I really need your help with these guys!!

Cassaundra · Jun 15, 2009

Well, I would answer C on the first one. It's not contagious, can be treated orally, does not pose a serious threat to life.

On the second one, I would answer A. A nurse can talk to the pt and get answers to some questions, but, unless s/he is a NP, cannot consult without the doctor. To me, consult means to diagnose or give treatment options.

nopainNurse · Jun 15, 2009

For the second question, I would answer C. I would be very concerned regarding the sending of any patient information through the internet, for security (privacy) reasons.

thinkertdm · Jun 15, 2009

For the second question, I would answer C. I would be very concerned regarding the sending of any patient information through the internet, for security (privacy) reasons.

"Via the internet" is a broad and poorly defined term. Are you sending via email? Is it encrypted and sent securely? Are you sending it through some sort of encrypted VPN connection?

There are so many ways that the internet can be made secure, and can be much more secure than a fax or a telephone call- or, for that matter, the regular mail.

Of course, not many people know about computer security, or blatantly disregard it. Additionally, most people are under the illusion that computers and "the internet" are evil, which is not true. It can be used for evil things, but if people watch what they download, and don't click on every damn thing they see, it can be very secure. (That's an over estimate, of course, but many simple precautions can make computers more useful).

Purple_Scrubs, BSN, RN · Jun 15, 2009

I said c on both.

On the second one, I was thinking HIPPA all the way. Even if the internet was secure, it does not specify that the patient gave consent for the medical records to be released, and to what doctors they gave permission for it to be released to. It just seems to vague to me.

thinkertdm · Jun 15, 2009

I said c on both.
On the second one, I was thinking HIPPA all the way. Even if the internet was secure, it does not specify that the patient gave consent for the medical records to be released, and to what doctors they gave permission for it to be released to. It just seems to vague to me.

Duh, I didn't even think of that. It really doesn't specify if releases were signed, of if the doctors were participating in the telehealth session.

jlyounginn · Jun 15, 2009

i agree with purple scrubs, i would say c for both also.

DebanamRN, MSN, RN · Jun 15, 2009

Telehealth (or Telepsych in my hospital) is where the pt is placed in a private room and talks to a crisis worker or some other form of health care provider over the television. It is two way, kind of like a comuter with a web cam. Its a way of providing services to patients when facilities are very short staffed.

I agree, with C for the second question, it violates HIPAA unless there is express consent given by the patient. Just to email files to doctors is illegal. I think this question violates confidentiality, and isn't about internet security.

For the first question, I'm going with A. The other three would probably require IV antibiotics and repeat blood work. A is a known commodity. The next three might require results from blood cultures and adjustments to antibiotics. It would be easier to manage these in the acute care facility. Patient A needs wound care. We know he has MRSA. We don't know specific type of bacteria the other patients have. I'm pretty sure our local nusing homes would toss back a patient with hematuria. Have to watch that one for sepsis.

oregonchinamom · Jun 15, 2009

I would say A for the first question. It is a chronic condition that may take years, if ever to heal. We have all seen diabetic foot ulcurs that are chronic and infected.

nopainNurse · Jun 16, 2009

"Via the internet" is a broad and poorly defined term. Are you sending via email? Is it encrypted and sent securely? Are you sending it through some sort of encrypted VPN connection?
There are so many ways that the internet can be made secure, and can be much more secure than a fax or a telephone call- or, for that matter, the regular mail.
Of course, not many people know about computer security, or blatantly disregard it. Additionally, most people are under the illusion that computers and "the internet" are evil, which is not true. It can be used for evil things, but if people watch what they download, and don't click on every damn thing they see, it can be very secure. (That's an over estimate, of course, but many simple precautions can make computers more useful).

I agree with you, and should have said my comment more clearly --- that internet is really broad and I would be wary about privacy/ security. My concern was that many people don't realize how unprivate various forms of communication are.

EarthChild1130 · Jun 16, 2009

I would say the UTI can go back to the residential facility because most UTIs can be treated fairly easily with oral abx, whereas the others will need to be treated more aggressively.

The second question is too vague for me...the word 'participate', to me, implies that the nurse is part of a healthcare team doing the telephone conference, not the sole participant, so the first choice is out...I can't think of any reason why one wouldn't identify oneself by name and title, so that one's out...the third one is legal per HIPAA guidelines, as is the 4th as long as the nurse is simply answering questions and not diagnosing...per HIPAA, it is okay to send information electronically between providers...hmmm...I dunno!! LOL

Valerie Salva, BSN, RN · Jun 16, 2009

I say C to both.