L12 Ethical Considerations and Patient's Rights PDF

Chapter 5 Professional Roles and Behaviors  Objectives Define ethics and list the ethical principles that apply to radiographers. Discuss professional communications including sensitivity, appropriateness, and the rationale for confidentiality. List four patient rights that t...

Chapter 5 Professional Roles and Behaviors  Objectives Define ethics and list the ethical principles that apply to radiographers. Discuss professional communications including sensitivity, appropriateness, and the rationale for confidentiality. List four patient rights that the radiographer is responsible for protecting. Discuss the ethical handling of genetic information and why this can be a sensitive ethical issue. Define informed consent and list the legal requirements for a valid informed consent document. Define the terms negligence and malpractice. List three specific acts of intentional misconduct and three acts of unintentional misconduct that may occur in radiology departments. List five reasons for keeping accurate medical records. Describe the radiographer’s responsibility for malpractice prevention and for reporting both unusual occurrences and misconduct.  Key Terms Advance directive Health Insurance Portability and Assault Accountability Act (HIPAA) Battery Informed consent Chart Libel Charting Malpractice Contributory negligence Misdemeanor Corporate negligence Moral agent Defendant Negligence e-chart Plaintiff Empathy Radiology information EMR management system (RIMS) Ethical analysis Res ipsa loquitor Ethics Respondeat superior False imprisonment Slander Felony Tort Gross negligence Vicarious liability  Self-Care Health professionals are responsible for their own well-being. Serve as health role models for patients and the community Care of Supplies and Equipment Medical equipment is expensive. Appropriate use and care of equipment demonstrates ethical behavior. Participation in Professional Activities Provide opportunities to advance the profession while helping its members Help members to develop leadership skills Ethics and Ethical Behavior  Ethics and Ethical Behavior Ethics: Define as the system or code of conduct and morals advocated by the particular individual or group. Ethic is a system of understanding determination and motivations based on individual conceptions of right and wrong.  Ethics and Ethical Behavior Imaging and radiation science professionals face a variety of ethical challenges within medical imaging service because of their differing diagnostic applications , individual modalities present specific ethical dilemmas.  Ethics and Ethical Behavior Ethical behavior: Is characterized by honesty, fairness and equity in interpersonal, professional and academic relationships and in research and scholarly activities. Ethical behavior respects the dignity, diversity and rights of individuals and groups of people.  Ethics and Ethical Behavior Ethical behaviour is designed to help in improving patient outcomes by respecting each patient's rights and conducting relationships with patients and the public in an ethical manner.  Individual and Societal Rights Rights : Are variously interpreted as legal, social, or moral freedoms to act or refrain from acting. Individual rights : Refer to the rights of individuals, in contrast with group rights. Are rights made by a group of people to maintain social order within a society.  Radiographic Technologist Code of Ethic 1-The radiologic technologist conducts himself or herself in professional manner associates within providing quality patient care. 2- The radiologic technologist acts to advance the principal objective of the profession to provide services to humanity with full respect for the dignity of mankind. 3-The radiologic technologist deliver patient care and service unrestricted by concern of personal attributes.  Radiographic Technologist Code of Ethic 4-The radiologic technologist practices technology founded upon theoretical knowledge and concept uses equipment and accessories. 5-The radiologic technologist assesses situation, exercises care ,discretion and judgment. 6-The radiologic technologist acts as agent through observation and communication to obtain relevant information for the physician to aid in the diagnosis.  Patient Rights Considerate and Respectful Care Information Privacy and Confidentiality Informed Consent Right to Refuse Treatment or Examination Death with Dignity Medical Information and records  Hospital Computers (1 of 2) Used extensively for clerical functions, such as scheduling, billing, or entering charges Also used for generating orders and for entering, accessing and storing medical information Strategically located for staff convenience. Use of hospital computers for personal communications is inappropriate.  Hospital Computers (2 of 2) Access to a hospital computer will be protected by a password or a barcode that must be scanned, i.e., employee badges. These systems maintain the security of all information stored on the computer network. Limited access for many employees Be sure to log-off after each use. Never share your password/access code. Medical Recording on Computers Radiology Information Management Systems RIMS or RIS—Radiology Information System  The imaging-specific documentation and recording system Allows RTs access to pertinent patient information, such as the room number, allergies and the reports of imaging studies and other diagnostic tests Also allows for ordering and billing of imaging exams Radiology Information Management Systems No information about a patient’s health history or plan of care is available in the RIMS. Some facilities have an all-encompassing medical record that shows the same view for the radiographer, the physician and the nursing staff.  All staff members have access to the same information, and any imaging examination performed is documented within this comprehensive system.  Charts Chart refers to an extensive compilation of a patient’s medical care and information. Patient medical records are almost always in a digital format called an electronic medical record (EMR) or e-chart. Advantages of e-charts  More legible than handwriting  Information is easily stored and accessible from multiple locations.  Quick access of information via tabs or menus  Medical Recording (1 of 2) Charting refers to the process of adding any information to a chart or to a document that will be incorporated into a chart. RTs are responsible for documenting certain information about a patient’s care  Example: Contrast media administration, changes in patient status, and reactions to contrast or medications, as well as any treatment received in the radiology department  Medical Recording (2 of 2) Must be accurate, objective, and pertinent  Check for complete signatures, i.e., informed consent. All recorded information is permanent and confidential.  Addendums are required for changes. The chart is a legal document that can substantiate or refute charges of negligence or malpractice and can also serve as a record of behavior, which may set a precedent.  Responsibilities for Record Keeping Chief reason for accurate, pertinent medical records—provide data about the patient’s progress and current status for other health team members  Prevents repetitious diagnostic examinations by various professionals  Encourages a systematic approach to therapeutic care, allowing for longitudinal comparisons that facilitate a more comprehensive approach to extended health care  Well-kept records also serve as a resource for research investigations  Diagnostic Images as Records Images are legally considered to be part of the medical record. Belong to the institution in which they are made Normal retention period is 5–7 years. Patients must sign a release form to obtain images for another provider—HIPAA requirement.  Accidents and Incident Reports Any fall, accident, or occurrence that results in injury or potential harm must be immediately reported to the departmental supervisor and/or to the radiologist. This is an essential component of the hospital’s risk-management program. SCOPE OF PRACTICE  Scope of practice The scope of practice delineates the parameters of the specific practice. Radiotechnologist Scope of Practice The scope of practice of the medical imaging and radiation therapy professional includes: Providing optimal patient care. Receiving, relaying and documenting verbal, written and electronic orders in the patient’s medical record. Corroborating a patient's clinical history with procedure and ensuring information is documented and available for use by a licensed practitioner. Verifying informed consent for applicable procedures.  Assuming responsibility for patient needs during procedures. Preparing patients for procedures. Applying principles of ALARA to minimize exposure to patient, self and others. Performing venipuncture as prescribed by a licensed practitioner.  Starting, maintaining and/or removing intravenous access as prescribed by a licensed practitioner. Identifying, preparing and/or administering medications as prescribed by a licensed practitioner. Evaluating images for technical quality, ensuring proper identification is recorded. Identifying and responding to emergency situations.  Providing education. Educating and monitoring students and other health care providers. Performing ongoing quality assurance activities. Applying the principles of patient safety during all aspects of patient care. The scope of practice of the radiographer also includes: 1. Performing diagnostic radiographic and noninterpretive fluoroscopic procedures as prescribed by a licensed practitioner. 2. Optimizing technical exposure factors in accordance with the principles of ALARA. 3. Assisting the licensed practitioner with fluoroscopic and specialized radiologic procedures. Seven Cs of Malpractice Prevention Competence: Knowing and adhering to professional standards and maintaining professional competence reduce liability exposure Compliance: The compliance by health professionals with policies and procedures in the medical office and hospital avoids patient injuries and litigation Charting: Charting completely, consistently, and objectively can be the best defense against a malpractice claim Communication: Patient injuries and resulting malpractice cases can be avoided by improving communication among healthcare professionals Confidentiality: Protecting the confidentiality of medical information is a legal and ethical responsibility of health professionals Courtesy: A courteous attitude and demeanor can improve patient rapport and lessen the likelihood of lawsuits Caution: Personal injuries can occur unexpectedly on the premises and may lead to lawsuits