When to evaluate a patient for N pep administration?
When care is sought less than 72 hours after a potential exposure and its non-occupational and
... [Show More] presents with a substantial risk for HIV acquisition.
Two factors to consider when giving Npep
HIV testing should be done prior to administration, preferably by using rapid combined AG/AB, or antibody blood test.
2nd Factor to consider when giving NPep
If rapid HIV blood test results are unavailable and NPeP is otherwise indicated, meds should be initiated without delay and can be discontinued if the patient is later determined to have HIV infection already or the source is determined not to have HIV infection.
What is the course for NPep
28 day course of a three drug antiretroviral regimen
What are the elements of negligence?
Duty, breach of duty, causation, damages
Duty
defined as acts or interactions required after the presumption of a relationship between the provider and the patient.
What are the three ways in which duty is established?
1. When you provide direct care to a patient
2. when you observe an unattended person in need of care, 3. Observes or is aware of provider performing care in a manner that may cause harm.
Causation
The proximate cause causation is often the most difficult to prove. The difficulty lies in the fact of the cause of an injury often cannot be identified.
Foreseeability
The ability of a reasonable person to anticipate the consequence of an action, a causation concept
Res Ipsa Loquitur
the thing speaks for itself
4 conditions of Res Ipsa Loquitur
The act that caused the injury was was in the nurses control
The injury would not have but fir the nurses negligence
No negligence on the patients part contributed to the injury
Evidence of the truth as to what what happened is unavailable
Intentional torts
Assault, battery, false imprisonment, quasi- intentional torts
Assault
An act to make a person feel fearful or an apprehension about Bodily harm. It does not have to be touching it can be a funny statement
Battery
Unlawful or offensive touching of another without consent
False Imprisonment
restraining an individual or restricting an individual's freedom, against his or her will.
Quasi-intentional torts
invasion of privacy, defamation of character, slander,
breach of confidentiality
Failure to keep privileged medical information private, legal and ethical concern
Blunt force trauma - Four kinds
Abrasions, lacerations, contusions, and fractures
4 types of abrasions
Scratch ( cat as scratch)graze ( road rash) impact ( object stamps the skin removing epidermal layer, linear( pressure with movement)
contusions or bruises
Blood extravasates from circulating vasculature into interstitial space
SANE programs beliefs (FNS-388-389)
Sexual assault survivors have the right to immediate, compassionate and comprehensive medicolegal evaluation evaluation and treatment by specially trained professionals who have experience to anticipate their needs during this time of crisis.
SANE responsibilities (FNS pg 389$
Ethical responsibilities to provide victims with complete information about choices so victims can make informed decisions about the care they want to receive
Assault survivors rights
Report to law enforcement, know what their options are and what to expect if they do, or do not decide to report.
Rights of those that do report (FNS 389)
Sensitive and knowledgeable support, without bias, during this difficult process [Show Less]