CENTRE INTÉGRÉ DE SANTÉ ET DE SERVICES SOCIAUX DE LANAUDIÈRE Code of ethics Année 2016 PREAMBLE The CSSS du Nord de Lanaudière s Code of ethics is a reference document for the establishment s clients and

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CENTRE INTÉGRÉ DE SANTÉ ET DE SERVICES SOCIAUX DE LANAUDIÈRE Code of ethics Année 2016 PREAMBLE The CSSS du Nord de Lanaudière s Code of ethics is a reference document for the establishment s clients and its intervenors who offer health care and other services. 1 It was prepared according to the provisions of the Act respecting health services and social services 2 and it stipulates the rights and responsibilities of users as well as the behaviour expected of its intervenors, who constitute the means by which the establishment undertakes to promote the rights of users and respect the provisions of its Code of ethics. The Code of ethics is a guide destined to unite everyone involved around the values of benevolence, teamwork, ethical behaviour and transparency, and innovation fostered by the establishment. It is, in fact, our moral commitment to our clients. 3 THE FOUR VALUES OF OUR ESTABLISHMENT ASSOCIATED WITH THE SEVEN RIGHTS OF OUR ESTABLISHMENT S CLIENTS BENEVOLENCE: Upholding relations steeped in caring, respect, consideration, politeness, satisfaction and humanism. Right to respect and dignity Right to independence Right to consent TEAMWORK: Coming together to participate and contribute to a group. Setting aside personal interests in favour of the greater good, sharing the benefits and satisfaction derived from collective efforts, and having a spirit of service and community. Right to participate ETHICAL BEHAVIOUR AND TRANSPARENCY: Keeping clients apprised of the establishment s activities, practices, plans, objectives and achievements. Right to information Right to file a complaint and to seek redress 1 The word intervenor includes all staff members, physicians, medical residents, volunteers, trainees or other persons offering services in our establishment. 2 Sections 233, 27.3 and 107 of the Act respecting health services and social services. 3 The word clients covers a variety of other terms used in our establishment, among these patients, users, beneficiaries, residents, family members, loved ones and representatives. 1 INNOVATION: Developing new solutions for action, seeking out best practices and striving to improve the quality and safety of the services offered to our clients. Right to safe quality health care and other services Benevolence YOUR RIGHT TO RESPECT AND DIGNITY Always speak to you in a respectful tone and language. Address you formally at all times. Call you by your name, preceded by Mr., Miss or Mrs. Acknowledge the inviolability of your physical person, your independence and your living environment. Listen to what you have to say. Let you speak without interrupting you, unless they have a valid reason for doing so. Avoid raising their voice or hailing you from afar. Only use the intercom system for emergencies or in specific situations. Keep the noise level to a minimum in areas where health care and other services are provided. Avoid inappropriate conversations in areas where health care and other services are provided. Wear appropriate clothing that is clean, modest, safe and respectful of the clients being served. Respect your lifestyle, values, interests and preferences as a whole person. Respect your sexual orientation. Respect the pace at which you live your life. Respect your religious beliefs. Protect your privacy. Knock on your door and wait until you answer before coming in. Close the doors and draw the curtains when providing intimate care. Dress you appropriately for outings. Ensure you are the only one who makes use of your personal belongings. Allow you to have private conversations with various persons of your choosing. Comply with your wishes regarding the gender of the service provider designated to offer you intimate care (with due consideration given to the available personnel). Be patient, polite, gentle, compassionate and understanding when providing health care and other services. Act in a careful manner and listen to your concerns and requests. 2 Prohibit all acts of violence or intimidation concerning you, among them threats, extortion, teasing, abuse of power, indifference or other behaviours impacting your integrity. Act respectfully and courteously when exchanging with intervenors. Adopt a respectful tone and language when speaking to intervenors. Respect the privacy of others. Respect the confidential nature of things they overhear or circumstances they may be privy to. Use services in an appropriate and discerning manner, to avoid hindering the establishment or the delivery of health care and other services by intervenors. Prohibit all acts of violence or intimidation concerning intervenors or others, among them threats, extortion, teasing, abuse of power, indifference or other behaviours impacting someone s integrity. Help foster a calm environment for others who are receiving services. Be tolerant of others. Dress modestly and respectfully when receiving health care and other services. Protect their personal property and valuables. Respect the professional scope of practice of all intervenors. Have faith in intervenors ability to provide the very best possible therapeutic support. Benevolence YOUR RIGHT TO INDEPENDENCE Uphold your independence while acknowledging your potential. Promote your continued physical, psychological and social autonomy. Maintain your right to oversee your possessions as you see fit, unless your capacity in this regard is being evaluated. Limit the use of physical and chemical restraints or isolation measures to situations where you represent a danger to yourself or others (and do so according to the policy in force). Take into account your preferences as to the professional or institution designated to provide the services you need (with due consideration given to the available personnel). Be responsible for their health. Make healthier lifestyle choices. Take steps to be apprised of their health condition. 3 Accept responsibility for their actions and decisions as well as the ensuing consequences. Make their contact details available so that intervenors can carry out all necessary follow-up. Keep loved ones apprised of their health condition. Benevolence YOUR RIGHT TO CONSENT Request your free and informed consent for all interventions concerning you. Keep you informed of available options (and their repercussions and consequences) when comes the time to make important decisions. Abide by the decisions of your representative if you are incapacitated. If you so wish, involve your family and loved ones in decisions or during exams or other meetings. Respect your decisions regarding your own life, and allow you to change your mind in this regard. Comply with your opinions regarding services or activities you have no interest in. Offer you health care and other services until you are able to reintegrate your living environment or are transferred to a centre adapted to your needs. Seek out further explanations whenever something is unclear, and this for the purpose of making free and informed decisions. Respect the expertise of intervenors with regard to the things that are being questioned. Accept the consequences of their decisions. Accept that they can be denied access to services should they willingly violate the rules or regulations of the department or establishment. Teamwork YOUR RIGHT TO PARTICIPATE Promote your involvement in discussions and decision-making with regard to your health and well-being. 4 Encourage you to participate in the drawing up of your intervention, care or service plan. Urge you to be accountable and get involved, within the limits of your interests and abilities. Keep you aware of the existence of various groups (user committees, resident committees, community organizations and associations) likely to foster your continued participation. Encourage you to participate in those activities and events that are of interest. Recognize your efforts and actions (according to your abilities). Help and support you in obtaining health care and other services from our establishment. Help you go through the various phases in your life. Guide and support you as you seek out other internal and external services likely to meet your needs. Modify our service offer in an equitable manner and based on your needs, with due consideration given to available human, financial and physical resources. D ÉQUIPE Abide by the establishment s values, regulations and standards. Play an active role in their care (to the extent of their abilities). Participate in the drawing up of their intervention, care or service plan. Be actively involved in their treatment (to the full extent of their abilities). Have faith in intervenors ability to make the very best possible use of the therapeutic and diagnostic resources available internally and externally. Rally their loved ones to provide care and services at home whenever necessary. Attend all appointments and honour their commitments. Let us know as soon as possible if they will not be able to keep an appointment. Let us know as soon as possible if a planned exam or intervention has been performed in another establishment. Advise us as quickly as possible if they cannot be present for a planned home visit. Ethics and transparency YOUR RIGHT TO INFORMATION Identify themselves and explain their role. Wear their ID card from the establishment. Adopt an easily understood language so that the information shared is clear. Provide you with clear and written information, whenever available, at the time of your intake, your evaluation and your orientation. Make sure you understand the information conveyed. Let someone else (of your choosing) be present when you are given information. 5 Take the time to explain the various interventions you will undergo and how they will be carried out. Ensure that the information associated with the health care and other services you will be receiving is only provided to you and your representative, as the case may be. Convey the information pertaining to your health care and other services in a location where your privacy is assured. Be discrete when communicating your personal or other information. Prior to and during service delivery, clarify once again your expectations, your needs and their role. Advise you of any costs not covered by the Régie de l assurance maladie du Québec, and for which you will be responsible. Ensure you have access to health care and other services in the language of your choice (with due consideration to available resources). Tell you about any accidents or incidents that occurred at the time of service delivery and with a possible impact on your health or well-being. Allow you to consult your record and provide you with any personal information concerning you, as per the Access to Information Act. Respect the confidential nature of the information contained in your record or correspondence, as well as any other information concerning you. Refrain from asking you for any loans, bonuses or donations. Refuse to accept any donation or bequest you might make. Refrain from asking you to perform any type of private service. Keep their relations strictly professional and in keeping with their role. Act with discernment as regards emotional relations or physical contact with you. Notify their immediate superior should there be even the appearance of a conflict of interest. Advise the department head of any action, service or treatment involving you and deemed unacceptable. Share all relevant information regarding their medication, any known allergies, and all other unusual details concerning their health. Compile all of the necessary information before calling to make an appointment. Learn about the waiting times for various services. Inform themselves as to the accessibility of certain service delivery areas. Find out which costs are not covered by the Régie de l assurance maladie du Québec. Voice their values, interests and preferences as whole people. Advise staff if they have an authorized representative. Let the person in charge of the department know of any service, action, gesture or treatment (concerning them or someone else) they deem unacceptable. Pay the costs of all services not covered by the Régie de l assurance maladie du Québec. 6 Ethics and transparency THE RIGHT TO FILE A COMPLAINT AND TO SEEK REDRESS Welcome your complaints and cooperate with you to find solutions. Support you as you seek redress in line with your dissatisfaction with the health care or other services you received or should have received. Advise you of the process for handling complaints and your right to redress. Gather as much information as possible before developing an unfavourable opinion as regards the health care and other services received. Express their dissatisfaction with the health care services received or which they should have received to the person likely to help resolve the matter. Let their dissatisfaction be known and if necessary, submit a request for assistance or file a complaint with the authorities concerned. RELATIONS WITH OUR CLIENTS ARE KEY! If your efforts do not bear fruit and you remain dissatisfied, please contact our Client relations department. To receive assistance or support, or to file a complaint, communicate with the regional service quality and complaints commissioner: CLIENT RELATIONS: , EXT Your request for assistance or complaint will be kept confidential, and we will not tolerate any form of prejudice or intimidation in conjunction with said request or complaint. The CSSS du Nord de Lanaudière user committee and CAAP Lanaudière, the region s support and assistance centre for persons wishing to file a complaint, can inform you of your rights and support you in your efforts concerning any one of our services, including the filing of a formal complaint. They can be reached at: CSSS DU NORD DE LANAUDIÈRE USER COMMITTEE: , EXT CAAP LANAUDIÈRE: OR TOLL-FREE Innovation YOUR RIGHT TO SAFE QUALITY HEALTH CARE AND OTHER SERVICES Make the establishment s various services available to you on the basis of eligibility criteria and available human, financial and physical resources. Rely on their knowledge, skills and competencies to offer you quality services. Quickly intervene in the event of an accident or emergency. Promptly take action to ensure your protection and protect your integrity. Discern any change in your health condition and take prompt action. Offer you services in a safe environment. Ensure your safety by avoiding risky situations. Enable you to freely move inside and outside of our facilities, thanks to safety mechanisms and devices such as access ramps, handrails or adequate lighting. Make services accessible to persons with limited mobility. Ensure that all service areas are sanitary and all facilities are wellmaintained, according to the established standards. Extend safe quality services that meet established standards and make it possible to reach the establishment s goals and objectives. Offer useful and relevant services that meet your needs or those of the community. Suggest ways in which you can prevent incidents, accidents or deteriorating health. Comply with infection prevention and control policies, procedures and provisions. Welcome our personnel in a safe and clean environment. Use the establishment s facilities or equipment in a careful, cautious and civic manner. Comply with the restrictions in force concerning tobacco. Adhere to the rules in force concerning infection prevention. Adhere to the safety rules in force in all facilities. Obtain information on the measures they must take to ensure their safety. Adopt behaviours that will ensure their own protection and help prevent nosocomial infections. 8 REGULATIONS GOVERNING THE USE OF CERTAIN PERSONAL INFORMATION CSSS du Nord de Lanaudière may use the first and last names, addresses and telephone numbers of users to request donations for its health foundation, the Fondation pour la Santé du Nord de Lanaudière, or to conduct satisfaction surveys of its clients as regards the quality of the establishment s services. 4 Users who do not want the establishment to use their personal information can make such a request at any time by calling SUPPORT OUR ONGOING EFFORTS TO IMPROVE THE QUALITY OF OUR HEALTH CARE AND OTHER SERVICES We invite you to share your satisfaction with the services received by contacting the persons concerned directly or by submitting a written message to the establishment s management. Your communication will be shared with the persons in question, and your feedback will allow us to assess the extent of your satisfaction and continue to uphold our best practices. To help us further improve the quality of our health care and other services, we urge you to let the appropriate manager know of any situation you deem unacceptable or feel could be corrected or enhanced. We truly appreciate all of the comments, suggestions and recommendations received. The CSSS du Nord de Lanaudière user committee, as well as the resident committees of all of our live-in centres, are mandated to oversee the quality of the health care and other services delivered. You can obtain more information from the manager in charge if you would like to share your recommendations. 4 Sections 27.3 and 107 of the Act respecting health services and social services. 9 ADDENDA TO THE CODE OF ETHICS OF CISSS DE LANAUDIÈRE FOR INSTITUTIONS GOVERNED BY BILL 52 AN ACT RESPECTING END-OF-LIFE CARE ANY INSTITUTION THAT OPERATES A LOCAL COMMUNITY SERVICE CENTRE, A HOSPITAL CENTRE OR A RESIDENTIAL AND LONG-TERM CARE CENTRE MEANING THE FOLLOWING EXISTING CODES OF ETHICS: CSSS DU NORD DE LANAUDIÈRE AND CSSS DU SUD DE LANAUDIÈRE On December 10, 2015, An Act respecting end-of-life care was adopted (CQLR, c S ). The purpose of this Act is to ensure that end-of-life patients are provided care that is respectful of their dignity and their autonomy. The Act defines endof-life care as palliative care provided to end-of-life patients and medical aid in dying (Bill 52, s. 3). Section 10 of this Act indicates that the code of ethics adopted by an institution must have due respect for the rights of end-of-life patients. In this regard, it is foremost important to identify and recognize certain citizen rights: Every person whose condition requires it has the right to receive end-of-life care (Bill 52, s. 4) Any person of full age who is capable of giving consent to care may, at any time, refuse to receive life-sustaining care or withdraw consent to such care. (Bill 52, s. 5) To the extent provided by the Civil Code, a minor of 14 years of age or over, and in the case of a minor or a person of full age who is incapable of giving consent, the person who may give consent to care on their behalf may also make such a decision. (Bill 52, s. 5) The refusal of care or withdrawal of consent to care may be expressed by any means. (Bill 52, s. 5) A person may not be denied end-of-life care for previously having refused to receive certain care or having withdrawn consent to certain care. (Bill 52, s. 6) A person of full age who is capable of giving consent to care may, by means of advance medical directives, specify whether or not they consent to care that may be required by their state of health, in the event they become incapable of giving consent. However, in such directives the person may not request medical aid in dying. (Bill 52, s. 51) 10 With due respects to these rights, the provision of end-of-life care is to be guided by the following principles: Respect for end-of-life patients and recognition of their rights and freedoms must inspire every act performed in their regard. The health care team providing care to end-of-life patients must establish and maintain open and transparent communication with them. Considering the previous principles, provision of end-of-life care involves patients rights and obligations for health professionals: Resources must ensure the patient s dea
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