CMA Lesson 3, 4 - Chapters 2, 3, 4 Notes
CMA Lesson 3, 4 - Chapters 2, 3, 4 Notes DESU-CM 02
Popular in Clinical Medical Assistant Certificate Program with Clinical Externship
Popular in Department
verified elite notetaker
verified elite notetaker
verified elite notetaker
verified elite notetaker
verified elite notetaker
verified elite notetaker
This 9 page Class Notes was uploaded by Brittney Stevenson on Wednesday August 31, 2016. The Class Notes belongs to DESU-CM 02 at Delaware State University taught by in Fall 2016. Since its upload, it has received 5 views.
Reviews for CMA Lesson 3, 4 - Chapters 2, 3, 4 Notes
Report this Material
What is Karma?
Karma is the currency of StudySoup.
Date Created: 08/31/16
Module 1 Lesson 2 Oral Communication o Tone of voice Pleasant, confident, project intentions o Word choice Professional & unbiased Avoid slang o Stay focused Avoid rambling & sharing personal info o Repeat if necessary o Allow questions/clarification Written Communication o State facts, not opinion o Use proper grammar, punctuation, sentence/paragraph structure o Writing to patient: avoid technical/med terms, abbreviations or symbols o Write legibly o Keep written communication confidential Symbolic Communication o American Sign Language Hearing impaired o Braille Vocally impaired Telephone Etiquette o Answering the phone Answer before 3 ring Say “Good Morning” or “Good Afternoon” State facility name & your name Ask, “How may I help you?” o Listen carefully, don't interrupt o Putting caller on hold First ask permission to do so Tell caller what you will be doing Check in every 20 seconds to keep them informed Offer alternative to waiting on hold (such as you or them calling back) o Never show anger or have negative attitude Faxing o Call ahead before sending fax to a patient (ensure confidentiality) o Note in chart that message was faxed, to whom, date & time it was sent HIPAA requires facilities to keep fax log (for at least 30 days) Emailing o Use secure sites to send o Use personal name in your email address o Always fill in subject line o Always use correct spelling/grammar o Never use all caps o Do not send emails expressing strong emotions (phone call instead) o Use signature line to identify who you are with & alternate ways to contact you o Avoid putting timesensitive information Hearing Impaired o Face them at all times o Do not raise your voice o Use gestures or written notes o If available, ask someone who knows ASL to assist you NonEnglish Speakers o Use simple terms o Make sure patient can repeat back important points (such as how to take medication) o Use demonstrations o If available, find interpreter Communicate directly w/ patient/family, not interpreter Have patient repeat important info back through the interpreter Avoid using patient’s child or family member as interpreter Nonverbal Communication o Be aware of personal space If you need to touch patient or get closer, explain what you'll be doing & ask permission o Body Language Maintain eye contact Don't stare Watch facial expressions Maintain upright, open posture Listening o Eye contact o Acknowledgement Nod, use facial expressions, restate what they said o Ask questions (clarify) o Don't interrupt o Avoid interjecting own stories/opinions/thoughts o Allow for silence so patient can organize thoughts Maslow’s Hierarchy of Needs o Physiological needs Food, shelter, warmth, health o Safety needs Feel safe physically and psychologically o Sense of belonging Friends, family, community o Selfesteem Can only occur when the previous levels have been met o Selfactualization Can only occur when the previous levels have been met Morality, creativity, acceptance of facts Barriers to Communication o Illness Cannot effectively communicate or understand Put important instructions in writing Ask patient to repeat back important instructions If available, ensure family member is in the room to offer support & hear important instructions as well Family members may also experience this barrier because they're worried o Culture Culture, religious, & ethnic factors & health beliefs Understand various cultural differences & impact on communication & healthcare treatments Examples: hiding emotion or needing permission/approval from an older family member, individual saying yes or agreeing out of respect but not really agreeing or understanding, patient delaying healthcare because they believe nothing can help them, needing to first seek advice for a healer o Age Pediatric Are they old/mature enough to grasp the concepts about their health care? Elderly Can they hear, speak, see, and understand what is being said? Important to be aware of these things & involve parents/other family members as appropriate Defense Mechanisms Grieving Process o First stage: Denial Refuses to believe the truth or face reality o Second stage: Anger Responds to illness with resentment/negative emotions o Third stage: Bargaining Tries to negotiate death or make a deal or delay the inevitable o Fourth stage: Depression Feels deep sadness or grief as reality sets in o Last stage: Acceptance Becomes at peace with the truth or reality o Avoid trying to comfort the patients, allow them to go through the process, listen without personal opinions/statements Module 1 Lesson 3 Wellness o Ongoing practice of healthy lifestyle to fend off disease & maintain healthy parameters o Average life span in U.S. = 76 years o Each individual has different risk factors, compromise wellness o GOAL: reduce as many risk factors as possible o Some factors cannot be changed (such as diseases that have genetic links, age, and ethnicity) o Many behaviors can increase the likelihood of wellness Holistic Approach to Healthcare o Holistic: focuses on whole patient& addresses the social, emotional, & spiritual needs of patient as well as physical treatment o Recognizes link between body & mind o If mind healthy, body has better chance of being healthy o GOAL: achieve and maintain wellness o FOCUS: prevent disease before it occurs o In facilities that emphasize holistic approach, MA’s role = help patients learn how to implement as many healthful behaviors as possible The MindBody Connection o physical elements associated with this concept Endorphins: proteins w/ analgesic (pain reducing) properties, cause many beneficial responses in brain such as: increased immunity to disease, lower stress, decrease in negative feelings that lead to physical problems Endorphins are released through laughter, relaxation, love, friendship, & spirituality Pain o Acute: immediate & often severe, temporary & lessens when treated & with time o Chronic: long term; result of chronic disease (such as cancer, arthritis, or back pain); long term effects (inactivity, decreased quality of sleep, fatigue, depression, anger, etc.) o Pain tolerance (high or low) Remember, some cultures teach to not show pain High pain tolerance might mean early warning signs go undetected or ignored Types of Pain o Physical: pain receptors send electrical impulses through nerves to brain Some people have impaired sense of pain (due to nerve damage) Origin can be superficial (on the body surface), deep in the muscles & joints, or visceral in organs Intensity range from minor discomfort to debilitating pain o Psychological Acute or chronic Acute: anger, fear, grief, etc. Chronic: anxiety disorders, PTSD, depression, etc. Caused by life situations (such as trauma or death) o Phantom Common occurrence after body part amputated Severed nerve endings initiate electronic impulses to brain just as they would if actual pain receptors in the area Often very severe; tends to subside permanently w/ time Pain Assessment o “5 vital sign” o May be part of job as a MA o Assess: When did the pain start? Where is the pain located? How frequently does the pain occur? Can you describe the pain? What actions or movements tend to lessen or increase the pain? Rating Pain o Numerical or Symbolic Scale 0 (no pain at all) to 10 (most severe pain they have ever felt) o Face Scale Similar to numerical scale, but uses smiley faces instead of # Ranges from happy smiling face to very unhappy face, patient chooses one that describes pain level Can be used if patient has trouble w/ number scale o Full Body Picture Diagram shows entire body front & back, patient marks picture to indicate areas where there is pain, different marks used for different types of pain Pain Management o Strategies to minimize or eliminate pain Medication Measures to increase comfort Heat/cold therapy, massage therapy, physical therapy Alternative therapies (in some cases used because patient can’t take medications due to dependence and/or side effects) Relaxation exercises, herbal remedies, magnet therapy, biofeedback, acupuncture, acupressure, chiropractic treatments Exercise Surgery o Often a combo of strategies used o If don't work effectively, controlled substance may be prescribed w/ close monitoring Teaching Pain Management o Important role of MA = teaching patient useful strategies for pain management o Teaching areas include: Disease process & why it is causing pain Treatments available for disease Medical dosage & treatment frequency Potential changes in patient’s condition that patient should be aware of Patients w/ Special Needs o Physically challenged in variety of ways Ask patients if they need assistance before helping As MA, important to learn how to assist patients who use crutches/canes/walkers/wheelchairs, etc. Sometimes MA will teach patients how to use assistive devices effectively/safely o Visually challenged or impaired Some patients may only need large print educational materials; others may need Braille or audio version Introduce yourself upon entering the room; always let them know when you’re leaving (say their name so they know you're speaking to them) o Hearing challenged or impaired May only have slight hearing loss in one ear OR complete hearing loss Speak clearly, face person so they can read your lips, use eye contact & facial expressions, don't walk up behind them o Speech challenged or impaired Limited ability to speak, distortion of speech sounds, voice disorder, stutter, apraxia (difficulty moving the muscles/structures necessary to form speech sounds into words), etc. Maintain eye contact, don't rush or try to finish their sentences (try other forms of communication such as signing or writing) o Do not speak English well or at all providing an interpreter when necessary is legal requirement o From different cultural backgrounds o Geriatric patients o Emotionally challenged Be kind, understanding, calm, empathetic, and speak quietly MA’s Role in Extended Life Care important to understand considerations, laws, & providers involvement in: Organ and Tissue Donations o Harvested from live donor or cadaver o Tissue compatibility must be determined before transplant o Source of donation: Cadaver Live donor o Waiting period Warm ischemic (pertaining to decreased blood supply to tissue due to impaired circulation to organ/body part) time = when the body is not refrigerated, this time cannot exceed 4 hours Cold ischemic time, where the body is refrigerated in morgue, cannot exceed 12 hours o Cryopreservation: tissues/organs frozen to preserve o Removal Order Heart always removed first, then other organs as quickly as possible o Uniform Anatomical Gift Act of 1968 Donor must be at least 18 yrs old Intent to donate in writing Donor may designate specific organs/tissues for transplant Death of the donor may not be determined by physician(s) involved in transplant Donor may revoke intent recipient or health care provider may refuse the gift No financial arrangements When no organ donation card or indication, decision usually up to the family in order: spouse, adult son/daughter, parent, adult sibling, grandparent, guardian Transplant of Organs & Tissues o Organ Procurement and Transplant Network (OPTN) Final Rule requires all hospitals to follow set of rules to receive Medicare/Medicaid reimbursement o United Network for Organ Sharing (UNOS) established national computer system for registering patients in need of transplants o The FDA regulates tissue procurement/storage/shipment o Live donor transplants may go to designated recipient o Transplant costs: patients must research full cost (most insurance policies do not cover transplants) Medical Directives o Legal documents signed by patient allow them to dictate what happens medically if he/she incapacitated, may also designate decisionmaker Durable Power of Attorney for Healthcare o If patient no longer mentally competent/incapacitated, appointed person w/ POA makes medical decisions in patient’s best interest Statement is voluntary, in writing, signed and dated Appointed person must be at least 18 yrs old Becomes effective when physician certifies in writing patient not able to consent 2 competent witnesses at least 18 yrs old required POA must be notarized Neither witness can sign on patient’s behalf (but another person may if patient not capable, at patient’s discretion & in their presence) Patient may revoke appointment by destroying document or informing the physician Living Wills o Document tells physician of person’s wish to die naturally rather than kept alive when death inevitable o DNR order can be part of living will o Attending physician must declare in writing: Patient has incurable injury/disease/illness Patient’s death will occur within short time Using lifeprolonging procedures would only artificially lengthen dying process Lifeprolonging Declarations o Some living wills include this, means patient wants providers to perform all possible medical treatment to prolong life o Must be signed while patient in good health o Signed, dated, witnessed by 2 people over age of 18 o A copy must be placed in patient chart Hospice o Facility or program, provides care for terminally ill, in hospice center or home setting o Focuses on palliative (relieving pain or discomfort) care o GOAL: allow patient to die with dignity in his/her own home or facility; care for family during difficult time