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Every medical office should have its own safety manual based on OHSA legislation, detailing general safe practice and any office specific procedures. Make sure that you have access to this manual and that you know all the sections of it that apply to you.
All peripheral devices should be as well protected as the main computer, i.e. through passwords and other security measures. With tablet computers, which can easily be forgotten and left in places accessible to non-authorized personnel, it is particularly important to make sure that they will automatically close when not in use and that a password is needed to reopen them.
The appointment matrix should display room availability, staff availability (and unavailability, e.g. holiday times) and should have built-in catch up times to make up for any overruns during the day. A well-run appointment matrix minimizes the chances of patients arriving and no doctor or room being available for them to be seen.
All medical institutions are required by the OHSA to have an exposure control plan in the event of an outbreak of airborne, waterborne or blood-borne pathogens. Make sure you are familiar with this plan and with the role that you are expected to take on in the event of an emergency.
Pain scales are often used in patient histories, particularly for patients with chronic pain, but often they are not clearly defined or explained to the patient. Generally, no pain is zero, nagging pain which doesn't impose on general life is 1 to 3, moderate pain which affects daily activities is 4 to 6, severe pain which greatly restricts activity is 7 or 8 and excruciating pain which leaves the patient disabled, screaming and possibly delirious is 9 to 10.
Hepatitis B is one of the most common diseases for health workers to contract through patient contact. If you have not received the vaccination you should ask your physician for it immediately. The full course of three vaccinations should ensure lifelong immunity to hepatitis B, although it may be advisable to have your immunity checked at intervals to see if you need a booster shot.
The median effective dose of a drug, or ED50, is the dosage that will be effective for 50% of the population. This is used as a benchmark when deciding on prescription strengths.
A palliative drug is one that relieves symptoms but does not treat them. Palliative drugs make patients more comfortable but do not help in treating their illness, and so they are often used in combination with curative drugs.
The lithotomy position is used for examinations of the perineal area, as well as in childbirth. The patient should be lying on their back, with their heels above their hips – stirrups will often be used to achieve this position.
Before removing any suture the wound should be cleaned with antiseptic. This should remove any encrusted blood or loosened scar tissue, which could not only cause unnecessary pain to the patient during removal but might increase the risk of infection.
Malpractice means to do harm through negligence or incompetence, not deliberately. A medical practitioner is judged to have committed malpractice if they do something, or don’t do something, a professional of their standing would reasonably be expected to do or not do. Causing deliberate harm is not malpractice and would be dealt with under applicable criminal law, e.g. assault.
It is undesirable for collected blood to flow back into the vein. To ensure that this does not happen always hold the collecting tube below the puncture so that gravity can assist you in ensuring this does not happen.
The environment in which a discussion occurs can have a significant impact on its success. In a noisy environment misunderstandings can easily occur, especially if the patient is hard of hearing. If you see that a patient is struggling to understand, consider taking them to a quieter environment.
A court subpoena is the only one of these with which it is compulsory to comply; the other entities must obtain court orders if they wish to access patient records and the patient refuses access. Even in the case of a subpoena, it is best to check the legality of the order with legal staff or senior management before complying.
Using a capillary puncture when only a small amount of blood is needed is advantageous, especially for obese patients, those who may have bleeding problems, people who may have severe burns, etc. The fingers are generally the best site for this type of blood draw, though the toes may also be used. Remember to use the correct lancet and wipe away the first drop of blood as it will contain excessive tissue fluid.
Occult literally means "hidden": the occult blood test looks for hidden blood in the stool which may be a sign of stomach problems. In order to make this test accurate it's very important that patients are clearly instructed on the correct way to collect the sample.
The financial liabilities of a deceased person fall to their estate. However, it must be appreciated that approaches for payment at a time of grieving may be regarded as insensitive and intrusive. Best practice is to approach the administrators of the patient's estate and negotiate payment through them, rather than directly approaching next of kin.
Best practice in recordkeeping is to check with the patient every time they visit the office that all their personal details (address, telephone number, email, next of kin etc.) are up-to-date. This should minimize the chance of important information going astray.
A person entering a legal complaint is known as the plaintiff. The person against whom the complaint is made is the defendant. All parties in a court case are known as the litigants, and an appellant is a person who appeals to a higher court to have the judgment of a lower court overturned.
Urine decays when stored and this decay can influence test results. Therefore between reception of a sample and testing it should be kept refrigerated to avoid this.
