5 hours ago The primary steps in eliminating patient abuse are opening communication, providing education, establishing competency, eliminating tolerance of unacceptable behavior, and creating a code of mutual respect. A change in culture to one of mutual respect and dignity for staff members … >> Go To The Portal
Before reporting suspected violence or abuse, the Code says physicians should: Inform patients about requirements to report. Obtain the patient’s informed consent when reporting is not required by law.
Some care workers may not know what constitutes abuse. Long-time employees may not realize that previously approved practices are no longer acceptable. Newer employees may not be properly trained, and therefore lack understanding of what neglect and abuse are.
Exceptions can be made if a physician reasonably believes that a patient’s refusal to authorize reporting is coerced and therefore does not constitute a valid informed treatment decision. Physicians should also protect patient privacy when reporting by disclosing only the minimum necessary information.
One of the most obvious conundrums is that care workers, besides witnessing abuse and neglect, may also perpetrate it as hidden cameras planted by concerned family members have revealed time and again. Here are some of the reasons care workers don’t report elder neglect and abuse in LTCFs: Some care workers may not know what constitutes abuse.
Patient Abuse in the Health Care Setting: The Nurse as Patient Advocate. Incidents of verbal and physical patient abuse in health care settings continue to occur, with some making headline news. Nurses have a professional and ethical responsibility to advocate for their patients when incidents of abuse occur.
Nurses have a professional and ethical responsibility to advocate for their patients when incidents of abuse occur. Tolerating or ignoring inappropriate behaviors occurs for multiple reasons, including ignorance, fear of retaliation, the need for peer acceptance, and concerns for personal advancement. Nurses need to reflect on their biases ...
Patient neglect is an issue of increasing public concern in Europe and North America, yet remains poorly understood. This is the first systematic review on the nature, frequency and causes of patient neglect as distinct from patient safety topics such as medical error.
Patient neglect, defined as “the failure of a designated care giver to meet the needs of a dependent” [ 1] (p.437), has become an issue of concern in both North America and Europe [ 2, 3 ]. In the UK, this has been driven by media outlets [ 4, 5 ], charities [ 6 ], and health regulators [ 7 ].
This is the first literature review on the nature and causes of patient neglect. Accordingly no protocol exists to guide the review, so standard protocols for literature review were applied [ 28 ].
Figure 1 reports the results of the literature review. Ten research articles were included, with data largely collected in Scandinavia, South Africa, and the US. The majority of articles used survey methods to measure staff, family, or patient observations of neglectful behaviours [ 32 - 39 ].
There is growing public concern over patient neglect in healthcare institutions. To understand and explain what patient neglect is, and why it occurs, it has been necessary to draw on a range of psychology literatures.
In this article we developed a social psychology-based conceptual model to explain the occurrence and nature of patient neglect.
Professor Julian Bion for his helpful comments on an earlier version of this manuscript.
The predominant reason why nursing homes can be reluctant to report abuse externally seems to be the fear-inducing nature of the safeguarding response. Interviewees explained how this response tends to presume guilt, and assume allegations of abuse are true before anything is proven.
Owners and managers thought these two characteristics of safeguarding responses deterred people from reporting incidents and were driving abuse further “underground”.
The outcomes of an empirical research study (Moore, 2017) indicate that abuse is far from being always reported, internally or externally, and that it is sometimes deliberately concealed from outsiders such as relatives and external agencies.
An empirical research study found that abuse in nursing homes is not always reported, and sometimes it is deliberately concealed. Nursing and care staff replying anonymously to a questionnaire revealed that they were often under pressure to keep quiet about abuse.
Physicians reported that discussing the case with a knowledgeable colleague helped them decide whether or not to report suspicious injuries. The clinician's past experiences with CPS. Clinicians who believed that CPS involvement would result in a negative outcome for the child or family were less likely to report.
The level of suspicion required to report suspected abuse is not clearly defined. But, with the knowledge that physicians tend to underreport suspected abuse, the following recommendations are made to increase physicians' confidence in making appropriate reports: 1 Obtain continuing education regarding child maltreatment. Routinely seeking out local and national opportunities for continuing education related to child abuse and neglect can help you maintain a current understanding of child maltreatment. 2 Know reporting laws. Familiarizing yourself with the reporting laws and to whom reports should be made in your state (i.e., CPS or law enforcement) can lessen the ambiguity in the reporting process. 3 Consult with colleagues. Establishing collaborative relationships with colleagues to consult with regarding difficult cases can assist in the decision-making process. Physicians in private practice who do not have colleagues readily available may want to create a referral process with local agencies that have teams who make these decisions. 4 Know your local CPS staff. Forming relationships with your local CPS staff members can facilitate an open line of communication and establish a better sense of the guidelines used by the agency.
Physical abuse is any physical injury to a child that is not accidental and may involve, but is not limited to, hitting, slapping, beating, biting, burning, shaking, ...
Emotional and psychological abuse exposes a child frequently and repeatedly to behaviors that impact his or her psychological well-being, including blaming, threatening, yelling at, belittling, humiliating, name calling, pointing out faults, withholding emotional support and affection, and ignoring a child. In some cases, exposure ...
In sexual abuse, an adult or older child engages a child in sexual activities such as fondling, intercourse, oral-genital stimulation, sodomy, observing sexual acts, viewing adult genitals, and looking at, watching, or engaging in pornography.
The number of children who are maltreated annually in the United States is difficult to document because: (1) definitions vary across tribal, state, and federal jurisdictions; (2) the standards and methods of collecting data vary considerably; and (3) many cases go unrecognized and unreported [5].
Such instances present physicians with difficult decisions. It is not the physician's responsibility to determine the intent of the parent or caregiver, or whether abuse or neglect occurred.
On the other hand, by not reporting the abuse, the psychologist may collude with the client in keeping her silence and in letting the abuser maintain power and control over her, which violates her autonomy and may not be in her best welfare.
To protect others from harm, the psychologist should explore whether the client is aware of any ongoing abuse, or danger of abuse. If the client lacks the answers to these questions, the potential harm from these relatively unknown risks must be weighed against the risks to the client if confidentiality is broken.
Three levels of ethical concerns should inform psychologists' decision-making: the aspirational level (ideal, moral principles), the professional level (standards set by a professional organization, e.g., APA) and the legal level (laws that mandate the standards of behavior that society will tolerate). When a conflict exists (e.g., the aspirational obligation to respect client's autonomy and the legal obligation to report abuse), psychologists face ethical dilemmas. Confidentiality is the bedrock of psychotherapy. If a psychologist breaks confidentiality, he or she violates the obligation to respect the client (the principles of justice and autonomy) and may cause harm (violating the principle of nonmaleficence). At the professional level, psychologists "have a primary obligation" to respect the confidentiality rights (Standard 5.01). At the legal level, privacy is a right guaranteed by the Fourth, Fifth and Fifteenth amendments of the U.S. Constitution and states have laws that mandate confidentiality.
If a psychologist breaks confidentiality, he or she violates the obligation to respect the client (the principles of justice and autonomy) and may cause harm (viol ating the principle of nonmaleficence). At the professional level, psychologists "have a primary obligation" to respect the confidentiality rights (Standard 5.01).
If the client expresses fear for the safety of other potential victims, the psychologist can help the client evaluate her options. Taking steps to confront an alleged perpetrator by reporting to state authorities or notifying others will require disclosure of the client's status as a prior victim.
When a conflict exists (e.g., the aspirational obligation to respect client's autonomy and the legal obligation to report abuse), psychologists face ethical dilemmas. Confidentiality is the bedrock of psychotherapy.
The choice belongs to the client. In the final analysis, the psychologist must respect the client's wishes or risk committing yet another betrayal potential ly more devastating than the prior abuse .
Nurses should provide a calm, comforting environment and approach the patient with care and concern. A complete head-to-toe examination should take place, looking for physical signs of abuse. A chaperone or witness should be present if possible as well.
As mandated, they are trained to identify signs and symptoms of abuse or neglect and are required by law to report their findings. Failure to do so may result in discipline by the board of nursing, discipline by their employer, and possible legal action taken against them. If a nurse suspects abuse or neglect, they should first report it ...
Employers are typically clear with outlining requirements for their workers, but nurses have a responsibility to know what to do in case they care for a victim of abuse.
The nurse should notify law enforcement as soon as possible, while the victim is still in the care area. However, this depends on the victim and type of abuse. Adults who are alert and oriented and capable of their decision-making can choose not to report on their own and opt to leave. Depending on the state, nurses may be required ...
While not required by law, nurses should also offer to connect victims of abuse to counseling services. Many times, victims fall into a cycle of abuse which is difficult to escape.
If Carly had younger siblings living with her father, for instance, she might need to report the abuse in order to protect the children. If Carly lived in a state that legally required social workers to report past abuse ...
On balance, given the facts of the case as interpreted by Gretchen, she decides to permit Carly to decide whether or not to report the abuse. This course of action not only respects Carly’s rights to self-determination and privacy, but also affords Gretchen with the opportunity of continuing to work with Carly.
Those workers who understand and witness neglect and abuse may not report it for fear of being censured, vilified, blamed, shunned by their co-workers or even of losing their jobs.
On the other hand, many care workers clearly do understand what constitutes abuse and neglect. In a 2001 study, care workers identified twenty-five such practices. Normalization might be restated thus: “If everyone else does it, it must be okay,” and if something is “okay” there’s no need to report it.
In particular, workers may not know that, for example, speaking down to people who live with dementia, overmedicating them instead of meeting unmet needs, not providing them appropriate stimulation and activities, and other common practices are in fact considered abuse.
Just as pedophiles enter the priesthood and other professions that make it easy to access victims while avoiding detection, elder abusers don’t want to report abuse, they want to continue abusing. That leaves it up to the rest of us to find out who the abusers are and to stop them.
“If a therapist fails to take reasonable steps to protect the intended victim from harm, he or she may be liable to the intended victim or his family if the patient acts on the threat ,” Reischer said.
“Clients should not withhold anything from their therapist, because the therapist is only obligated to report situations in which they feel that another individual, whether it be the client or someone else, is at risk,” said Sophia Reed, a nationally certified counselor and transformation coach.
A therapist may be forced to report information disclosed by the patient if a patient reveals their intent to harm someone else. However, this is not as simple as a patient saying simply they “would like to kill someone,” according to Jessica Nicolosi, a clinical psychologist in Rockland County, New York. There has to be intent plus a specific identifiable party who may be threatened.
For instance, Reed noted that even if a wife is cheating on her husband and they are going through a divorce, the therapist has no legal obligation whatsoever to disclose that information in court. The last thing a therapist wants to do is defy their patient’s trust.
“If a client experienced child abuse but is now 18 years of age then the therapist is not required to make a child abuse report, unless the abuser is currently abusing other minors,” Mayo said.