Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Phase I: H&S > Block 11 > Flashcards

Block 11 Flashcards

1
Q

Outline arguments in favour of assisted reproductive technology:

A
  • procreative autonomy

- welfare interests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Outline ethical objections to IVF:

A
  • involves destruction of embryos
  • harmful to those trying to conceive
  • it’s “unnatural”
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does the Human Fertilisation and Embryology Act (1990) say about the interests of the future child?

A
  • women won’t be provided with fertility treatment unless account has been taken of the welfare of any child who may be born as a result of that treatment
  • includes need of that child for a father
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the right to an open future?

A

dilemmas should be resolved so as to ensure that children will have a maximally open future e.g. will enjoy the widest possible range of opportunities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the criticisms of the “welfare criterion” in the Human Fertilisation and Embryology Act 1990?

A
  • fertile couples don’t have to meet this criterion (maybe they should have to ?? positive vs negative rights)
  • research suggests a father is not always required for a child to flourish (2008 Act replaced “need for a father” with “need for supportive parenting”)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the uses of Pre-implantation genetic diagnosis?

A
  • avoid genetic disease
  • sex selection
  • saviour siblings
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Under what circumstances is abortion legal according the Abortion Act?

A

If two medical professionals agree:
A)
- the pregnancy has not exceeded the 24th week
AND
- continuing the pregnancy would be more risky than termination
OR
- the termination is necessary to prevent mental or physical injury to the women

B)
- there is substantial risk that if the child were born it would suffer physical or mental abnormalities such that it would be severely disabled

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Explain the premises and conclusions of the pro-life argument

A

1) abortion end the life of a foetus
2) a human foetus has the same moral status as a person
3) it is wrong to end the life of an entity with the moral status of a person
= abortion is morally wrong

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Who can make treatment decisions about children under the age of 16?

A
  • the child themselves if they are Gillick competent
  • someone with parental responsibility (legal obligation to make decisions in the best interest of the child - courts should be involved if they don’t)
  • doctors if it’s an emergency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why should parents generally be allowed to make treatment decisions for their children, and what is this principle called?

A
  • assumption that parents know their children best (best interests does not equal clinically indicated)
  • assumption that close parental bonds will motivate parents to do what is best for their children
  • principle of parental autonomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Who can make decisions about young people aged 16-17?

A
  • presumed competent to consent at 16 so consent should be obtained from the young person before treating
  • if a young person refuses treatment then the law allows treatment to be given if in best interests and approved by parents or courts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When was the Midwives Institute formed? Who formed the institute?

A
  • 1881

- elite group of philanthropic, middle class, upper middle class and aristocratic women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What did the Midwives Act (1902) say?

A
  • normality in childbirth is the midwives role - referring to doctors is only necessary when an abnormality occurs
  • childbearing women should have equal access to midwives and doctors, regardless of socioeconomic status
  • aimed to drive out laity in midwifery (handywomen)
  • made physicians/obstetricians societies the gatekeepers of midwifery education
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What did the 1970 report of the Peel Committee say?

A

Facilities should be sufficient to allow 100% of childbearing women to give birth in hospital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the disadvantages to the statement: “Childbirth can only be considered normal in retrospect” (Walsh, 2007)

A
  • turns physiological event into a medical procedure
  • interferes with freedom to experience birth how and where women choose
  • leads to unnecessary interventions
  • concentrates women in technically equipped hospitals which is costly, and their care is influenced by standardised protocols
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How many childhood deaths are there in England and Wales? How does this compare to other places?

A
  • 5000/year (infants, children and adolescents)

- higher rate than comparable european countries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the pattern of childhood deaths in England and Wales?

A

Mortality rate varies by age:
- highest mortality in infancy
- low rates in middle childhood
- rises again in adolescence
Cause of mortality also varies by age:
- perinatal and congenital causes predominate in infancy
- acquired natural causes more prominent in later childhood and adolescence
- more than half adolescent deaths occur due to external cause
Mortality also varies by sex:
- higher mortality in males than females at all ages
- biggest difference between sexes during adolescence

18
Q

> 50% of external death in adolescents are attributable to…

A

Traffic accidents

19
Q

What types of child death causes may be non-intentional?

A
  • drowning
  • falls
  • fire related injuries
  • road traffic collisions
  • poisoning
20
Q

How do rates for suicide and self-harm change in children and young people in the UK?

A
  • rare in children under 10
  • higher in adolescent boys
  • > 60 deaths per year in adolescent boys
  • deaths due to intentional self-harm and suicide have not changed in 30 years
21
Q

50% of poisoning cases occur in what age range?

A

under 5’s

22
Q

What are the implications of chronic illness in children?

A
  • potential physical, mental and social deficit due to missed school
  • caregiver burden on parents
  • effects on other siblings
  • financial worries related to logistics of attending treatment or due to the need for parents to reduce time in work
  • stigma
  • financial / infrastructure / workforce planning for the government and health services
23
Q

What proportion of deaths in under 19s occur in the first year of life?

A

50%

24
Q

What is the most frequent cause of death in children post-infancy?

A

Injury

25
Q

What is the 14th leading cause of global disease burden? (Comparable to TB or malaria burden)

A

Patient harm

26
Q

What is an adverse event?

A
  • AKA: patient safety event

- an unintended event resulting from clinical care and causing patient harm

27
Q

What is a near miss?

A

A situation in which events (or omissions) arising during clinical care fail to develop further, whether or not as the result of compensating action, thus preventing an adverse event

28
Q

What is the adverse event rate in the UK hospital sector? How much is preventable?

A

~10% (850,000/year) -

~30% is preventable

29
Q

Give examples of adverse events

A
  • wrong site surgery
  • medication errors
  • pressure ulcers
  • wrong diagnosis
  • failure to treat
  • patient fall (most common)
  • nosocomial infection
30
Q

What are serious incidents?

A

Events where the potential for learning is so great, or the potential consequences are so significant, that they warrant using resources to investigate and act

31
Q

What are never events? Give examples and rates

A
  • serious incidents that are entirely preventable (guidance/safety recommendations are available at a national level and should be implemented by all providers)
  • around 500/year
  • examples include: wrong site surgery, retained foreign object post procedure, medication administration by wrong route
32
Q

What are the consequences of patient harm?

A
  • £2bn cost in extra days of admission
  • clinical negligence claims (11,000/year)
  • £1.63bn in settlements
  • reduced patient trust in health professionals
33
Q

How is hospital safety measured?

A
  • mortality data
  • reports of never events and serious incidents
  • inspections e.g. CQC
34
Q

Why is standardised mortality rate not a suitable measure of hospital safety?

A
  • largely dependent on non-hospital care (e.g. large hospice nearby with good care available = less hospital deaths)
  • variation in definitions and coding
  • not a valid screening instrument: no relationship with quality of care has been demonstrated
35
Q

What does the Swiss cheese model show?

A

Latent conditions and active failures - all the holes in the cheese (active failures) between to permit the hazard (latent condition) to cause the adverse event

36
Q

What are active failures?

A
  • unsafe acts committed by people in direct contact with patient
  • two types (errors, violations)
37
Q

What are the three types of active failure errors?

A

Knowledge-based:
- forming wrong plans due to inadequate knowledge or experience
Rule-based:
- misapplication of a good rule OR application of a bad rule
Skills-based:
- unintended deviation from what may have been a good plan e.g. attention slip / memory lapse

38
Q

What is a violation active failure? What are the subtypes?

A
  • people intentionally break rules
    Routine: violation has become normal behaviour
    Situational: context-dependent e.g. poor staffing
    Reasoned: deliberate deviation from rule which is thought to be in patients best interest at the time
    Malicious: deliberate act to cause harm
39
Q

What are examples of latent conditions?

A
  • poor training of staff

- socio-cultural factors

40
Q

What are the important elements of a safety culture in healthcare?

A
  • leadership
  • teamwork
  • use of evidence
  • good communication
  • learning culture (not blame culture)
  • fairness
  • patient-centeredness
41
Q

How can healthcare use a human factors approach to reduce adverse events?

A
  • Acknowledge human fallibility, the inevitability of error and that error does not equal incompetence
  • Design everything with the assumption that people will make mistakes so that mistakes cannot happen e.g.
    - avoid reliance on memory
    - make things visible
    - review and simplify processes
    - standardise common processes and procedures
    - routinely use checklists
    - decrease reliance on vigilance

Phase I: H&S (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions