Clinical Governance Flashcards
NMP are accountable in 4 areas?
-professional
-employer (vicarious liability, employment contract)
-civil law
-criminal law
Civil law definition?
When harm is cause by the breach of duty of care with resultant loss
Criminal law definition?
Premeditated harm with resultant loss
Clinical negligence definition?
Defined as the breach of duty of care by the HCP that had cause harm/injury to Pt
Criteria to prove clinical negligence? 4
-establish duty of care
-establish breach of duty of care
-the breach of duty of care has caused harm/injury
-the harm/injury was foreseeable
Bolam test holds that?
A dr is not guilty of negligence when acted according to a practice considered as proper by a responsible body of professional skilled in that art. There is a duty of care, however the standard of that duty of care is matter of medical judgment.
Bolitho test?
Holds that the Dr is liable of clinical negligence in regards of treatment and diagnosis, despite acting in accordance with a professional body of opinion where it has not been demonstrated to the judge satisfaction that the body of opinion was reasonable and responsible.
Scope of practice explained? 5
-defines competence and experience of NMP
-includes the formulary of medication available to NMP
-it is intended for a group of pt
-it is intended for a specific care setting
-can be expanded overtime
When the IP should refer to an appropriate prescriber?
When the IP does not fully understand the implication of their prescribing practice in regards of the physiology and phamaco-therapeutic action of the medication prescribed despite being able to take Pt history and formulate a working diagnosis.
Vicarious liability definition?
The employer is responsible of the negligent act of their employees.
Vicarious liability criteria ? 3
-the prescriber is negligent
-the prescriber is employed
-the prescriber acted on the course of the employment
Mandatory for all NMP?
An insurance cover that matches the risks associated with their prescribing practice.
Clinical governance definition?
System through which the NHS organisations are accountable for:
-improving services
-safeguarding the high standard of care
-creating environment in which excellence can flourish
7 pillars of Clinical Governance?
-audit
-pt involvement
-clinical effectiveness
-staff management
-risk management
-information Managment
-education & training
Clinical Governance objective? 4
-pt care approach
-pt involved in the decision making
-commitment to high standard
-reduce risks of clinical errors
How to develop systems to prevent errors? 3
-identify what works
-put process in place
-make the process sustainable
Error definition?
Failure of a planned action where the intended outcome has not been achieved
Active error definition?
Unsafe act performed that had caused direct harm to pt
Latent error definition?
Inevitable pathogen in the system
Accident causal model
Describes how the accident occurred and the factors contributing to the incident
Factors affecting errors? 5
-environment
-team
-individual
-task
-pt factors (polypharmacy)
Swiss Cottage cheese model explained
Duty of candour definition?
It is a legal duty of HCP to apologise when there have been a clinical mistake in the care of the pt which led to significant harm.
Berwick report defined? 4 points
-quality of it care
-connect with pt
-foster growth and staff development
-embrace transparency
