5.2 legal practices


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National Healthcare standard power point for standard 5 legal practices

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  • This PowerPoint is designed to review legal practices in a healthcare setting, and should include student questioning and discussion.
  • Activate prior learning. At screen title, ask if any students know what HIPAA stands for.Remind students that HIPAA is a federal (US government) law.Do any students know what HHS stands for? It is the Department of Health and Human Services. Do they know who the currently serves as the Secretary of Health and Human Services?
  • Ask students if they have ever seen or signed a HIPAA consent form.Ask if they had ever heard about HIPAA before learning about HIPAA in their health science class. (students examples can help connect learning.)
  • Answer Key:Department of Health and Human ServicesYesNo – Many times a physician may talk with family members but they will not share confidential information.Yes. HIPAA requires that patients can get a copy of their records but does not prevent offices from charging a fee.No. Births and deaths are required by law to be reported and registered according to the laws of the state.
  • Point out to students that the correct term is “advance” and not “advanced.”
  • Help students understand the POA can be done in addition to a living will or instead of a living will.
  • After reading the bullet points, ask students to summarize the PSDA in their own words.
  • Answer KeyLegally, if the facility accepts federal money, then the physician cannot refuse a living will request. Otherwise, it would depend on state law.The intent of the PSDA is to protect a patient’s right to have an advance directive followed.NoNoThe nurse should not call a code, or rather should notify the doctor and allow the patient to die with dignity.
  • The purpose of this slide is to let students know that there are many organizations and professions who have written statements about the observance of patients’ rights.
  • Ask students, which of these two standards do you think is most often compromised in a health care setting? The discussion will help students think about the rights by drawing from their own experiences.
  • Ask students - Do you think most patients are fully informed before giving consent to medical procedures?
  • Ask students – what law covers the confidentiality of all communication and records? They should ALL get this right.
  • Ask students – can you think of any example of when facility relationships would matter to a patient?
  • Ask students – do you think patients ever negotiate their doctor bills or other healthcare charges?
  • Point out to students that Patient’s Rights usually refers to hospitalized patients. Resident’s rights involve the rights of residents in long-term care or nursing homes.Ask students – how are resident’s rights different from patient’s rights?
  • Answer KeyYesYesTalk to the surgeon, share concerns, and request a different anesthetistOpinion question
  • Explain to students that as a health professional, they may be asked to witness a consent form.
  • Answer KeyNo, because a patient must be of sound mind to legally sign a consent?Possibly, yes. If the physician has properly informed the patient of the procedure, risks, and intended outcomes, then yes, the signature is legal. It is possible that the legality of the signature could be questioned if the all the rules for informed consent have not been followed.No
  • These are three labor laws that affect the employment of healthcare workers.
  • Introduce this content by helping students understand the importance of this topic. Sometimes young people have a tendency to make light of the discussion of sexual harassment, but they really should take it seriously and learn the difference between actions that are permitted and not appropriate.
  • This might also be a good time to mention that healthcare workers should use care when forwarding funny e-mails, particularly from work e-mail.
  • Explain the concept of chain of command. Ask students why they think it is important to follow the chain of command – why not just file a formal grievance every time they do not like something at work?
  • Many malpractice lawsuits are a result of violation of scope of practice. Make sure students know that scope of practice varies from state to state in many different health professions. For example, in some states, Optometrists can perform eye surgery – in other states, only an ophthalmologist can perform eye surgery.
  • Answer KeyNoYesUsually, noAsk him/her to stop, and tell him/her that the sexual comments make you uncomfortable
  • OSHA rules provide for safe working conditions.The office would be required to make reasonable accommodations for Roxy if hired. They may not refuse to hire her because she has a disability, although they may have other reasons for not hiring her.You should file a grievance when your efforts to resolve a problem following the chain of command have not been successful.Yes
  • 5.2 legal practices

    1. 1. In a healthcare setting
    2. 2.  5.21 Apply standards for HIPAA. 5.22 Describe advance directives. 5.23 Summarize the Patient’s Bill of Rights. 5.24 Understand informed consent. 5.25 Explain laws governing harassment, employment and scope of practice.
    3. 3.  Health Insurance Portability and Accountability Act Federal protection for privacy of health information in all states. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule
    4. 4.  Patients must sign HIPAA consent form for health care provider.
    5. 5.  Onlyexception to confidentiality rules is information that must be reported by law to protect the safety and welfare of the public.  Births and deaths  Injuries caused by violence that require police involvement  Communicable diseases  Sexually transmitted diseases
    6. 6. 1. What federal department regulates HIPAA?2. Must a patient sign a HIPAA authorization form before his/her physician’s office files an insurance claim for the patient?3. Can a physician give a son confidential information about his father’s condition without the father’s written consent?4. Karen wants a copy of her dental x-rays. Can the dental office charge her $10 to provide her with a copy?5. Brenda has a baby but does NOT want the information made public. Can she refuse to have the birth registered?
    7. 7.  Also known as “legal directives” A legal document They allow individuals to state what medical treatment they want and do not want if they become incapacitated. Two main directives:  Living will  Durable power of attorney (POA)
    8. 8.  Document that states measures that should not be taken to prolong life when the patient is terminal. Must be signed when individual is competent and witnessed by two adults who would not benefit from the death. Most states have laws that honor living wills. Living wills often have a Do Not Resuscitate (DNR) request. If so, a doctor may write a Do Not Resuscitate order.
    9. 9.  Also “Designation of Health Care Surrogate” or “Medical Power of Attorney” Permits an individual (known as a principal) to appoint another person (known as an agent) to make healthcare decisions if the principal becomes unable to make decisions. Usually given to spouse or adult children. May be given to any qualified adult. POA must be signed by the principal, the agent, and two adult witnesses.
    10. 10.  Abbreviated PSDA Federal law in 1990 Facilities receiving federal aid must:  Inform patients of their right to make decisions concerning their medical care, including right-to-die.  Provide assistance in preparing advance directives.  Document advance directives in patient record.  Provide written statements to implement the patient’s requests.  Affirm no discrimination because of advance directives.  Educate staff on legal issues regarding advance directives.
    11. 11. 1. If a patient legally signs a living will, can a physician refuse to cooperate?2. What is the intent of the PSDA?3. Robert has never been married and has no children. Can he give durable power of attorney to his cat?4. Barney is very ill. His daughter puts a pen in his hand and bullies him into signing a Living Will. Is that legal?5. Joe has signed a living will and the doctor writes a DNR order. What should the nurse caring for him do if he experiences cardiac arrest?
    12. 12.  Many different forms  American Hospital Association – Patient’s Bill of Rights  Mental Health Patient’s Bill of Rights  Patient’s Bill of Rights for Medicare and Medicaid  Resident’s Bill of Rights (OBRA)  Managed Care Bill of Rights  Complementary and Alternative Care Client Bill of Rights  Etc.
    13. 13.  Considerate and respectful care. Obtaincomplete, current information concerning diagnosis, treatment and prognosis.
    14. 14.  Receive information I refuse. necessary to give informed consent prior to the start of any procedure. Have advance directives for health care and/or refuse treatment to the extent permitted under law.
    15. 15.  Privacy concerning a medical care program. Confidentialtreatment of all communications and records. Reasonable response to a request for services.
    16. 16.  Obtain information regarding facility relationships to other healthcare and educational institutions. Right to refuse to participate in research. Reasonable continuity of care.
    17. 17.  Review medical records, examine bills, get explanations of care and charges. You owe $9,999,999 Be informed of for your hospital rules and office visit! regulations, and available resources to resolve disputes or grievances.
    18. 18.  Freedom from abuse and chemical/physical restraints. Participate in family/resident groups and in social, religious and community activities. Manage personal funds and use personal possessions. To share a room with his/her spouse if both are residents.
    19. 19. 1. A physician walks into a patient’s room with three medical students. Does the patient have the right to ask the medical students to leave?2. Does a patient have the right to challenge charges on his/her hospital bill?3. A nurse anesthetist visits a patient before surgery, but the patient is not comfortable with the anesthetist. What should he/she do?4. Do you think nursing homes ever violate any residents’ rights? Which ones?
    20. 20.  Informed consent is permission granted voluntarily by a person who is of sound mind after the procedure and all risks have been explained in terms the person can understand. Can be verbal, but for most procedures, should be in writing. Person can withdraw consent at any Consent time. Form Procedures should not be performed if the patient does not give consent.
    21. 21. 1. If a patient gives permission for a procedure but is heavily drugged at the time, is that legal?2. If a patient signs a consent form without reading the form, have the rules for informed consent been legally met?3. If a patient signs a consent form and, while of sound mind, changes his mind about having the procedure, can the physician still perform the procedure?
    22. 22.  Americans with Disabilities Act  Prevents employment discrimination against disabled workers who are qualified to perform the job with reasonable accommodations. Civil Rights Act of 1964  Prevents hiring discrimination on the basis of race, color, religion, sex, age or national origin. Occupational Safety and Health Act (OSHA)  Prevents unsafe working conditions.
    23. 23.  Unwelcome actions that are sexual in nature. Victim and harasser may be man or woman, and may not be of the opposite sex. Harasser can be a supervisor, coworker, or nonemployee. Victim can be anyone affected by offensive conduct. One of these days you’re going to stop pretending you don’t want to go out with me.
    24. 24.  Victims should first speak Doctor Jay, please do directly to the harasser. not ask me out again. I Clearly identify the have a boyfriend and you are making me very unwelcome behavior and that uncomfortable. it must stop. If the harassment continues, follow the facility’s sexual harassment policy.
    25. 25.  Avoid discussing sexual matters not related to the job. Do NOT tell dirty jokes. Avoid sharing intimate details of your personal life at work. Do NOT joke about sexual matters. Avoid touching coworkers and patients in suggestive ways.
    26. 26. A complaint about a circumstance considered to be unfair or potentially harmful. Learn facility grievance policy. Usually best to resolve workplace issues at the lowest level possible. Start with your immediate supervisor. Only file a grievance after working up the chain of command.
    27. 27.  What one is legally allowed to do in one’s profession. You MUST understand and practice within the guidelines of your profession. A supervisor should only ask you to perform activities within your scope of practice. In most instances, you should refuse to perform skills outside your scope of practice.
    28. 28. 1. A healthcare worker tells dirty jokes to coworkers who encourage the jokes. Is this sexual harassment?2. A male pharmacist makes crude comments about women to nobody in particular. A pharmacy assistant who hears his remarks finds the remarks offensive. Is this sexual harassment?3. Are workplace romances considered sexual harassment?4. What should you do if someone at work makes sexual comments that make you uncomfortable?
    29. 29. 5. What role does OSHA play in protecting the worker?6. Roxy applies for a job as a medical receptionist. She is well qualified for the job, but is a double- amputee and uses a wheelchair. Can she be denied the job because her wheelchair use might require the office to make some renovations?7. When should you file a grievance?8. Do nursing assistants have a scope of practice?
    30. 30.  Healthcare workers must know and follow the law in the practice of his/her profession – in order to safeguard the rights of the patient and the integrity of the profession. Spend your career here . . . . not here.