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93 Cards in this Set
- Front
- Back
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What is HPSP? What is HPSP's mission?
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Health Professionals Services Program. Mission is to enhance public safety in healthcare.
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What are HPSP's goals?
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To promote early intervention, dx & tx for impaired health professionals & provide monitoring services as an alternative to board discipline.
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What are some factors that make an individual ineligible for HPSP services?
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Termination from HPSP or any other state professional program for noncompliance, diversion of controlled substances for other than self administration, currently under Board Disciplinary Order for Correction Action Agreement, being monitored for HIV or HBV by Department of Health, been accused of sexual misconduct or continued practice would create a serious risk of harm to the public.
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T or F: HPSP serves health professionals with substance, psychiatric & other medical disorders.
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True
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What are the purposes of credentialing & privileging?
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Ensure quality, identify providers, protect the public & control the practice.
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How does JCAHO define credentialing?
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Process of obtaining, verifying & assessing qualifications of health care practitioners.
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Define privileging.
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Process whereby a specific scope & patient care services are authorized for a health care practitioner by a healthcare organization based upon evaluation of the individual's credentials & performance.
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T or F: Some states have nursing rules or regulations that require CRNAs to be supervised by an anesthesiologist.
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False, some nurse practice acts or state laws governing healthcare do require CRNAs practice under physician supervision or direction.
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What are primary sources?
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Organizations which issue credentials (boards of nursing or anesthesia schools). Employment primary sources are hospitals or facilities in which experience is obtained.
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What is the NPDB?
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National Practitioner Data Bank. Practitioners are reported to it that have either made a settlement in a claim or been found guilty of a legal claim. CRNAs have a right to enter an explanation r/t the claim. Hospitals & other credentialing bodies must query the NPDB.
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Define jurisdiction.
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A geographic area over which the entity has the power to adopt, implement & enforce laws. Practical authority granted to a formally constituted legal body to deal with & make pronouncements on legal matters &, by implication, to administer justice within a defined area of responsibility.
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Define statutes.
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Laws, enacted by state legislatures.
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Define regulations.
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Rules, specific written policies adopted by an administrative agency, generally have the force of law.
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Define licensure.
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Governmental process designed to protect the public (public health, safety & welfare).
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Define certification.
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Non-governmental agency attests that an individual has met certain pre-established standards of skill, knowledge or ability.
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Define accreditation.
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Non-governmental process that assess an institution's compliance with a standard.
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What is the importance of Dent v Virginia?
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Confirmed that states have the authority as part of their police power to license & regulate health care professionals (1889).
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What year did MN formally regulate the practice of CRNAs? How did the law define practice with regard to physicians? Has the law been changed since?
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1999 (Nurse Practice Act), CRNA collaborates with physicians & defines scope of practice, has not been updated since 1999.
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In MN, how long following graduation can a SRNA practice before taking the certification exam?
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Six months, if fail exam, cannot practice until retaken & passed.
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When was COA established? How many members?
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Council on accreditation formed in 1975, has 11 members & 1 student.
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When were mandatory CE requirements for recertification approved & implemented? How many CEs are required?
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Approved 1977, implemented 1978, 40 hours every 2 years
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When was the COR established? How may members?
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Council on recertification formed in 1978, has 9 members
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Who is the chair of the COA?
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Becky
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When was the COC established? How many members?
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Council on certification formed in 1975, has 11 members & 1 student
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When was the first certification exam administered?
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June 4, 1945; has been a requirement for practice since
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What is the SEE test?
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Self Evaluation Examination, 160 question long, based on a blueprint reflects the COA's minimum curriculum requirements, scoring compared with peer group
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What is the NCE?
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National Certification Exam, 90-160 questions, based on professional practice model, scaled scores
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What qualifications are necessary to take the NCE?
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Unrestricted professional nursing license, graduate of an accredited program & meet graduation requirements for clinical experience, completed application/copy of license, payment of a fee & certify as to eligible status
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What is the NBCRNA?
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National Board on Certification & Recertification of Nurse Anesthetists, COC & COR merged to form in Summer of 2007.
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Who is a co-chair of NBCRNA?
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Mary Ann
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What is the CPIA?
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Council for Public Interest in Anesthesia, 11 members & one student, formed in 1975 & currently disbanded
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What is the hallmark of a profession?
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Its ability to set its own standard of care.
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What are the six sources of law?
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Constitution, legislature, courts, common law, executive branch & administrative agencies
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What are the two basic functions of the attorney general?
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Brings lawsuits & represent the country or state in court. Interprets the law for various branches of the government.
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What is the importance of attorney general opinions?
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Official advisory statements (not mandatory orders) that are very persuasive & influence court deliberations & legislative actions.
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What are torts?
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Civil wrongs recognized by law as grounds for a lawsuit.
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What are civil matters?
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Disputes between individuals
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Would medicare fraud be tried in federal or state court?
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Federal
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A medical malpractice suit would be tried in federal or state court?
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State
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What broad category does medical malpractice fall under?
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Tort
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What are the three types of torts?
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Intentional, unintentional & strict liability
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Define medical malpractice.
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Act or omission by a healthcare provider which deviates from accepted standards of practice established by the medical community, which leads to injury of the patient.
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What are four basic components of a malpractice suit?
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Duty, breach, causation & damage
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What are the components of duty?
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Duty to perform, duty to perform in an acceptable manner & duty not to perform
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What are the two ways to end duty?
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Lack of need for further care or relieved by another qualified person
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What are the three types of consent?
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Expressed, implied-in-fact & implied -in-law
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What must be discussed for informed consent?
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Diagnosis, procedure, probability of success, risks & reasonable alternatives
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Who can give consent?
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Patient (> 18 years), next-of-kin, court designated guardian, POA or emancipated minors
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Who can give consent for minors?
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Parent or guardian
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When is a minor considered emancipated?
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If they are a parent, married or live on their own
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What is breach of duty? What two types of errors can it include?
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Practice that falls below level required by law. Error of commission & error of omission.
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What is an error of commission?
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Error made in the performance of an act.
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What is an error of omission?
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Plaintiff has burden of proof & must prove a deviated from standard of care.
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What is a standard of care?
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A diagnostic & treatment process that a clinician should follow for a certain type of patient, illness or clinical circumstances.
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T or F: Anesthesiologists & CRNAs share the same standard of care
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True
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What should a practitioner do if they deviate from standard of care?
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Fully document the reason.
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How is standard of care determined in medical malpractice suit?
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Expert testimony, anesthesia textbooks & professional organization standards
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What are the two types of causation in law?
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Cause-in-fact ("but for") & proximate (legal) cause
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How is causation established?
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Deviation from standard of practice (negligence), presence of damages & proof that damages were caused by negligent act
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What is cause-in-fact?
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But for the action, the result would not have happened.
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What is proximate cause?
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Event sufficiently r/t a legally recognizable injury to be held the cause of the injury
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When is a defendant not liable?
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Possibility of damage was remote or unforeseeable & damage would not have been caused without the presence of a remote, independent intervening factor
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What are damages awarded for? When what is proved by plaintiff?
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Financial, physical &/or emotional harm. Duty, breach of duty & causation.
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What are the three burdens of proof?
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Beyond a reasonable doubt, clear & convincing & preponderance of evidence ("more likely than not")
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What is res ipsa loquitur? When did it originate?
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The thing speaks for itself, England 1863
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What is an amicus curiae?
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Friend of the court; amicus brief is a document filed in a court by someone not directly r/t to case under consideration
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What is vicarious liability?
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Holding someone liable for the negligence of another
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What is respondent superior?
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Employer responsible for actions of employee performed within the course of their employment
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Who discovered anesthesia?
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Horace Wells (dentist) in 1844 used nitrous oxide, discredited. William T.G. Morton in 1846 used diethyl ether.
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Who is Catherine Lawrence?
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First documented nurse administering anesthesia, used chloroform during 2nd Battle of Bull Run during Civil War.
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Who is Sister Mary Bernard?
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First recorded nurse to specialize in anesthesia (1877).
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Who is Alice Magaw?
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Mother of Anesthesia, started working as nurse anesthetist at St. Mary's Hospital (Mayo) in 1893, later taught & published papers.
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Who is Florence Henderson?
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Worked at Mayo starting in 1903, published papers.
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What is Lakeside Hospital?
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One of first schools for nurse anesthetists. Dr. Crile worked their with Agatha Hodgins beginning in 1908. School formally established 1915.
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Who was Agatha Hodgins?
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Founded NANA in 1931 in Cleveland, was first president & AANA's first donor.
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What is the importance of Frank v South?
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Nurse anesthetist Margaret Hatfield not engaged in practice of medicine (1917).
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What year did AANA not hold a annual meeting? Why?
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1945, WWII
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What organization did the NANA & AANA hold their meeting with? During what time frame?
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American Hospital Association, 1933-1976
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Who is Helen Lamb?
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Founded & directed Barnes Hospital School of Anesthesia (1929-51), received second membership card to NANA, AANA's fifth president & champion for nurse anesthetist anesthesia. Education committee chairwoman in NANA & AANA.
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What is the importance of Chalmer-Francis v Nelson?
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Established legality of nurse anesthesia practice (1934), NANA filed its first amicus curiae brief for this case.
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When did NANA change its name to AANA?
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10/17/1939; reincorporated in Illinois
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When were males allowed to be members of AANA?
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1947
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When was the CRNA title first used?
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1956
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Who was the first male president of AANA? What year?
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John Garde, 1972
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Who was first & only african american president of AANA? What year?
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Goldie Brangman, 1973
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What is the importance of Bahn v NME Hospitals?
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CRNAs compete with anesthesiologist & have standing to bring a federal antitrust suit (1985)
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When did CRNAs get right to bill Medicare directly? Under what part? When was this implemented?
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1986, B, 1989
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What role did the Clinton administration play in removal of supervision clause for nurse anesthetist from Medicare Part A?
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Signed bill removing supervision clause from all states
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What role did the Bush administration play in the removal of the supervision clause for nurse anesthetists under Medicare Part A?
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Delayed bill from Clinton removing clause, published new rule in 11/2001 that kept supervision clause in place but allowed state governors to write Medicare to opt out of requirement
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What was first state to opt out? When?
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Iowa, 2001
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How many states have currently opted out?
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16
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When did MN opt out?
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April 2002, Jesse Ventura
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What is thoughtbridge?
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Mediation company used by ASA & AANA to improve communication between two groups when met in 2004, ASA eventually fired the group.
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