12 hours ago · Patients may refuse treatments for many reasons, including financial concerns, fear, misinformation, and personal values and beliefs. Exploring these reasons with the patient may reveal a solution or a different approach. Involve Family Members and Caregivers. Involving family members and other loved ones in the conversation can help get ... >> Go To The Portal
The documentation of a patient's informed refusal should include the following: identify the potential benefits and risks of the intervention; note that the patient has been told of the risks — including possible jeopardy to life or health — in not accepting the intervention;
If the patient cannot be reached by the available contact information, try other means including online sources as warranted by the clinical importance of contacting the patient. Assess how reliably individual patients are likely to be contacted and customize your approach.
KP: A simple example of when treatment over a patient’s objection would be appropriate is if a psychotic patient who had a life-threatening, easily treatable infection was refusing antibiotics for irrational reasons. Treatment would save the patient’s life without posing significant risk to the patient.
Competent patients have a right to refuse treatment. This concept is supported not only by the ethical principle of autonomy but also by U.S. statutes, regulations and case law.
Non-adherence: is generally a term which includes unintentional refusalby the patient (i.e. patient is overwhelmed, does not understand, helpless, confused, and/or concerned with healthcare costs).
Failure to report errors may subject clinicians to disciplinary action and increased risk for legal liability. Beneficence and nonmaleficence are ethical concepts that are violated when an error is not reported. Practitioners often fear they will gain a reputation for committing mistakes and may not self-report.
Physicians' training and attitudes place additional barriers to reporting errors. As the gatekeeper for a patient's care, the physician who commits an error, especially one that harms the patient, may feel deep shame, guilt, and a sense of failure.
Medication errors have significant implications on patient safety. Error detection through an active management and effective reporting system discloses medication errors and encourages safe practices.
Most importantly, communication supports the foundation of patient care. So, hand-off reporting during shift change is a critical process that is crucial in protecting a patient's safety. Throughout the hand-off report, it is vital to provide accurate, up-to-date, and pertinent information to the oncoming nurse.
The reporting of incidents to a national central system helps protect patients from avoidable harm by increasing opportunities to learn from mistakes and where things go wrong.
Fear of punishment and legal consequences in clinical practice has always been one of the barriers to error reporting. It is estimated that about 95% of medication errors are not reported due to the fear of punishment.
Most hospitals currently rely on voluntary reporting. A 2011 Health Affairs study, however, found that voluntary reporting missed 90% of adverse events.
Recommendations suggest that the disclosure be made soon after the mistake occurs. 36 Typically, patients do not expect a medical mistake to occur. Hence, the disclosure timing is important to consider, as are general precautions and best practices surrounding disclosure of all bad news.
They prevent duplication of work, decrease errors and show efficiency level of the staff. Records and reports hold an important place in the process of educational administration.
The U.S. Food and Drug Administration (FDA) receives more than 100,000 U.S. reports each year associated with a suspected medication error. FDA reviews the reports and classifies them to determine the cause and type of error.
The most common causes of medication errors are: Poor communication between your doctors. Poor communication between you and your doctors. Drug names that sound alike and medications that look alike.
Medical treatment could be unauthorized because the doctor didn’t fully explain either the procedure or the risks associated with the procedure. First, the patient must show that the doctor performed the treatment or procedure without her informed consent.
If a doctor fails to obtain informed consent for non-emergency treatment, he or she may be charged with a civil offense like gross negligence and/or a criminal offense such as battery or gross negligence which is the unauthorized touching of the plaintiff's person. In a civil suit, the patient would have to show two elements. Medical treatment could be unauthorized because the doctor didn’t fully explain either the procedure or the risks associated with the procedure. First, the patient must show that the doctor performed the treatment or procedure without her informed consent. Second, the patient has to show that had she known about the risks of the procedure, she would’ve decided not to have it done and, therefore, avoided the injury.
First, the patient must show that the doctor performed the treatment or procedure without her informed consent. Second, the patient has to show that had she known about the risks of the procedure, she would’ve decided not to have it done and, therefore, avoided the injury.
Informed Consent. Virtually all states have recognized, either by legislation or by common law, the right to receive information about one's medical condition, treatment choices, risks associated with the treatments, and prognosis.
The informed consent process isn’t only an ethical obligation for doctors -- it is also a legal one. State laws often take a patient-centered approach.
Minors, unlike adults, are generally presumed to be incompetent. Therefore, they are unable to give consent to medical treatment and procedures. In these cases, the parent or guardian of the child must give consent on the minor’s behalf.
In order to give his or her informed consent, a patient must be competent. Generally, adults are presumed to be competent. However, this presumption can be challenged in cases of mental illness or other impairments. Minors, unlike adults, are generally presumed to be incompetent.
Negligence is the failure to use ordinary care, that is, failure to do that which a health care provider of ordinary prudence would or would not have done under the same or similar circumstances. One of the main issues in this case was documentation.
The patient had a fever of just above 100 degrees every day during his 3-day admission, including the day of discharge. According to the cardiologist, but not documented in the patient's medical record, the patient declined cardiac catheterization and wanted to be discharged home.
A patient had a long-standing history of coronary artery disease, suffering his first myocardial infarction (MI) at age 47. He had recurrent chest pain a year later and underwent a work up to rule out MI. He was treated medically without invasive procedures. Four years after the first MI, he came to a new cardiologist, the defendant in this case.
Prudent practice involves comprehensive documentation. As with the informed consent process, informed refusal should be documented in the medical record. In the case study, the jury found in favor of the plaintiffs when faced with a deceased patient and an undocumented patient decision of great importance.
INFORMED REFUSAL. Texas law recognizes that physicians must obtain consent for treatment and that such consent be "informed.". A variant of informed consent is informed refusal, in which a patient refuses treatment after having been informed of the risks and benefits of the intervention. Many physicians associate the concept ...
The jury found the physician negligent and awarded damages of approximately $50,000 for funeral costs, medical expenses, and past mental anguish.
However, as the case study illustrated, a patient's refusal to consent to a recommended intervention can occur under a variety of circumstances, and can lead to lawsuits involving allegations of failure to treat or failure to inform. "Implicit in and intrinsic to the concept of consent for treatment is the option of refusal.
If this negligence caused you to suffer financial damages, you could be entitled to recover compensation for these damages through a medical malpractice claim. To learn more, contact our team at Baizer Kolar, P.C. today to set up your initial consultation in our Chicago office.
Failure to disclose any relevant information about a medical procedure is an act of medical malpractice because it robs the patient of the ability to provide his or her informed consent to the procedure. Patients have the right to know what is being done to their bodies and why. They also have the right to decide not to undergo a specific medical treatment, which is a determination frequently made after weighing the risks and benefits of the procedure.
The corresponding obligation on the part of the physician is to obtain voluntary informed consent when a patient is to be subjected to surgery and, increasingly, to some nonsurgical interventions as well.
Treatment typically includes dietary and environmental modification, prophylactic medications, analgesics, and, more invasively, chemical or surgical denervation procedures. The combination of diet, prophylaxis, and analgesic is reasonably effective for the majority of patients, but not for all [2-4].
There are no reliable diagnostic markers or radiological findings. Nevertheless, in the United States, almost every patient who reports migraine headaches is subject to neuroimaging studies (CT or MRI) at some point, if only to exclude an underlying vascular lesion, space-occupying mass, or other treatable pathology.
Health care organizations can do the same. If the patient cannot be reached by the available contact information, try other means including online sources as warranted by the clinical importance of contacting the patient. Assess how reliably individual patients are likely to be contacted and customize your approach.
Whatever is done should be documented in the medical record for the usual reasons: to communicate to others what has been done and to provide written or electronic documentation in case the failure to contact becomes the subject of a lawsuit.
The malpractice standard of care requires an effort to contact patients about abnormal test results that is proportionate to the harm that might occur without proper follow up. Two steps that could reduce the harm from failure to contact patients about abnormal test results are engaging patients in following up on pending tests ...
The ultrasound technician did not notice the abnormal test result or the fact that the chlamydia infection had not been treated. The following day, a different OB/GYN clinic nurse tried to call the patient with the ultrasound results, and again no one answered the phone.
Remember, the purpose of documentation is to communicate with other members of the health care team. (If you are the only person who can read your handwriting, your documentation won’t communicate anything to anybody!)
Patients in acute care settings tend to be quite sick. If you are ordered to document vital signs every four hours, it’s important to take the vitals—and document the results—on time.
Home health clients on Medicare must be homebound—and must need help with bathing— to receive the services of a home health aide. Your documentation should show that your client meets these requirements. However, if your client has already bathed when you arrive, document the reason and tell your supervisor right away.