Clinical Governance Flashcards
Define clinical governance
A framework through which NHS organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish.
Explain why we govern clinical work
To improve the standard of patient care
1) Explain why clinical governance is important (3)
2) How is clinical governance is quality assurance for the NHS? (3)
i) it is about being accountable, taking professional responsibility, having the right systems and processes in place and continuously improving what we do
ii) it is a fundamental element of healthcare practice. It is a continuing process, not an event.
iii) it is relevant to everyone-counter assistants, technicians, pharmacists
2) ~Setting standards and monitoring them and learning from what went well
~ what went wrong (shipman)
~ developing quality staff - quality service
What are the core services a pharmacy offers (7)
1) dispensing
2) repeat dispensing
3) waste management
4) public health (healthy lifestyle advice)
5) signposting
6) support for self-care
7) clinical governance
List the 7 pillars of clinical governance (7)
1) patient and public involvement
2) clinical audit
3) risk management
4) clinical effectiveness
5) staff & staff management
6) use of information
7) premises standards
Outline patient and public involvement (2)
1) involve in:
- service improvement & redesign
2) community pharmacy
- display practice leaflet
- notify public of NHS services provided (poster/website)
- annual patient satisfaction survey
- monitor medicines owed and out of stock items
- complaints/errors procedures
- make “reasonable adjustments” in line with disability discrimination act (DDA)
- co-operate with inspections/ reviews from NHS England
Define clinical audit and explain how often this needs to be completed
clinical audit - a process of improving the care of patients by looking at what you are doing, learning from it and, if necessary, changing practice
Frequency- at least one practice based ( completed in pharmacy) and one NHS England based ( organised for all pharmacies in a geographical area) audit annually
What is risk management
Trying to minimise risks to patients, practitioners and the organisation. You can’t eliminate risk but you must manage it
List some examples of practice based and NHS England based audits (5, 3)
Practice based:
1) advice on inhaler technique audit
2) “as directed” instructions for use audit
3) health promotion travel health audit
4) lung cancer audit
5) near misses audit
NHS England:
1) audit on introduction to stop smoking services
2) how much do you drink?
3) know your waist measurement and risk of diabetes audit
List some risks to staff and patients (4, 6)
risks to staff:
1) health and safety issues
2) financial loss - fridge temp failure (2-8)/ stock loss/ prescription charge loss
3) needle stick/ chemical injury
4) violence in the workplace
Risk to patients:
1) health and safety issues
2) poor standards of care/advice
3) poor service
4) dispensing errors
5) infection from pharmacy
6) confidentiality breach
Outline what characteristics to look out for when appointing someone to lead clinical governance (3)
1) knowledgeable about clinical governance issues
2) knowledgeable about other core NHS services
3) authority to make decisions or report to a person with authority to make decisions on CG issues
What systems can be implemented to reduce risk, with regards to stock integrity, equipment maintenance and waste disposal. (2, 3, 3)
1) stock integrity:
- stock expiry date checks 3 monthly minimum
- reputable suppliers and premises suitable for medicine storage
2) equipment maintenance:
- fridge temperatures
- thermometer calibration
- blood pressure/ cholesterol/ monitor service contract/ recalibration
3) appropriate waste disposal arrangements:
- patient returned waste medicines procedures (infection/needle stick and chemical contamination risk)
- clinical waste, sharps and needle stick injury procedures
- confidential waste- shredders
List some health and safety issues in a community pharmacy (9)
1) fire
2) handling sharps
3) handling large or heavy objects
4) slips, trips, and falls
5) dealing with dangerous chemicals
6) electrical safety
7) display screen equipment
- risk assessments
- equipment testing
- safe practice training
- documentation
8) compliance with child protection/ vulnerable adults legislation
9) risk reduction to patient/ customers and also staff
What is medicines risks-incident reporting (4)
1) error and incident reporting ( near miss)
2) clinical (significance) event analysis
3) send incidents to national reporting and learning services (NRLS)
4) timely response to patient safety communications from national patient safety alerting system (NPSAS)
A) What are standard operating procedures (SOPs)
B) What are they important for? (4)
C) What does an SOP have to be?
A) SOPs are very detailed documents describing the routine method to follow for a specific operation, service, analysis, or action- SOPs describe what we do and how we do it
B) Important for:
1) safety
2) Delivery
3) training
4) cost control
C) Make sure SOP is:
-legally correct, following best practice, following current clinical and operational guidelines, and is up to date.
Useful official guidance: GPhC, RPS, MHRA, NPSA, NICE, GPM