Law & legislation week6

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9781284538588_SLID_CH17.pptx

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Legal Reporting Requirements

Chapter 17

LEARNING OBJECTIVES

Describe various forms of child abuse, how to recognize it, & reporting requirements.

Describe various forms of elder abuse, how to recognize it, & reporting requirements.

Explain why it is important to report communicable diseases, adverse drug reactions, & infectious diseases.

LEARNING OBJECTIVES - II

Discuss the importance of reporting births & deaths.

Describe the types of patient events reportable under state law.

Abuse in Health Care Setting

Involves most vulnerable & dependent on others for care.

Abuse can take many forms

Physical

Psychological

Medical

Financial

Not Always Easy to Identify

Child Abuse

A child is one who has suffered intentional serious mental, emotional, sexual, and/or physical injury inflicted by a family or other person responsible for the child's care. Some states extend the definition to include a child suffering from starvation.

Child Abuse – II

Reporting Child Abuse

Caregivers (e.g., physician, nurse, administrator)

Detecting Abuse

Physical Signs

bruises

burns

broken bones

Child Abuse – III

Behavioral Indicators

diminished psychological & intellectual functioning

failure to thrive

no control of aggression

self-destructive impulses

decreased ability to think & reason

acting out & misbehavior

habitual truancy

Good Faith Reporting

Reasonable cause to believe injuries not accidental.

Professional not acting in bad faith to injure another in filing an abuse report.

Psychologist Immune from Liability

Failure to Report Child Abuse

Psychologist

Failure to Report Past Abuse

Nurse

Failure to Document & Report

Physician

Text Case: Physician Immune from Liability

Elder Abuse Signs of Abuse

Unexplained or unexpected death

Development of "pressure sores“

Heavy medication & sedation used in place of adequate nursing staff

Occurrence of broken bones

Sudden emotional outbursts, agitation, or withdrawal

Bruises, welts, discoloration, burns, etc.

Absence of hair and/or hemorrhaging below scalp

Dehydration/malnourishment without illness

Hesitation to talk openly

Elder Abuse Signs of Abuse – II

Implausible stories

Unusual or inappropriate activity in bank accounts

Signatures on checks & other written materials that do not resemble patient's signature

Recent legal changes or creation of a will, when person is incapable of making such decisions

Missing personal belongings, including jewelry

An untreated medical condition

Patient unable to speak for himself or herself, or see others, without presence of caregiver/suspected abuser

Documenting Abuse

Caregivers

record symptoms and condition

Witnesses

record information provided by witnesses

Photographs

photograph injuries

Preserve the evidence

use of rape kits

Documenting Abuse – II

Suspected abuse should be defined clearly & objectively.

Witnesses: Reporters of abuse must describe statements made by others as accurately as possible

what actions were taken, by whom, when, where, etc.

Info should be included about how witnesses may be contacted.

Documenting Abuse – III

Photographs: It may be necessary to photograph wounds or injuries.

hospital emergency room or the police department can be asked to photograph in emergency situations.

Births & Deaths

Reportable by statute

Necessary to maintain accurate census records

Suspicious Deaths

Referral to medical examiner

Violent deaths

Criminal activity

Medical Examiner

Determines cause of death

Provides information for criminal investigation

Communicable Diseases

Reported to protect citizens from infectious diseases

Reporting required by statutes

Adverse Drug Reactions

harmful reactions that occur as a result of administration of a drug or combination of drugs

Report adverse drug reactions to the FDA

FDA https://www.accessdata.fda.gov

FDA, 10903 New Hampshire Avenue Silver Spring, MD 20993

800-332-1088 or 888-463-6332

HOSPITAL-ACQUIRED INFECTIONS

2006, Archives of Internal Medicine

up to 98,000 deaths annually

Approximately 30 states have requirements to report infections

2010 PPAHCA requires acute care hospitals to report hospital-acquired infections or be subjected to reduction in Medicare reimbursement.

Physician Competency

Health Care Quality Improvement Act of 1986

Authorizes National Practitioner Data Bank to collect & release information on competence & conduct of health care practitioners.

National Practitioner Data Bank

Reporting requirements

Required queries

Medical Staff Privileges

Who should report?

Data bank queries

Confidentiality of data bank information

Incident Reporting

Hospital Incident Reports

do not place in patient’s record

direct reports to legal counsel to help prevent discovery

State Reportable Incidents

defined by state law/regulations

Infections

patient injuries

Failure to Report

State Reportable Incidents

State reportable events include

reporting communicable diseases

Infections

unusual or an unexpected cluster of patients with symptoms/diseases or exposures suggestive of a health emergency or terrorism event

REVIEW QUESTIONS

What is child abuse?

Who should report child abuse?

Describe the signs of elder abuse.

Describe a variety of the types of reportable incidents.

Describe the purpose of the National Practitioner Data Bank.