Health Systems Exam 1 PDF

WHAT ROLE DOES THE OPTOMETRIST PLAY IN PUBLIC HEALTH ISSUES? (Module 1) Public Health Issues Affecting Optometry Apply Public Health Surveillance reporting responsibilities—senior, child or domestic abuse, infectious disease outbreaks ○ F.S. 39.20: mandatory reports...

WHAT ROLE DOES THE OPTOMETRIST PLAY IN PUBLIC HEALTH ISSUES? (Module 1) Public Health Issues Affecting Optometry Apply Public Health Surveillance reporting responsibilities—senior, child or domestic abuse, infectious disease outbreaks ○ F.S. 39.20: mandatory reports of child, elder, or vulnerable adult abuse, abandonment, or neglect MUST be reported by healthcare professionals, EMTs, mental health professionals, nurses, physicians, etc. ○ ONE EXCEPTION to mandatory abuse reportings = domestic violence victims! In FL, a healthcare provider may not report DV w/o informed consent from an adult, even if the victim themselves disclose the violence Doing so is considered unethical and can lead to civil action against the HCP A competent adult is considered to have the right of privacy and self-determination ○ F.S. 790.24: does require healthcare professionals who knowingly treat a gunshot wound or life-threatening injury indicating an act of violence to report immediately to the county sheriff’s w/ or w/o the victims consent ○ Practitioners who provide point of care testing and treatment, are required by state law to notify the Health Department of certain diseases of urgent public health importance upon initial clinical suspicion of the disease prior to confirmatory diagnosis. Many states require optometrists to report these diseases. This used to include optometrists in the state of Florida, but no longer is the case as per Regulation 64D-3. Nonetheless, if we suspect one of these diseases, we must be sure that the patient gets tested. Labs who perform these tests are always required to report positive tests to the state and national system. ○ Disease reporting pathway Understand how to handle situations where ocular conditions may be caused by family violence ○ Trauma-Informed Care: meant to provide services in a way that is welcoming and appropriate to the unique needs of the survivors of trauma and invites their participation Focused on trust, safety and report for the survivors choice and autonomy Avoid victim blaming/judgment - abuse is a choice by the abuser, never the victim's fault Use language that focuses on the abusers responsibility for abuse - nonpassive ○ AVDR ASK/Assess safety: “How is everything at home?”, “Do you feel safe going home?” VALIDATE: “I know this is hard to talk about”, “I’m listening” DOCUMENT: confidentially, and in an empowering connotation, take photos, describe ocular condition in great detail REFER: offer (dont force) resources - not your responsibility to solve the problem, your role is to facilitate the intervention process  Recognize and know where to find community resources for the non-optometric social needs of patients ○ Intimate Partner Violence: broad term for DV and dating violence; a pattern of abusive behaviors through the use of power and control tactics used by one person over another in an intimate relationship A learned behavior, NOT caused by anger or drugs/alcohol Not just physical, includes emotional, verbal, economic abuses, use of children, etc. ○ #1 reason why victims stay: fear & safety; also children, legal barriers, social pressures, finance ○ Red flags: injuries without clear explanations - black eyes, bruises on the face, conj hemes, RDs ○ Resources: hotlines and websites (Women In Distress, National/Florida DV Hotline 2-1-1, etc) 2-1-1 is the 24 hour comprehensive helpline, providing all people with crisis, health and human services support and connecting them to resources in our community for social service information and referrals Ex: Transportation services for seniors, Homeless Shelters, Suicide Prevention, Family Violence counseling, Teens and Child care issues, Home health assistance agencies, Services for those with Special Needs *Understand your role in disaster preparedness for your practice and emergency response efforts in your community ○ 3 steps to business preparedness 1. PLAN to stay in business - know the potential emergencies, plan for medical emergencies, protect your employees, provides the basics and sheltering 2. TALK to your employees and colleagues - plan alternate communication for employees/patients/suppliers, plan for those who will require special assistance during an emergency (deaf, blind) and even after 3. PROTECT your investment - understand your insurance policies and what is included, prepare for utility outages, secure physical assets, protect your data and IT systems (back-up patient file info, alternate site storage) ○ Costs associated with preparing your business for an emergency No cost solutions - promote family and individual preparedness Create in-shelter and evacuation plans, emergency contact lists, document inventory Under $500 - keep an emergency kit, provide first aid/CPR training to employees, back up records - keep a copy off-site Over $500 - buy additional insurance, backup generators, upgrade sprinkler systems, HVAC, computer/data systems ○ IT considerations, office preparedness  ○ Business Continuity Plan (BCP): a collection of resources, actions, procedures and info that is kept available in the event of a major disruption Ensure that key business functions remain available to patients Provides the ability for your practice to retain some level of function despite disruption 4 Phases 1. Determine essential functions and resources 2. Conduct a Business Impact Analysis (BIA) for each essential function 3. Develop recovery strategies - physical assets, personnel, financial 4. Test the plan to make see what works and what doesn't; address those issues and update plan Apply motivational interviewing and smoking cessation techniques in an optometric practice ○ Most smokers want to quit and see HCPs, not many get the help they need A brief conversation with a HCP followed by referral to cessation services can (more than) double the chances of quitting → Ask, Advice, Refer ○ Tobacco addiction is: emotional, behavioral, physical ○ Motivation is a state of readiness and can vary from situation to situation Dynamic, fluctuating and modifiable state You can influence this state by how you talk to your patients! ○ Motivational interviewing: a collaborative conversation to strengthen a person’s own motivation for commitment to change Patient centered, yet directive Empathetic communication style to build rapport - becomes less intrusive to discuss health behaviors that should be changed Goal: to elicit reasons for quitting tobacco use from patients rather than confronting/lecturing them to quit Involves - Guiding (not directing), Dancing (not wrestling), Listening (not telling) Collaborative - partnership Evocative - evoke their own motivation to make change, goals, reason for changing, values Honor patient autonomy - acceptance that patient has responsibility for changing and plays active role ○ 2 key components Style - how you say it Empathetic, non-judgemental, non-confrontational, supportive manner Content - what you say Non-MI approach: “smoking is not good for you, why don’t you quit?” (judgment) MI approach: “it sounds like you are not sure about quitting as you tried many times before” (reflection) ○ Focus of MI approach - want to explore patients ambivalence about quitting in a way that increases motivation without invoking resistance; 5 techniques: Asking permission to discuss quitting or for providing information Provides opportunity for & continued conversation, respectful and reduces resistance Reflective listening - summarize/paraphrase what they’ve shared Decisional balancing - pros and cons of smoking - validates the struggle they’re having Goal - tip the scales in favor of quitting Readiness rulers - to assess readiness to change and confidence “Where are you now vs 6 months ago” (1=not ready, 10=ready) Patients giving voice to changing OARS - Open-ended questions, affirmations, reflections, summarizing  Assess your patients’ occupational vision needs ○ Occupational optometry targets the efficient and safe visual functioning of one in their work environment (want to maximize their vision and enhance performance) ○ Provides services in 3 levels: primary care, eye safety consultation, vision ergonomics consultations Encompasses vision assessments of workers/patients, taking into account their specific vision requirements and demands Preventing occupational eye injuries Environmental settings (lighting requirements) Know the visual requirements for the following occupations: Police Officer, Fire Fighter (NFPA 1582 Standards), Commercial Driver License (FMSCA Guidelines), Marine Pilot, Aviation Pilot (FAA Guidelines) ○ Police Officer Visual Skills Standard Screening Referral/Failure VA (cc) 20/20 OU R: