Communication and Documentation Flashcards

When delivering a new diagnosis of laryngeal squamous cell carcinoma, which protocol provides a structured approach to breaking bad news?

Answer: SPIKES

SPIKES (Setting, Perception, Invitation, Knowledge, Emotions, Strategy/Summary) is the widely taught framework for delivering bad news.

A patient with a cuffed tracheostomy cannot speak. What is the most appropriate first step to facilitate communication?

Answer: Provide a writing board or communication board

With an inflated cuff, a speaking valve is contraindicated, so alternative communication tools like writing boards are used.

A wrong-side ear procedure is narrowly avoided during the surgical time-out. How should this event be handled?

Answer: Report it through the institution's incident or near-miss reporting system

Near misses should be reported through safety reporting systems to identify system vulnerabilities.

Under HIPAA, which disclosure of protected health information does NOT require patient authorization?

Answer: Sending information to a consulting physician for treatment

HIPAA permits PHI disclosure without authorization for treatment, payment, and health care operations.

When communicating with a patient who has severe hearing loss and reads lips, which practice is best?

Answer: Face the patient in good lighting and speak clearly at a normal pace

Lip-readers need a clear, well-lit view of the speaker's face and natural articulation.

A 15-year-old is scheduled for septoplasty. Which statement about consent best reflects standard US practice?

Answer: The parent gives permission and the adolescent's assent should be sought

For most minors, parents provide legal permission while clinicians seek the adolescent's assent.

After an intraoperative complication such as a CSF leak during sinus surgery, what is the recommended approach to disclosure?

Answer: Promptly and honestly disclose the event, its implications, and the plan

Ethical and institutional standards call for timely, transparent disclosure of adverse events to patients.