Informed Consent
If it is determined after reasonable investigation that the patient does not have a Surrogate, the Attending may authorize this type of care.
Routine medical care
The MOLST form should be printed on this color paper.
Pink
Patient is stuck with dirty needle and the patient who was stuck demands to know if the previous patient had any blood born illness such as HIV, Hepatitis B or C. If known, can the nurse tell the patient?
Yes – If the source patient’s status is known, the information can be given to the patient without any other patient information about the source patient. If the source patient’s status is not known, the source patient’s blood can be tested anonymously if the provider treating the exposed patient orders the test anonymously. See HIV Testing and Management #100.92.
Is parental consent required to administer Vitamin K to a newborn?
No – the hospital is required by law to administer the shot. The guidelines attached to our policy are meant to provide a clear procedure that can be followed in the event parents have actually objected before the shot can be administered.
This is the department to whom all pathology requests which involve Northwell as a named party should be directed.
Risk Management
The acronym for driving while intoxicated.
What is DWI?
A concurring determination of incapacity is required by another physician or Health of Social Service Practitioner for patients who lack capacity for medical reasons if the decision involves this.
Withdrawing or witholding life sustaining treatment
If the decision to withhold or withdraw life-sustaining treatment pertains to a minor and there is a parent who is unaware of the decision, providers should do this prior to withholding treatment.
Attempt to inform the other parent.
An enraged patient bites a nurse. The nurse who was bitten by the patient can be told the HIV and Hepatitis status of the biting patient because:
a. The Consent to Admission, Treatment and Disclosure authorizes HIV and hepatitis testing if a healthcare worker is exposed to the patient’s bodily fluids.
b. The biting patient feels badly and consents to testing and disclosure of her HIV status.
c. The biting patient refuses testing but the lab has the patient’s blood and the provider treating the nurse orders testing on the blood anonymously.
d. a,b and c
D
What steps must be followed before the parent can sign the Vitamin K refusual?
1st. Nurse must attempt to educate parents using the information form attached to the policy. 2nd. There must be a consultation with the pediatrician and/or neonatologist, social work and the parent where reasons for refusal are discussed. Consultation must be documented in EMR. 3rd. Physician must notify hospital administration. Optional: Physician may, in his or her discretion, inform the parents that CPS may be called if they refuse.
This is the Legal intervention required for Northwell to release original slides or recuts.
A Court Order
This NYS law provides that “any person who operates a motor vehicle in this state shall be deemed to have given consent to a chemical test of one or more of the following: breath, blood, urine, or saliva, for the purpose of determining the alcoholic and/or drug content of the blood.”
What is Section 1194 of the New York State Vehicle and Traffic Law (VTL)?
Prior to issuing an order to withhold or eithdraw life-sustaining treatment (including DNR) for patients with a developmental disability, notify these individuals.
Mental Hygiene Legal Services and the Executive Director of the patient's licensed residence or program.
Decisions by an emancipated minor with Capacity do not require parental consent, but the decision by an emancipated minor to withdraw life-sustaining treatment requires approval by __________.
A Clinical Ethics Consultation
Who orders the anonymous testing of blood from a source patient who can’t consent to testing because the source patient is in a coma or otherwise lacks capacity?
The provider caring for the exposed patient
If a parent objects, is the care team required to follow the procedure outlined in the guidance?
The guidance is only guidance, and is not mandated. A clinician could administer the shot despite parent objection (assuming he or she feels they can safely do so). The guidance is meant to provide clear direction in the event that the clinician does not feel comfortable doing so. Risk has stated that they will defend the clinician in either circumstance.
This is the form that must be completed whenever original slides are released or removed from Northwell property.
Chain of Custody form
This device, designed by Dr. Robert Borkenstein in 1954, uses the relationship between a person’s alveolar air and passes it through an alcohol-sensitive chemical re-agent.
What is the breathalyzer?
The individual that appears third on the list to act as a patient's surrogate
Adult child (if any)
A Surrogate may consent to withhold/withdraw life sustaining treatment (including DNR and MOLST form) provided the Physician determines the treatment would be an extraordinary burden to the patient and the patient has one of these.
An illness or injury which is expected to cause death within six months regardless of treatment; OR permanent unconsciousness,; OR an irreversible or incurable condition.
The source patient’s blood is positive for HIV but the source patient’s blood was tested anonymously. Do you put the results in the source patient’s chart?
No
Can parents claim religious exemption to the Vitamin K requirements?
There is no religious exemption to the hospital’s mandate to administer the shot.
This is the term used to describe the method for either confirming the presence of a lesion identified on the first slide or obtaining a second opinion.
A red-cut slide
If consent for chemical testing of a motor vehicle cannot be obtained from a patient at the request of the police department, then staff shall comply with the officer’s request only upon receipt of this document.
What is a court order (to obtain specimens for blood and alcohol testing)?