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82 Cards in this Set
- Front
- Back
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Health of Health care workers |
o Physicalrisks (from repetitive lifting and moving) o Threatof violence o Chemicalrisks o Riskof infection |
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Sars infected 375 ____ were HCP |
45% |
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Number of files for compensation |
less than half of injuries |
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• Timeloss injury rate for health careworkers |
in BC was 5.0 injuries per 100 person-years - rangedfrom 1.6 to 8.0 timeloss injuries per 100 person-years |
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Injuries for HCP are ___ that of techincal assisting and others |
half |
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Types of HCP injury |
- Musculoskeletal injuries - Violence related - Infectious disease - Puncture wounds |
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Injury prevention efforts |
- Safer equipment - MSI prevention programs - Return to work programs - Violence prevention programs while therehas been an increased focus on prevention and safety programs, the impact ofthese efforts may have been undermined by increased risks within the healthcaresector |
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Compassion fatigue |
State of exhaustion and dysfunction(biologically, psychologically and socially) as a result of of prolongedexposure to secondary trauma or a single intensive event signs: anxiety, intrusive thoughts, poor concentration, exhaustion |
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Coping Compassion Fatigue |
o Positivepersonal coping strategies (e.g. adequate sleep, good nutrition, exercise,personal support networks, healthy work/life boundaries) o Organizationalstrategies (e.g. diversified caseloads where possible, employee training,positive social networks in the workplace) |
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Burnout |
• Common factors leading to burnout inhealth sector: high patient load, unsupportive supervisors, limited resources,low salaries, unclear role expectations, staff shortages • Three broad dimensions: • Emotional exhaustion • Feelings of low personalaccomplishment• Depersonalization of the patient |
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Precarious jobs |
o temporary, part-time, low paying or withoutbenefits – hurt people § associated with anxiety and unstable socialstructures § one in five had experienced precariousemployment o experienced by homecare workers and personalsupport workers |
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Stopping precarious jobs |
1. Limiting temporary, part-time jobs to less than 5% of an organization’s workforce (as recommended by the International Labour Organization). 2. Making sure temporary, part-time employees are offered fair wages, extended health benefits, and generous professional development opportunities to help find stable employment. 3. Protecting temporary, part-time employees by adopting higher than minimum compliance of employment standards and occupational health and safety policies. |
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Patient Navigators |
• Effort to address barriers toscreening, diagnosis, treatment for patients from marginalized communities - patientshelped improve their five-year survival rates from 39 per cent to 70 per cent |
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evidence for patient navigators |
1. Navigationimproves screening rates(Evidencefrom cancer care: screening adherence improved from 11% to 23%) 2.Navigation improves rates of confirmatory testing(Evidencefrom cancer care –navigation improved confirmatory testing rates between 21%and 29%) 3.Navigation leads to earlier diagnosis (Evidence from cancer care) 4.Navigation improves access to care (Evidence from cancer care, HIV care)(Evidencefrom cancer care – improvements with access and retention in care) 5.Navigation improves treatment outcomes (Evidence from HIV care and cancer care) 6. Clientsare satisfied with navigation programs (Evidence from cancer care) 7.Healthcare providers are satisfied with navigation programs (Evidence fromcancer care) 8. Navigationhas a positive impact on mental health outcomes (Evidence from cancer care) 9.Navigation improves client self management (Evidence from cancer care) |
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Barriers to health care |
o Systems-level barriers are barriers that arecaused as a result of the structure of the healthcare system § appointment scheduling process,10 § fragmented service delivery,11,12 and § lack of specialized local healthcare services- individualbarriers. o Transportation o acess to food and lodging o money o substance abuse and mental health |
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Navigation services |
Logistical services, where a navigator targets task-oriented barriers such as making appointments, finding transportation to appointments and offering health information. Relational services, where a navigator provides emotional support, builds a relationship with the client, gains their trust and strengthens the relationship between the client and provider. |
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Ethics case |
Mr Rasouli in a coma on life support - physician wanted him off fam didnt - appealed to court and he stayed on |
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ethics case 2 |
Therapist didnt disclose to someone that their patient wanted to kill them - they killed them - psyciatrist got in trouble |
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Law vs ethics |
Laws are formal and specific - Ethics may be unwritten, and even when written, may have different wording expressing the same ideas rules and principles - Laws conflict but gives rules for these situations, ethics don't have a definitive course in these situations Coercion vs voluntary acceptance - law is obligations, ethics is beliefs or expectations Standard of behaviour - law secures a minimal standard of behaviour, ethics presents a high standard of behaviour |
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Legitimacy and effect on third parties |
- only under code of their own job section- in law democracy forms everyones opinions- in jobs its just that association that makestheir own rules |
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Unique expertise |
- acknowledging the special education of a job - whetherthe profession is considered to have a positive social value |
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Ethos |
- if at thecore of the profession's ethos is empathy and compassion towards thoseaffected, or putting their interests first, society finds it easier to trustthem |
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Professional independence |
need for self-regulation |
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Terra Incognita |
Newtechnologies, new values and social practices, new diseases, all create newquestions and often new dilemmas practitionersface in almost every field. |
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Ethics washing |
acorporation or a professional community producing their code of ethics as apublic relations spin to falsely assure the public of their ethical conduct andavoid the interference of government authorities into these practices. |
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Ethics cases readings |
Isrealian lobbyist reality tv show Big brother show giving contestants drugs |
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International HCP challenges |
- obtaining timely, accurate information about howto register in health care professions |
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Bridging programs |
• for internationally educatedimmigrant professionals who have completed formal training in another country • may not have same abilities neededin Canada • help with professional transitions |
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Bridging Challenges |
- Difficulty securing placements o Compete with regular full time programs- Financial sustainability o Pilot money from gov o Shift to tuition model hard o Fluctuating enrolment based on external factors - Curriculum development o Diverse education backgrounds of participants o Hard to design to address gaps o Balance § What needs to be learnt vs what already has- How and where to deliver programs o In person vs on line o Differ in length/ when/where classes are held |
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Rates of IEHPs |
Sas- 50% Quebec- 11% |
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Suggests HCP/1000 = ? |
2.5 |
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Countries luring back IEHP |
China and India |
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WHOGlobal Code of Practice on the International Recruitment of Health Personnel Adopted in 2010 by World Health Assembly |
• Code establishes and promotesvoluntary principles and practices for ethical recruitment of health workersand strengthening of health systems • Multinational framework – tackleshortages in global health workforce/address challenges with health worker mobility Keyprinciples governing the Code: 1. Right of all people to the highest attainable standard of health 2. Right of the individual, including health personnel, to leave any country and migrate to any other country that wishes to admit and employ them (WHO, 2010b; 2010c) |
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IEHPS considerations |
• Need to address the “push” factorsin source countries - important toimprove working conditions, wages, health resources • Consider possible/fair forms ofcompensation from recipient countries to source countries when migration ofhealth workers • Additional investment in healthworkforce in both low and high-resource countries • Ensure health workers ethicallytreated when migrate to recipient countries |
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Philipines nurse export to sas |
Nurses were being exported from the Philippines to the pointthey made a policy which has led to a 50% decline in the nurse/patient ratio |
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IEHP discourse |
1) Market-based discourse: shortages, competition andplanning failures - international solution is last resort - international market trying to recruit their workers back - need to recruit internationally-trained healthprofessionals was also related to a failure of Canadian HHR planning to meetits labour market requirements - once wecut drs cause too many 2) Ethical discourse: professional conduct andinternational responsibility - we need the physicians and the physicians want toget out of those countries. Yet, there were so many people that needed theirservices you feel a little guilty doing it so you've got mixed emotions aboutthe whole thing. - Active and targeted recruitment is 'discouraged' inexisting codes of ethics - Other recruiters recognized that people were leavingsource countries for reasons other than unemployment |
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skills “mismatch |
The country is in dire need of engineers, health workers andskilled tradespeople. Yet tens of thousands of students continue to pursuedegrees in the arts and humanities. |
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Canadian trend |
people without jobs, jobs without people” poses the singlebiggest long-term threat to Canadian economic growth - one-fifth of Canada’s labour market already suffers fromtoo few qualified workers, particularly in the health care, mining, businessservices and advanced manufacturing sectors |
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Labour shortages |
many of the most acute labour shortages are in the country’shinterlands, where oil and mining companies’ operations are based - immigrants want to go to big towns trucking industry is suffering a critical shortage ofdrivers, |
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21st centuray glbal health |
Chronic conditions currently account for more than half ofthe global disease burden and are a primary challenge for 21st centuryhealthcare system |
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Five competencies to treating chronic conditions |
Patient centred care - Understanding the experience of illness from the patient's perspective captures the essence of patient centred care Partnering - join with patients, other providers, and communities for effective care of patients Quality improvement - clear about the outcomes they are working towards, know what changes would lead to improvements, and know how to evaluate their efforts Information and communication technology - skills to use available technologies to support care of patients Public health perspective - caring for one patient at a time to planning care for populations of patients |
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Developing country problems |
- HIV, AIDS, and tuberculosis account for most chronicconditions, other chronic problems are on the rise over age45, the prevalence of cardiovascular disease surpasses that of HIV and AIDS |
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Summary of today's problems |
- Traditional models of acute care are inadequatefor training a workforce to manage today's most prevalent health problems:chronic conditions - WHO has led an effort to identify a new set ofcore competencies that will yield better outcomes for patients with chronicconditions- These competencies apply to everyone who caresfor patients with chronic conditions - Several influential health professional bodiesand patients' associations support these competencies - The competencies must now be translated intoreality by initiating reform in training institutions and centres of highereducation |
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Chiroprody |
- commonly works with bunions - Michener institute 3 year program - In CANADA… All provinces, excluding Ontario usethe term “podiatrist” - Make about 52k a year - Since July 1993 now new podiatrists |
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Optometrist |
- 7-8 y post secondary edu - 2 canadian schools, waterloo and montreal (eng and french education costs 60-70k - income 95k |
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Nurse |
- 22 possible schools - bachelor of nursing and then apply to coleges ofnurses nursing employment act 1991 8% growth in job |
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Physiotherapist |
Need about 87 average to get into masters in physio - 55-75k salary - More than 60% of PTs experiencework-related pain & discomfort |
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Denturist |
- 5 accredited colleges no undergrad o 2-3y- mostly self employed - 61k/ yr |
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Chiropractor |
- treatpatients' neuromuscular-skeletal disorders of the spine and other body joints - education = 4-5 y - self employed - 360 clinical hours - standardized test - currently more males 60% - 66k year |
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Diagnostic medical sonography |
- ultrasound is used for more than just pregnancy,internal x ray - tech came from studying bats - general cardiac or vascular - sonography exams and membership with society ofsonography but no regulated profession - 60% in hospitals - 65-75k salary |
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Message Therapy |
- don’t need undergraduate degree (fanshaweprogram) - certification exam - apply at college of message therapists - only regulated in Ontario bc nfl and nb - 150 clinical hours - 43k salary - possible pain reliever during labour |
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Dentist |
- undergraduate -> dental aptitude test - 4 years in dental school and 1 year in residency - 10 canadian universities offer education- western lets 4 students into residency a year - Membershipin the provincial or territorial and national dental associations is anecessary component for licensure EXCEPT in Ontario and Quebec. - 6 dentists per 10000 people - Muskoskeletal disorders |
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Hospital administration |
- can have masters degree - 90k salary - female dominated |
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Occupation therapy |
- thescience of enabling people to perform the occupations that foster health andwell-being; and of enabling a just and inclusive society - undergraduate in any field then 2 years masters - 1000 hours supervised job training - 57k/y mostly in hospitalsLGBQ ots conceal identity causing stress |
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Health care attorney |
- policy, clients or counselling - 80-84 average - 160/180 on lsat - 133k salary - private practice as well as large firm work- fight public vs private |
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Pharmacist |
- degree in pharmacy don’t need a fullundergraduate degree - national board exam - ~100k/yr - 43.5 y old average - case: failture for pharmacist to put correctdosage on meds - pharmacy cant be open unless a pharmacist ispresent |
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Pharm tech |
- 2 year college program - 15.22/h |
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Resp Therapy |
- wide scope o surgery o educate and siagnose lung heart problems- 60k/y - technically self regulated - intubation o Usinga laryngo scope to get a view of the vocal cords/epiglottis - Spirometry o Vitalcapacity: The maximum volume of air you can exhale in one breath |
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Osteopathy |
- theknowledge of the structure, relation and function of each part of the humanbody applied to the correction of whatever interferes with its harmoniousoperation - body is a machine and when working properly canheal itself - palpation o feel or sense state of tissue or systems of body - Osteo-articular adjustments: precisely timed and placed “impulse” intended to reduce strain onarticular unit without force - Cranial-sacral application: restoration of optimal rhythms of PRM-PrimaryRespiratory Mechanism - Visceral normalization: seeks to alleviate dysfunctional relationship between organs andmusculoskeletal system. - Fascial release: aimed at restoring soft tissue mobility and motility - MCAT 1 year internship + 2-6 y residency- No Canadian college |
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Psychologists |
•Clinical •Developmental •Health •Social •Counselling 2-3 y master degree 3-6y phd 75k salary lack of mental health care = silent crisis Burnout: identity crisis, competence acquisition, productivity, rededication |
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Dermatology |
Mcat and 5 year res - 420k salary mostly private No dermatologists in PEI Psoriasis inflam skin disease |
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Naturopaths |
blendsmodern scientific knowledge with traditional and natural forms of medicine. - support natural healing of the body 1.Nutritional counselling (85.7%) 2.Botanical medicine (81.7%) 3.Homeopathy (79.3%) 4.Nutritional supplementation (41.7%) undergrad and 1 year internship |
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Language Pathology |
developmentand disorders of communication andswallowingwhich includes assessment and intervention undergrad +masters 1/4 work in school system |
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Audiology |
•Experts in the anatomicalstructures of the middle and inner ear: 94% are women 2nd least stressful job |
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Surgeon |
4y med school + 5-6y residency + 2 y for specialty training 16% of new specialists cant find work invests about$780,000to educate a specialist |
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Ethic fundamental responsibilities |
•Consider first the well-being of the patient. •Provide for appropriate care foryour patient, even when cure is no longer possible, including physical comfortand spiritual and psychosocial support. •Consider the well-being of societyin matters affecting health. Resist any influence orinterference that could undermine your professional integrity •Refuse to participate in orsupport practices that violate basic human rights. |
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Ethic General responsibilites |
•Recognize and disclose conflictsof interest that arise in the course of your professional duties andactivities, and resolve them in the best interest of patients. •Inform your patient when yourpersonal values would influence the recommendation or practice of any medicalprocedure that the patient needs or wants. •Do not exploit patients forpersonal advantage. |
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ethics Relationships |
•Provide whatever appropriateassistance you can to any person with an urgent need for medical care. •Having accepted professionalresponsibility for a patient, continue to provide services until they are nolonger required or wanted; until another suitable physician has assumedresponsibility for the patient; or until the patient has been given reasonablenotice that you intend to terminate the relationship. |
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Ethics decision making, consent |
•Provide your patients with the information they need to make informed decisionsabout their medical care, and answer their questions to the best of yourability. •Recommend only those diagnosticand therapeutic services that you consider to be beneficial to your patient orto others. If a service is recommended for the benefit of others, as forexample in matters of public health, inform your patient of this fact andproceed only with explicit informed consent or where required by law. •Respect your patient's reasonablerequest for a second opinion from a physician of the patient's choice. •Ascertain wherever possible andrecognize your patient's wishes about the initiation, continuation or cessationof life-sustaining treatment. •Respect the intentions of anincompetent patient as they were expressed (e.g., through a valid advancedirective or proxy designation) before the patient became incompetent. |
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ethics Privacy and confidentiality |
•Protect the personal healthinformation of your patients. •Avoid public discussions orcomments about patients that could reasonably be seen as revealing confidentialor identifying information. •When acting on behalf of a thirdparty, take reasonable steps to ensure that the patient understands the natureand extent of your responsibility to the third party. |
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ethics research |
•Ensure that any research in which you participate is evaluated bothscientifically and ethically and is approved by a research ethics board thatmeets current standards of practice. |
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Ethics responsibilities to society |
•Recognize the responsibility ofphysicians to promote equitable access to health care resources. •Recognize a responsibility to givegenerally held opinions of the profession when interpreting scientificknowledge to the public; when presenting an opinion that is contrary to thegenerally held opinion of the profession, so indicate. |
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Ethics responsibilities to profession |
•Be willing to teach and learn frommedical students, residents, other colleagues and other health professionals. •Avoid impugning the reputation ofcolleagues for personal motives; however, report to the appropriate authorityany unprofessional conduct by colleagues. •Be willing to participate in peerreview of other physicians and to undergo review by your peers. Enter intoassociations, contracts and agreements only if you can maintain yourprofessional integrity and safeguard the interests of your patients. •Avoid promoting, as a member ofthe medical profession, any service (except your own) or product for personalgain. •Do not keep secret from colleaguesthe diagnostic or therapeutic agents and procedures that you employ. |
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ethics Responsibilties to self |
•Seek help from colleagues andappropriately qualified professionals for personal problems that mightadversely affect your service to patients, society or the profession. •Protect and enhance your ownhealth and wellbeing by identifying those stress factors in your professionaland personal lives that can be managed by developing and practicing appropriatecoping strategies |
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RSI |
Repetitive strain injury inconsistent reports and compensation rates |
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MSI |
Musculoskeletal injury occur due toequipment and environmental inadequacies, high work demands, inadequatestaffing, poor work morale and low socialsupport most timeloss claims, during direct patient care activitites |
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Needlestick injuries and infectious diseases |
Small proportion but leads to anxiety |
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Ethics towards towards third party information |
some physicians may think that their contractual obligation to a third party (employer, health insurer)exceeds their ethical obligation to protect patient confidentiality, it is clearly established in their CE that no agreement(even if with an employer) may abolish this (or other) professional duty. |
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COI Statements |
Forms similar to consent forms that really relieve HPC's of liability than inform patients |
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Ethics vs law |
inquiry in this paper has revealed that codes ofprofessional ethics are oftenmore law than "pure" ethics |
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IEHP |
Most health professionals enter thecountry before passing registration examinations or contacting regulatory bodies, and manyremain unregistered for several years or indefinitely common pan-CanadianQualification Recognition Framework and Implementation Plan for better integration ofimmigrants into the Canadian labour force (2009) |
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Health Force Ontario |
provides information, advice, support and Integrating Internationally Educated Health Professionals Into the Ontario Workforce 9 programs to IEHPs pursuing registration in regulated health professions Wants to make ontario the health employer of choice |
