Legal issues and follow up of ROP

In this webinar we shall learn about legal issues and follow up pertaining to ROP
To know about the legal issues that can arise How to prevent legal problems? Importance of follow up
Legal issues could arise due to – Poor communication Poor documentation Complications arising out of the procedure Lack of follow up
The need and timing of ROP screening must be communicated to the parent by: Doctor, Nurse, Ophthalmologist. It should be explained in parent’s language in easy understandable terms and their understanding should also be checked. They should be provided with the parent information leaflet. Phone call reminders linking with local doctor health worker are also important steps to improve follow up rates.
A consent form before any procedure should include: the details of nature of disease, possible side-effects, complications of the treatment . It must be prepared in at least two languages (simple understandable terms) The same must be communicated verbally to the parents.
The discharge summary must contain: The findings of the first screening and the date and place for follow-up first screening. Advice regarding ROP screening preferably in the local language. The case record must contain the details of the screening and treatment as shown in the figure
Legal problems can be reduced by a considerable extent only through a system of multiple levels of checks. Assigning roles and responsibility to each person (screening line list, screening, treatment and follow up)
Legal problems can be reduced by a considerable extent only through a system of multiple levels of checks. Assigning roles and responsibility to each person (screening line list, screening, treatment and follow up)
Follow up examination should be individualized It depends on the severity, treatment received and regression of findings It is absolutely necessary that the neonate undergoes serial examinations till the retina is fully mature Assessment for visual acuity and squint is continued into childhood
Support system should include SNCU/RBSK team- Paediatrician/Follow -up nurse/Optometrist/DEO Trained Ophthalmologist Community level –ANM/ASHA/AWW Screening facility should made available at all SNCUs Treatment facility at select SNCUs Availability of early access to treatment Social and educational support
Key messages: Screening for ROP has to be done at the right time to prevent progression to severe forms Multiple levels of checks and parents education will ensure follow-up thus avoiding complications and legal issues. Linking with various health functionaries is very crucial for the success of the ROP programme. Thank you
  • Introduction...
  • 1. Learning object...
  • 2. Legal implicati...
  • 3. Proper communic...
  • 4. Consent form...
  • 5. Proper document...
  • 6. Proper document...
  • 7. Checklists...
  • 8. Importance of f...
  • 9. Support system...
  • 10. Key messages...
 

Introduction

DR. J. KUMUTHA
MD, DCH

Professor & Head
Department of Neonatology
Saveetha Medical College
Thandalam, Chennai

1. Learning objectives

â–º To know about the

      ♦ Legal issues that can arise
      ♦ Prevention of legal problems
      ♦ Importance of follow up

2. Legal implications

â–º Legal issues could arise due to

      ♦ Poor communication
      ♦ Poor documentation
      ♦ Complications of the procedure
      ♦ Lack of follow up

3. Proper communication

4. Consent form

â–º A consent form should include

      ♦ The details of nature of disease
      ♦ Possible side-effects
      ♦ Complications of the treatment
      ♦ At least two languages (simple understandable terms)

â–º The same must be communicated verbally to the parents

5. Proper documentation

â–º The discharge summary must contain

      ♦ The findings of the first screening, the date and place
         for follow-up/ first screening

      ♦ Advice regarding ROP screening preferably in the local
         language

      ♦ The case record must contain the details of the
         screening and treatment

6. Proper documentation

7. Checklists

â–º Legal problems can be reduced by a considerable extent
    only through a system of multiple levels of checks



â–º Assigning roles and responsibility to each personnel
    (screening line list, treatment and follow up)

8. Importance of follow-up

â–º Follow up examination should be individualized

â–º It depends on the severity, treatment received and
    regression of findings

â–º It is absolutely necessary that the neonate undergoes
    serial examinations till the retina is fully mature

â–º Assessment for visual acuity and squint is continued into
    childhood

9. Support system

â–º SNCU/ RBSK team- Paediatrician/ Follow - up nurse/
    Optometrist/ DEO

â–º Trained Ophthalmologist

► Community level – ANM/ ASHA/ AWW

â–º Screening facility should made available at all SNCUs

â–º Treatment facility at select SNCUs

â–º Availability of early access to treatment

â–º Social and educational support

10. Key messages

â–º Screening for ROP has to be done at the right time to
    prevent progression to severe forms

â–º Multiple levels of checks and parents education will
    ensure follow-up thus avoiding complications and legal issues

â–º Linking with various health functionaries is very crucial
    for the success of the ROP programme