ETHICS-MEDICA (Cont..): Maintaining standards of excellence: To optimize success in protecting life and health to an acceptable standard, surgeons must only offer specialized treatment in which they have been properly trained. To do so will entail sustained further education throughout a surgeon’s career in the wake of new surgical procedures. While training, surgery should only be practiced under appropriate supervision by someone who has appropriate levels of skill. Such skill can only be demonstrated through appropriate clinical audit to which all surgeons should regularly submit their results. When these reveal unacceptable levels of success, no further surgical work of that kind should continue unless further training is undergone under the supervision of someone whose success rates are satisfactory. To do otherwise would be to place the interest of the surgeon above that of their patient, an imbalance which is never morally or professionally appropriate. Surgeons also have a duty to monitor the performance of their colleagues. To know that a fellow surgeon is exposing patients to unacceptable, levels of potential harm and to do nothing about it is to incur partial responsibility for such harm when it occurs. Surgical teams and the institutions in which they function should have clear protocols for exposing unacceptable professional performance and helping colleagues to understand the danger to which they may exposing patients. If necessary, offending surgeons must be stopped from practicing until, again, they can undergo further appropriate training and counseling. Too often such danger has had to be reported by individuals whose anxieties have not been properly heeded and who have been professionally pilloried rather than congratulated for their pains. Surgeons and anyone else discovered to participate in such cover up and ostracism should share the blame and punishment for any resulting harm to patients. QUESTIONS: A facility has a system for transcribing medication to a computerized medication administration record (MAR). A surgeon writes the following order for a client: Zopiclone 5 mg P.O. daily for 3 days (NOCTE). The nurse who transcribes the order onto the MAR neglects to place the limitation of 3 days on the prescription. On the 4th day after the order was instituted, a nurse administers Zopiclone 5 mg P.O. During an audit of the chart, the error is identified. The person most responsible for the error is the: A. Nurse who transcribed the order incorrectly on the MAR B. Nurse who administered the erroneous dose. C. pharmacist who filled the order and provided the erroneous dose. D. Surgeon that wrote the order.
Posted on: Mon, 29 Sep 2014 08:36:06 +0000
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