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    5530: Chapter 13 5530: Chapter 13 Presentation Transcript

    • Chapter 13Legal Reporting Requirements 2
    • Child AbuseAn abused child is one who has suffered intentional serious mental, emotional, sexual, and/or physical injury inflicted by a family or other person responsible for the childs care. Some states extend the definition to include a child suffering from starvation. 3
    • Child Abuse Who Should Report• How Do You Detect Abuse• Good Faith Reporting – Psychologist Immune to Liability 4
    • Child Abuse – III• Failure to Report Child Abuse – Psychologist’s Failure to Report Abuse – Nurse’s Failure to Document and Report – Physician Entitled to Immunity 5
    • Elder AbuseElder abuse is any form of mistreatment that results in harm or loss to an older person. It can involve: – physical abuse – sexual abuse – domestic violence – psychological abuse – financial abuse – neglect: failure to provide needed care 6
    • National Center on Elder AbuseThe National Center on Elder Abuse(NCEA), directed by the U.S. Administrationon Aging, is committed to helpingnational, state, and local partners in the field befully prepared to ensure that older Americanswill live withdignity, integrity, independence, and withoutabuse, neglect, and exploitation. 7
    • Signs of Elder Abuse – I• Unexplained or unexpected death• Development of "pressure sores“• Heavy medication & sedation used in place of adequate nursing staff• Occurrence of broken bones• Sudden emotional outbursts, agitation, or withdrawal 8
    • Signs of Abuse – II• Bruises, welts, discoloration, burns, and so on• Absence of hair and/or hemorrhaging below scalp• Dehydration/malnourishment without illness related cause• Hesitation to talk openly• Implausible stories 9
    • Signs of Abuse – III• Unusual or inappropriate activity in bank accounts• Signatures on checks & other written materials that do not resemble patients signature• Power of attorney given, or recent changes or creation of a will, when person is incapable of making such decisions 10
    • Elder Abuse Signs of Abuse – IV• Missing personal belongings such as silverware or jewelry• An untreated medical condition• Patient unable to speak for himself or herself, or see others, without presence of caregiver (suspected abuser) 11
    • Preventing Abuse Policies & Procedures• Prohibition of mistreatment• Description of reporting procedures regarding alleged abuse• Maintenance of evidence of alleged abuse• Investigation of alleged abuse, & prevention of further potential abuse while investigation is in progress. 12
    • Elder Abuse Documentation – I• Suspected abuse should be defined clearly & objectively. – Witnesses: Reporters of abuse must describe statements made by others as accurately as possible • what actions were taken, by whom, when, where, etc. • Info should be included about how witnesses may be contacted. 13
    • Elder Abuse Documentation – IIPhotographs: It may be necessary to photograph wounds or injuries. • hospital emergency room or the police department can be asked to photograph in emergency situations. 14
    • Communicable Diseases• Reported to protect citizens from infectious diseases• Reporting required by statutes 15
    • Births & Deaths• Reportable by statute• Necessary to maintain accurate census records 16
    • Suspicious Deaths• Referral to medical examiner • Violent deaths • Criminal activity• Medical Examiner • Determines cause of death • Provides information for criminal investigation 17
    • Health Care Quality Improvement Act of 1986 Authorizes the National Practitioner Data Bank to collect & release information on the professional competence & conduct of health care practitioners. 18
    • National Practitioner Data Bank - I• Reporting requirements• Required queries• Required Report• Data Bank Queries 19
    • National Practitioner Data Bank - II• Query Fees• Data bank fees• Penalties for failing to report• Confidentiality of data bank information 20
    • Incident Reporting• Incident/Occurrence Reports Discoverable• State Reportable Incidents – Incidents that have resulted in a patient’s serious injury or death – events such as fire, loss of emergency power, infection outbreaks, & strikes by employees.• Incident reports should not be placed in the medical record. 21
    • Sentinel Events - I• Joint Commission Reportable “sentinel events” include: – Events that result in • unanticipated death • major permanent loss of function 22
    • Sentinel Events - II• Suicide• Unanticipated death of a full term infant• Infant abduction• Rape• Hemolytic transfusion reaction• Surgery on the wrong patient or wrong body part 23
    • Root Cause Analysis – IA process for identifying the basic or causalfactors that underlie the variation inperformance including the occurrence orpossible occurrence of a sentinel event. 24
    • Root Cause Analysis – II• Thorough• Credible• Investigation involves general & special causes• Researching literature• Searching for best practices• . . . implementing & monitoring change 25
    • Corporate Compliance ProgramsFederal government’s initiative to investigate& prosecute health care corporations forcriminal wrongdoing . . . 26
    • Elements of a Corporate Compliance Program1. Establishment of policies & procedures2. Appointment of a corporate compliance officer3. Communication of program to employees4. Implementation of program5. Consistent enforcement6. Provide for disciplinary action7. Modify compliance program as necessary 27
    • REVIEW QUESTIONS1. What is child abuse?2. Who should report child abuse?3. Describe the signs of elder abuse.4. Why was the Health Care Quality ImprovementAct of 1986 enacted?5. Describe the purpose of the NationalPractitioner Data Bank. 28
    • REVIEW QUESTIONS, cont.6. What is a sentinel event?7. Discuss the process of conducting a root-causeanalysis.8. Describe the basic elements of an effectivecorporate compliance program. 29