. non compliance with professional Medical error 3. not doing your duty 4. negligance and not paying attention when pursue complain against someone you have to do the following 3: 1. fill medical complain by healthcare authority 2. fill civil case before uae court 3. fill criminal complaint before police or public prosecution all should be submitted to medical liability committee which must submit within 30 days criminal negligence claims cant stop a paramedic of working unless a claim is proved by MLC conciliation and settlement can be done and case will be closed Medical 2 key defences to negligence claim: Liability Law 1. contributory negligence: paramedic can prove that injury wouldn’t happen if patient isn’t negligence 2. voluntary assumption of risk: patient approved to take responsibility of the result 4 ways we cant complain against paramedic: harm not caused because of medical error harm caused by patient/refusal of treatment used a different but sufficient method medical effects issued by MOHAP or president of health body Medical Responsibilities: examine complaints, decide medical error severity, multiplicity Liability - justice, make use of experts Committee civil claims: must accept the claims or it will be faulty performing in all circumstances, obtaining medical error, take precaution, Protect develop good relationship, assessing in time, communicating effectively, being paramedic up to date with skills Lesson 2.1 moral and legal entitlements of a patient why is it important? improve healthcare system and safety ability to make their own decision what are their right? right to know ones right rights to explanation of one’s rights rights to exercise rights right to ask questions right to complain by DoH right to formulate and to execute advance directives (to plan their health options in advance when they become unable) right to emergency care right to examination and treatmenet right to know who's treating them right to informed consent (treatment options) right to adress any special needs Patient’s Rights right to refuse treatmenet right to choose the treating physician(s) right to trust the caregivers right to fulfill spiritual needs (care about their mental health) right to ethic consultation right to choose treatment right to recieve quality medical care right to compassionate care right to respect right to pain management (by pain rating scale) with graphic rating, numerical rating scale, pain drawing right to privacy and confidentiality right to discharge right to be tansfer right to access medical records right to be aware of medical service charges right to freedom from harassment and abuse right to be aware of any medical error Patient Charter policy for the patient rights by DoH Lesson 2.2 maintain healthy lifestyle maintain current medication record (drug allergies, dosage, medication, how they take the medicine) keep appointments provide full and honest disclosure of medical history by (SAMPLE) S- signs and symptoms, A- allergies, M- medication, P- past Patient medical history, L- last meal, E-event, why you’re here Responsibility report any changes in health status follow treatment plan seek second opinion incase of doubt stay informed and ask questions follow discharge instructions treat health professionals with respect respect the right of other patient Lesson 2.4 patient health must not be comprimsed because of paramedic right right to fair treatment right to refuse to take part in patient care (abortions or end a life) right to question patient care right of freedom from disruptive behavior (if being harmed) right to work in sexual harassent free enviroment right to be treated with dignity and respect right to privacy and confidentiality Paramedic right to have different types of leave (annual leave 30 days) (sick Rights leave 15 days) (maternity leave 4 months + nursing 2 hours) (paternity leave 3 days) right to work in safe environment (health and safety, know the procedure, training provided, safety equipment provided, equipment working) right of indemnity for labour accidents and occupational diseases (if if injured because of work place, payment for paramedic should be paid for his/her treatment with off day) Lesson 2.5 know your patient educate and encourage patients to ask questions (patient handbook) be compassionate comply with local and federal regulations and hospital policies comply with assigned duties respect patient right Paramedic maintain confidentiality Responsibility adhere to safe pictures (infection control protocol) admit to mistakes sexual harassment report unethical behaviour protects patients from harm report patient abuse Lesson 2.3 voluntary agreement by a patient, if consent is not given its considered assault and battery Autonomy: patient right to make decisions Consent being valid by 4: 1. Consent voluntary without forcing 2. give all information 3. consent includes treatments 4. patient at legal age of 18 ways its not considered valid: pain, fatigue, fear, grief consent cant be given if: 1. below 18 2. mental disability 3. drugs 4. unconscious 5. memory loss forms of consent: 1. expressed: oral or written document 2. implied: act Consent 3. informed: patient knows all the procedure 4. written consent: visible proof when to obtain consent 1. examining patient of opposite sex unless necessary 2. preforming unnecessary surgeries 3. undertaking examination 4. providing treatment 5. involving patient in research when consent is not required: 1. emergency situation 2. non-emergency situation 3. law authorises prescribed treatment who can give consent: 1. adult 2. above 18 3. family member when consent considers invalid: 1. patient withdraw consent 2. paramedic changed plan 3. new treatment way is developed due to change in condition Refusal Of patient can refuse even if it results to death Treatment refusal can be valid if: patient is able to decide, voluntary adult have the right to refuse and if we fail to respect it considers as Paramedic battery and assualt, if approval is needed and patient is refusing we Legal Liability should fill a “Agaisnt medical advice or refusal consent form” Lesson 3.1 define specific rules of the paramedic by MOHAP their job is to: Administrative 1. describe paramedic role regulations 2. define requirements 3. describe list of behaviors types of learning: 1. Formal learning: university degree 2. informal learning: online courses or degree levels of education for Ems: Academic 1. EMT - technical Foundation 2. EMS - 4 years 3. CPD - continuation: maintain stauts, renewe licence, stay up to date, prevent degradation, showcase issues (by internet courses, colleges, journals, conferences) process education program may complete that ensures certain standard have been met Accreditation CAAHEP for health education program CAEMSP for EMS program person has fulfilled requirements of education and performance meets Certification the standards and more mandatory by the law to allow paramedics to work by the scope of Licensure practice by passing a test and maintianing standards, licensure can be removed due to breach or rules listing the names of persons in a certain occupation who satisfied Registration requirement Scope of legal description of the distinction between licensed health practice professionals, what is legally permitted to be done 1. emergency medical responder EMR (out of hospital, immediate life saving) 2. emergency medical technician EMT (respond, assess, limited Professional training, apply basics only) level of EMS 3. advanced EMT AEMT (respond, assess, apply basics, focus advanced knowledge, medical transportation) 4. paramedic (respond, assess, physiological and psychological, medication, complex patient care) Paramedic finished education & licensed in order to work License Lesson 3.2 UAE Health Local health authority and federal health authority care authorities 1. DHA - dubai (residents of dubai) 2. DHAD - abu dhabi (provide healthcare for abudhabi, Alain, Local Health aldhafra) regulate for public and private healthcare sectors. Authority SEHA: manages and regulates hospitals 3. SHA - sharjah (2010 may) to enhance health system Ministry of health and prevention (MOHAP) SHJ, AJ, RAK, FUJ, Federal Health UAQ Authority controlled by MOHAP National ambulance for all UAE EMS DCAS for dubai Police for each emirate their job is to: leading prehospital care public and private and air ambulance transport service first aid manpower National prehospital care: Ambulance first aid assessment planning fit out response evaluate Lesson 3.3 Professionals develop regulated by MOHAPH, DOH, DHA Qualification license can be issued after meeting PQR Requirement you can transfer the license across emirates 1. education qualification (bachelor degree, ACLS, PALS, PHTLS, 2 years experience) 2. professional experience (internship & experience) 3. good standing status (valid at time of application) 4. primary source verification (certificates & documents) 5. assessment (pass assessment *not needed for UAE* English language, OSCE, 3 attempts only in that authority) General 6. exam equivalency (if completed international examination will exempted from Requirement assessment) 7. discontinuity of practice (UAE Nationals have up to 10 years after clinical, non UAE nationals have up to 5 years) If stopped for 2-3 years they need (10 credit + 4 months practice) if stopped for 3-4 years they need (20 credit + 6 hours practice) if stopped for 4-5 years they need (30 credit + 8 hours practice) CME - Continous medical education CPD - Continous professional education License Renew 10 CMD/CPD requirements annually PQR authority; Same title as PQR Valid License License PSV report Validity expiration/cancellation shouldn’t exceed 6 months follow authority policies Lesson 3.4 ambulance: vehicle specially equipped with mobile hospital care to transport when do we need to call ambulance: Emergency 1. sings and symptoms of cardiac distress Vehicle 2. severe bleeding Regulation 3. trauma, unconsciousness, burn, fractures 4. oxygen requirement 5. not able to move Transportation patient should be transported to designated hospital that treatment for their needs shall not be deprived from their rights + DCAS: created ambulance for them Special Needs 1. adapt assessment questions (People Of 2. deal carefully Determination) 3. consider their needs and safety Good legal provisions that offer legal protection to public and citizens who give reasonable Samaritan Law assistance Lesson 4.1 study of right or wrong actions micro ethics: individual view of what's right/wrong based on tradition macro ethics: global view of what's right/wrong ethical dilemma: situation where you should choose between right or Ethics wrong considering micro and macro 1. philosophical ethics 2. general pattern such as religious 3. moral codes such as professional codes (bio) - life; it’s a greek word that helps us to make better decisions Bioethics (branch of philosophy) 1. Hammurabi is a medical code of ethics by what is expected from Historical physicians Context 2. Pledge for physicians written by Hippocrates (greek) 3. Code of ethics for EMS practitioners issued by NAEMT Importance of help paramedics make good decisions and to do good studying ethics Morality code of conduct in accordance with right and wrong standards Moral Values family, culture and society influence formal statements that was published for healthcare professionals that Code of conduct guides them to ethical situations Standards used to guide human conduct by stating traits to be exhibited Principles responsibilities that do not specify what should be the required conduct Rules specific conduct that must be followed judgements concerned with the believe of individual or group to be right in given situation, ability to select option among many choices Moral laws are created to set boundaries Judgement an ethical act is not necessarily legal an illegal act is always unethical when values, rights, duties, and loyalties conflict; moral dilemmas in Moral Dilemma healthcare setting often arise Lesson 4.2 The study of the origin and meanings of ethical concepts goal/seeks: Meta Ethics understand ethical terms and theories explores connection between values & reasons of actions moral standards that should be followed in order to have a correct human Normative Ethics behavior; study of what's right and good Descriptive Ethics comparative ethics; what people believe to be right or wrong Applied Ethics search for what's right/wrong within controversial scenarios; abortion Despite the procedure as long as the end results are sufficient Consequentialist 1. Utilitarianism: greatest good for the greatest number (AIM) Ethics 2. Hedonism: the best outcome is the one that produces the most happinesss Uses rules to distinguish right from wrong, follow rules and don;t lie Deontological Immanuel Kant: doing action is good but might not lead to right Ethics consequences Deon: Duty Philosophy developed by aristotle and other ancient greeks; understand and live Virtue Ethics a life of moral character The person that is moral will make the right decision Lesson 4.3 Autonomy, Non-maleficence, Beneficence, Justice Principles an action is ethical if it is the action that best able to uphold the principles patient has the right to make their own decisions, and the right to refuse care Informed consent should be gained after following: 1. Liberty: freedom Autonomy 2. Agency: capacity to make decision 3. Understanding: inform patient of options and consequences 4. Respect other’s autonomy Can be affected if: disability, maturity, mental status, inability to make decision Non Maleficence “first; do no harm” caregivers avoid harming patient (can cause dilemma) Doing good, showing compassion, demonstrating kindness Beneficence Doctrine of double benefit: only used if its the last solution Justice obligation of being fair in distribution of benefits and risks, treat patient fairly Lesson 5.1 1. Problem: ethical problem 2. Reconnaissance: gathering facts to gain advantage 3. Ethics: autonomy, non-maleficence, beneficence, justice 4. Code: code of conduct; guidance of ethical and professional behavior, protects the Components of public, support physicians in good care, law is the first haven Precare Model 5. Alternative: consequentialist, deontological, virtue ethics 6. Regulations: considering relevant legal action 7. Evaluate: evaluate your decisions Features of a good reason: easily explained, relevant to issue, important, connected, provides support Lesson 5.2 History (Code of Hammurabi) created 50 years ago Self governance or morality: self control Domains of Group Governance: performance of the whole group (football team) Governance Legal Regime: the whole society towards the law of the land control that is exercised within a group through the creation of certain regulations Ethical 1) Legal: personal & professional (marriage, birth, pet ownership) the heart=enforcement Governance 2) Moral: the heart=persuasion, generosity, kindness, sympathy, faithfulness, compassion 3) Ethical: the evaluation of professional behavior falls under code, guideline, conduct we must explain to patient the reason of delay & difficulty then be open to consequences The Legal If patient complained; the law will solve the issue within a year or 6 years Considerations 2nd way to defend paramedics; patient negligence such as overdose & Good Good Samaritan Law: protects paramedics of charges against negligence Samaritan Law Duty of care: when we are off duty we don’t have legal obligation to duty of care accept for emergency like a crisis Moral to be fairly treated and make the moral choice Consideration justice, autonomy, beneficence, and non-maleficence, compassion are bare values & Principles Moral Evaluation: applies socially derived moral notions to our personal behavior Difference The legal governance creates legal duties through laws and these duties are Between Legal consistently applied and enforceable across society Governance The ethical governance through professional codes creates educative and persuasive And Ethical material that is based on conventionally accepted moral principles and applies only to Governance groups within society Lesson 5.3 Fake medicine or drug; to compare in clinical trials (we lie to the patient that we are Placebo giving them an actual drug) in order to see the real affect of the medicine 1. Justice: we need to be treat fairly 2. Autonomy: allow the patient to choose treatment option and provide them with facts 3. Finding an address associated problem: ambulance must arrive in time Ethical Issues 4. Stigmatization: care administrating to drug addicts, alcoholics, and cancer patients before medical 5. Refusal of transport to hospital: convince patient, if not; they must sign a contract intervention 6. Dangerous situations interventions: incase of crisis like accident, war, or fire; we must question to treat or refuse for our safety? 7. Safe Driving: we must ensure our safety as well 1. Beneficence and non-maleficence: what is the best for the patient? 2. Triage: who needs urgent care? get right patient to the right place at the right time Which patient is priority? Priority 1 (Most serious and life threatening) Priority 2 (serious but not life threatening) Priority 3 (non serious non life threatening) Priority 4 (Dead patient) 3. Disagreement between patients families and healthcare providers: types of difficult patients: alcohol or drug/terrified patient 4. Dealing with the public patients relatives and bystanders: quite challenging if relatives comment on every treatment step Ethical Issues 5. Achieving informed consent: can be difficult due to situation Related to 6. Decision making capacity Treatment 7. Truth telling: give proofs and explain the procedure Process 8. Patient privacy and confidentiality 9. Relationship within crew and paramedic 10. Waiting lists; can affect people who need ICU care 11. Ethical issues related to participation in research & clinical trials: by implied or informed consent 12. Surgical innovation ethics: new drugs and treatment ways 13. issues related to the access for needed health resources for aged, chronic, and mentally ill people: everyone should have access 14. The issue of medical error 15. The shortage of family physicians and paramedics Ethical Issues EMS can be viewed differently to patients, for this reason we must clearly define medical Using conditions to the public Ambulance Perceptions of using ambulance as a taxi or faster treatment is false, respect human life, Ethical taking account of human quality life, respecting integrity of human body, assessing what Considerations is important Lesson 5.4 (greek) mercy killing - not allowed in islam, removing machines for bed dead patient Euthanasia The legal system must ensure: Constitutional rights patients, Protecting, Preventing suicide, Maintaining integrity Abandonment Termination of care without consent or without transfer of care to appropriate level The patient can appoint a surrogate decision-maker to make decisions on their behalf Advance The patient must be competent & freely and voluntarily Directives Document should include: location, name, mobile, patient information Provides guidance of patient wishes for treatments, valid instructions of treatment, protects Living Will patient’s rights, protects the provider who honors them (not permitted in UAE) Can include preference such as organ donation Durable Power Individual (principal) gives another person (attorney-in-fact) authority to act upon them of Attorney 2 types are (General) & (Special) Health Proxy (agent) Allows the person to appoint healthcare agent to make a decision on their behalf Organ Donor Dead: document that indicates patients’s wish to donate organs when they die Directives Alive: must be legally a competent person donating by their own free will (document) Surrogate Surrogate decision making is an agent who acts on behalf of the patient who lacks capacity Decision and unable to make his or her decision failure to save a life by CPR Futile CPR Medical futility is defined as a clinical action serving no useful purpose in attaining a Treatment specified goal for a given patient. DNR (advance) Written directions that a person doesn't wish to be resuscitated if they suffer from harsh case 1. Withhold: avoid treatment because of no hope thoughts 2. Withdraw: stop treatment Withhold & Both Considered when: Withdraw Care Patient is deadly, patient has no possibility of treatment, heart will stop after while Common Reasons: By choice, burden outweigh benefits, undesirable quality of life, prolonging dying process Initiation CPR decision should start within seconds for patients with the potential for long -term survival Medical Order MOLST (patient is incapacitated or lose decision making capacity) *not permitted in UAE* End of life Fixed and dilated pupils, no palpable pulse, no CPR 20 minutes, Asystole decisions on ECG, injuries, incompatible with life, signs of rigor mortis. Lesson 6.1 Medical Writing affective report is a skill we must learn Documentation PCR (patient care record) is the legal record A complete PCR helps healthcare providers obtain needed information Objective information: measurable signs such as blood pressure Subjective Information: symptoms described by patient such as pain Principles degree Must include paint picture of the entire call use quotation marks to write statements provides basis of defences legal proceedings that’s why it needs to be PCR completed Importance agency or service like facilitation of quality care, continuity of care and billing to insurance patient continuity of care communication legal implication of pcr minimum requirement of billing Purposes EMS research and education quality assurance and incident review historical documentation analyzing decisions Accurate and factual complete data PCR Report legibility includes objectivity timeless validaty accurate or factual start by writing date and time relevant and chronological (by age) order clear or legible Characteristics organized or sensible of effective confidential documentation appropriate health risk factors patient progress billing statement use abbreviation and signed by healthcare professional Lesson 6.2 electronic documentation paper documentation Types Of PCR dropdown menu (risky because we might check wrong boxes) computerized documentation (bubble sheet that is scanned in computer for easy information management) used by DHCA data reaches to the hospital and is always saved information entered in uniform format by everyone Advantage Of stored and secure Electronic reports are in standard legible format which can be printed staff can view incidents they have been involved in more clinically relevant information Costs a lot of money Disadvantage can have system damage of Electronic can have system update duplication of work Disadvantages requires space to store of Paper PCR medical errors related to medication doses and orders in wrong spelling Run data: incident time, location, responding unit, crew members names EMS Call Patient data: chief complaint, vital signs, assessment, level of Documentation consciousness (AVPU), patient age, sex, ethnic background, MOI Transfer Of signature of healthcare professional when leaving patient after treatment Care handover of patient to another agency EMD which allows the dispatcher to give simple directions for medical care and medication administration via phone. If you encounter such Care Prior To situations, as a paramedic you should document such findings and do not Arrival only obtain the information form the patient or the caller about the care, they have receiver prior to your arrival. Lesson 6.3 Patients have the right to refuse treatment and as paramedic we should; Documentation Know the patient’s rights of Refusal of Be familiar with laws in the country. care: Make sure the patient is informed about his situation. Inform patient about consequences of refusing care The unresponsive patient may be treated under the implied consent. Situations In situation of immediate care and patient refuses, involve online control Requiring when paramedics don’t agree with refusal they must contact their agency Additional Document refusal of medical assessment after applying AVPU documentation Document whose care you left your patient (self, family, or the law) HAAD created patients charter in order to refuse or accept treatment OSHA has specific form for documenting workplace injuries Document The precautions that were taken workplace The protective equipment was being worn by the person involved injuries: Be familiar with the requirement of your agency and state Perform medical monitoring for the hazardous medical teams Mass Casualty Incidents (MCI) require detailed documentation incase of abuse or Documentation neglect, the paramedic should supply detail for criminal investigation. of Special When paramedic begins patient’s care that's beyond paramedic’s scope Circumstances: document the use of any additonal services such as helicopter paramedics 1. Chronological order; from beginning to the end 2. SOAP: subjective, objective, assessment, and plan (most used) 3. Charte: chief complaint, history assessment, treatment, transport, and expectation (most used) Method of 4. Body system/part approach: each body system from head to toe Documentation 5. SOMR: history, patient progress, diagnostic results 6. POMR: database, problem list, educational diagnosis and treatment plans Pertinent negatives: patients behavior, MOI, suicidal attempts, denial of pain 7. PIE charting: problem, intervention, and evaluation 8. Focus charting: data, action, and response chart writing date and time medications Properly incident times and narratives written PCR the call Elements neat handwriting with black or blue ink free of slang and use of quotation marks The 6 C’s: client words, conciseness, chronological, confidentiality, completeness, clarity Correct Error correct errors immediately, explain correction, use different color, write time of correction Incident time correctly document timing of dispatch and incident tracking Lesson 6.4 PCR legal document that outline the needs, care and the management of patients Medical Record (facilitates communication and evaluation of care) Guidelines The federal & local health authorities in UAE (outline requirements) Develop regulation, policy, and standards Licensure & inspection of health facilities and health professionals Managing complaints & health advertisement DHA Guideline Governing the use of drugs Strengthening health tourism Assuring management of health informatics Content of Three unique patient identifiers (DOB, emirates ID number, full name and address) Health Record Medication allergies; or any special information/needs like HIV, blindness, disability Methods of Dubai Health Authority established: electronic medical record system “Salama.” Documentation (MOHAP) unveiled smart connectivity between the National Ambulance services and in UAE hospitals, able to update patient information SOAP Subjective: patient words, Objective: symptoms, Assessment: diagnosis, Plan Health records should be maintained for every patient & created by electronic or paper Management Dated, legible and indelibly verified Health record Authentication should include the official stamp, written initials or computer entry e- signature should be issued with a unique username and password Telephone or verbal (must be recorded) Healthcare Big data analysis; SKMC incorporated ‘iCare’ – Electronic Medical Records (EMR) Innovation Examination, diagnosis and assessment findings Time frames Completion of Signed and stamped by the physician including; name, specialty and license number Record Written signature and stamp, identifiable initials or computer key Stamp accepted if; rubber stamp used by authorized physician in administrative office Modification Correctors and no erasable pens, electronic form should trace any changes, no initials Lesson 6.5 Confidentiality: information of patient shouldn’t be shared Records can be requested for: specific time, symptoms, diagnosis, or test results DOH stated: records updated, information documented, confidential, no loss Information provided to patient includes: Patient’s Right Of Patient’s rights & responsibility Confidentiality Service cost Complaint mechanisms Privacy and confidentiality Access health records Written consent by acceptance of patient Exeptions to Ordered by court / police / law to prevent crime Confidentiality Needed for insurance For research or education after asking for consent Access medical HAAD - patients can access their medical records records No fees should be charged to access medical records unless asking for copies Eclaim by HAAD electronic form with free and easy access In English & Arabic language Ensure retrieval (recovery) Storing of Health Temperature controlled room Records Protected from loss & always available for physicians Backup by e-health records & ensure confidentiality Maintiaing for Retain such records for at least 2 years form the date of the last health insurance insurance treatment and may only be disposed of permanently 5 years after last treatment Paper based Health Records (UAE); kept for 10 years & following recent visit Retention (Keeping) Paper based Dental records (UAE and Expatriate); kept for 10 years & recent of health records visit For legal cases (20 years) - For dead patients (5 years) - For diseases (25 years) Responsibility of the concerned healthcare facility Ensure completion of the retention period required Disposal & Destruct in secure place destruction of medical Create a record destruction log (name, record no, date of destruction, company, records signature, method of destruction; shredding, trammeling, pulping) No disposal or destruction for birth and death medical records and for cases of pending litigations or ongoing investigation by HAAD. Lesson 7.1 broad range of behaviors of people in the healthcare Professionalism Importance: promote patient safety 1. Partnership: collaboration, communication, caring, advocacy Pillars Of 2. Practice: confidentiality, management, self-care, interest, competence Professionalism 3. Performance: reflection, quality assurance, role model, commitment Vocation vs Profession: a job, gained by a degree and skills Profession Vocation: occupation, without a college degree Business vs Business: fiduciary duty is legal obligation of one party to act in a way Profession Profession: code of ethics, specific obligations obligations of trust and equity, bound to act for another Fiduciary Duties Breach: failing to fulfill responsibilities and obligations Primacy of patient welfare: trust 3 Fundamental Patient Autonomy: importance of honesty, educate patient to make decision principles Social Justice: importance of equity and avoid discrimination Professional Commitment to: honesty, confidentiality, appropriate relationships, care, Responsibility competence, finite resources, scientific knowledge, trust, responsibilities Professional: (qualified in their field with a degree) put effort, responsibility, Professional vs improve skills, acknowledge mistake Unprofessional Unprofessional: rude, criminal behavior, ignorance, no time managing, attitude Lesson 7.2 Medical way physicians interact with patients and society including values, behaviors Professionalism Accountability, altruism, excellence, humanism General Principles subordinate their interest, ethical standards, demonstrate value, reflect decisions healthcare professional who is the first contact practitioner who provides medical Who is a Paramedic? care outside the hospital Integrity, Empathy, Confidence, Communication, Active listener, Teamwork Duties Respect for patient, informed consent, data management, advertising, practice Complying scope of practice, licensed can work, avoid harm, inform costs, dont Duties as per DOH accept gifts Code of Ethics by Act your best, maintain privacy, work with care, communicate effectively, be DHA truthful, act with limits of your knowledge, maintain high standards Lesson 7.3 Improve outcome, share information, educate people, develop network, promote Social Media health Issues of Social Commitment to patient confidentiality, maintain appropriate relations with patient, Media professional responsibilities 3 P’s of electronic Public + Permanent + Powerful Lesson 7.4 all actions whose primary intent is to promote mental health Health System Equity, accessibility, affordability, quality, accountability in health Community Based Aims to get the right response to the right patient in the right time frame EMS: provide out of hospital treatment and transport illnesses Service & Responsibility Includes: Respond for help, provide medical service, fostering public education, transport National Ambulance: Ambulance pre-hospital emergency care, continous service across UAE Vision: To be the paramount pre-hospital care provider in the Middle East Mission: deliver top pre-hospital care, enable statement, ensure excellence, transport General Health Care 7 Points: Primary health care model, continuity of care model, shared care model, Model welfare model, long term model, caring for frequent users, expanded scope Primary Health Care prevention of disease, BLS, mental health, health promotion, maternity care Continuty Of Care quality of care overtime, team work, patient experiences Shared Care use of skills to care of patients as a team new model where paramedics work beyond standards & transport roles differently Benefits: Community access primary care, provide follow ups, enrich opportunity for EMS skills Paramedic Principles: right care by right time, fill gaps, licensed, undergo training Welfare Model emotional support given to patient incase of crisis Expanded Model Support immunization clinics, home visits provide treatment, stitching, IV, X-ray Clinical Roles: ALS, MICA, flight paramedic, Urban Paramedic Careers Leadership: Team manager, clinical instructor, University Academic, Research Outside Ambulance: communication center, industrial paramedic, international Lesson 7.5 Professional lifelong process by which health professionals maintain their knowledge to ensure Development competence to ensure they meet patient needs Development Ways training, brainstorm with colleagues, research, meeting with manager, practice Reflective Practice revising with myself in order to imporve any mistakes done Personal Chart to recognize your needs and list the steps needed to achieve them Development range of learning activities through which health care Continuing professionals maintain and develop their knowledge and skills throughout Professional their career to ensure that they maintain their ability to practice safely, Development legally and with high level of effectiveness Lesson 7.6 Patient care Communication Skills Competencies Kindness Professional Development Empathetic & Compassionate Role Model of integrity Examples on Model Demonstrating altruism Humanistic Behavior Respecting patients Consider self faults Prioritise self needs Don't express empathy Examples on Lapses Don't provide optimal care Humanistic Behavior Poorly manage conflict Make Bias assumptions Avoid self improvement