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The key standards and practices for providing comprehensive healthcare services in correctional facilities. It covers a wide range of topics, including access to care, administrative processes, infection control, patient safety, staff training, medication management, diagnostic services, intake screenings, chronic disease management, mental health services, and end-of-life care. The document emphasizes the importance of ensuring timely access to quality medical care, maintaining patient privacy and confidentiality, and adhering to ethical principles in the delivery of healthcare within the correctional setting. It serves as a comprehensive guide for healthcare professionals and administrators working in the correctional healthcare system to ensure the provision of safe, effective, and humane care for incarcerated individuals.
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Access to Care - Correct Answer-A patient can be seen by a clinician in a timely manner. Responsible Health Authority (RHA) - Correct Answer-The RHA functions to ensure that health services are organized, adequate and efficient. Medical Autonomy - Correct Answer-Clinical decisions are made for clinical purposes and without interference from other personnel. (The non medical considerations needed to carry out such clinical decisions are made in cooperation with custody staff). Administrative Meetings & Reports - Correct Answer-Administrative meetings are held at least quarterly. Health staff meetings occur at least monthly. Statistical reports are made at least monthly. Policies & Procedures - Correct Answer-They are site specific. Reviewed at least annually. Policies cross reference an NCCHC standard. CQI Program - Correct Answer-CQI Committee meets no less than quarterly. Initiates process and/or outcome CQI studies. Emergency Response Plan - Correct Answer-At least one mass disaster and one man down drill is conducted annually so every shift participates within 3 years. (Classroom or tabletop exercises do not meet the standard.) Communication on patients' health needs - Correct Answer-Health and custody staff communicate about inmates with special needs conditions, including health needs that may effect housing, work, program assignments, disciplinary measures and admissions to or transfers from institutions. Privacy of Care - Correct Answer-Discussions regarding patient care occur in private. Clinical treatment encounters occur in private. Procedure in the event of an inmate death - Correct Answer-All deaths are reviewed within 30 days. A death review consists of: An administrative review; A mortality review; and a psychological autopsy if the death was a suicide. Grievance mechanism for health complaints - Correct Answer-Responses are timely and based on principles of adequate medical care.
Infection Control - Correct Answer-An exposure control plan is reviewed and updated annually. Patient Safety - Correct Answer-Systems are in place to prevent adverse and near miss clinical events. Staff Safety - Correct Answer-Health Staff work in a safe environment. PREA - Correct Answer-Facilities comply with the Prison Rape Elimination Act of 2003. Response to Sexual Abuse - Correct Answer-Health staff are trained in how to preserve physical evidence. A history is taken and staff determine if a transfer to a hospital is indicated. Prophylactic treatment is provided. A MH professional evaluates and a report is filed. Credentials - Correct Answer-Qualified health care professionals do not perform tasks beyond those permitted by their credentials. Clinical Performance Enhancement - Correct Answer-Performance of direct patient care clinicians are reviewed at least annually. Professional Development - Correct Answer-Full time qualified health care professionals obtain 12 hours of continuing education per year or if they are a CCHP Health Training for Correctional Officers - Correct Answer-Received every 2 years by at least 75% from each shift Medication administration training - Correct Answer-Correctional or health staff who administer medication are permitted to do so and are trained as needed. Inmate workers - Correct Answer-Inmates do not provide health care services. Staffing - Correct Answer-The health care delivery system has sufficient numbers and types of health staff to care for the inmate population. (staffing plan) Health Care Liaison - Correct Answer-Coordinates health services when no qualified health care professional is available for 24 hours. May be a CO or other non-licensed person. Orientation for Health Staff - Correct Answer-Orientation lesson plan is reviewed once every 2 years. Basic orientation on the first day. In depth orientation within 90 days. Pharmaceutical operations - Correct Answer-Complies with all DEA and federal regulations. Formulary, Dispensing and Administering.
Continuity of care - Correct Answer-Patients receive health services and follow up in keeping with clinicians recommendations and evidence based practices. Discharge planning - Correct Answer-The process of providing sufficient medications for short-term continuity upon release. Healthy lifestyle promotion - Correct Answer-Health education pamphlets are available to inmates in accessible areas. Medical diets - Correct Answer-Medical diets are ordered for temporary or permanent health conditions. This standard does not address special diets for religious or security reasons. Chronic disease services - Correct Answer-Chronic disease is a condition that effects an individual's well being for at least 6 months and generally is not curable. Patients with special needs - Correct Answer-Treatment plans are developed at the time the condition is developed. Infirmary care - Correct Answer-Patients are always within sight and hearing of a qualified health care professional. A supervising registered nurse is on site at least once every 24 hours. Basic MH Services - Correct Answer-MH services are available to all inmates. Outpatients are seen "not less than every 90 days." Suicide prevention program - Correct Answer-Acutely suicidal inmates are placed on constant observation. Nonacutely suicidal inmates are monitored with no more than 15 minutes between checks. A psychological autopsy is completed within 30 days following a suicide. Patients with AOD problems - Correct Answer-A patient's addictions are identified and properly managed. Intoxication and withdrawal - Correct Answer-Inmates who are intoxicated or undergoing withdrawal are appropriately managed. Contraception - Correct Answer-Emergency contraception and continued contraception is available when medically necessary. Counseling and care of the pregnant inmate - Correct Answer-Counseling and assistance are provided in accordance with the inmate's expressed desires. Restraints are not used during active labor and delivery. Restraint during other pre- and postpartum periods should be avoided. Restraints are to be removed when a medical professional determines it is medically necessary.
Aids to impairment - Correct Answer-Orthoses, prostheses and other aids to impairment are supplied in a timely manner. Where they are contraindicated for security reasons, alternatives are considered. Care for the terminally ill - Correct Answer-Treatment includes pain management and palliative care. Consistent with state regulations, professionals initiate or facilitate early release for terminally ill patients. Health record format and contents - Correct Answer-A health record is properly created and maintained. Confidentiality of health records - Correct Answer-Health records are stored under secure conditions. If records are transported by non health staff, the records are sealed. Management of health records - Correct Answer-Evidence exists that the health record is available and used by health staff. Access to custody information - Correct Answer-Qualified health care professionals have access to information in the inmate's custody record when the RHA determines such information may be relevant. Restraint and seclusion - Correct Answer-Every 15 minutes, health trained personnel or health services staff check on any patient placed in clinically ordered restraints or seclusion. When restraints are used by custody staff for security reasons, health services staff are notified immediately. An order for restraint is not to exceed 12 hours. Emergency psychotropic medication - Correct Answer-Given without patient's consent. Follow up documentation is made by nursing staff within 1 hour and again within 24 hours of administration. Check patient within 15 minutes then every 30 minutes. Forensic information - Correct Answer-Health services staff are not involved in the collection of forensic information. The services of a staff member who is not involved in a therapeutic relationship with the inmate is obtained. End of life decision making - Correct Answer-Inmates approaching the end of life are permitted to execute advance directives including living wills, health care proxies and "do not resuscitate" (DNR) orders. These orders are signed only after the patient receives appropriate information regarding the meaning and consequences of such decisions. Informed consent and right to refuse - Correct Answer-Specifies circumstances under which risks and benefits of intervention are explained to the patient. For invasive procedures, informed consent is documented. Medical and other research - Correct Answer-Inmates are protected from being taken inappropriate advantage of due to their status as inmates.