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3A > CotE and PH past paper questions > Flashcards

CotE and PH past paper questions Flashcards

1
Q

Pressure ulcers - Predisposing factors

A 
Immobility 
Smoking 
Dehydration 
Poor nutrition 
Sensory impairment

Alzheimer’s
Parkinson’s

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2
Q

Pressure ulcers - Risk assessment

A

Warterlow tool

Braden tool

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3
Q

Pressure ulcers - Prevention

A

SSKIN

Supportive surfaces - Mattresses and cushions made of viscoelastic foam
Skin assessment - Barrier creams, pressure redistribution, repositioning, regular skin assessment
Keep moving
Incontinence and moisture management
Nutrition and hydration

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4
Q

Osteoporosis risk factors

A

SHATTERED

Steroids 
Hyperthyroidism. hyperparathyroidism, hypocalcaemia 
Alcohol 
Thin
Testosterone LOW
Early menopause 
Renal failure 
Erosive - IBD 
Dietary intake and drugs
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5
Q

Fracture risk assessment

A

FRAX score

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6
Q

Osteomalacia

A

Softening of bones
Due to impaired metabolism
Calcium and phosphate deficiency

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7
Q

Osteoporosis non-pharmacological treatments

A

Increase calcium intake
Vitamin D supplements
Exercise and weight bearing
Stop smoking

Falls prevention
Home OT assessment

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8
Q

Osteoporosis medical treatment

A 
Bisphosphonates 
Strontium ranelate 
Raloxifene 
Calcitonin 
Denosumab
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9
Q

Discharge planning

A 
Care package 
OT and PT assessment 
Social worker assessment 
Follow-up with community OT and PT 
Active recovery
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10
Q

Healthcare evaluation - Donabedian

A

Structure - What is available

Process - What happens

Outcome - 5Ds

  • Death
  • Disability
  • Disease
  • Discomfort
  • Dissatisfaction
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11
Q

Qualitative methods of healthcare evaluation

A

Focus groups
Interviews
Surveys and questionnaires
Observations

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12
Q

Never event reporting

A

National Reporting and Learning Systems - NRLS

Strategic Executive Information Systems - SEIS

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13
Q

System approach to error

A

Focus on working conditions

Errors are commonplace
Adverse events are the product of many causal factors

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14
Q

Person approach to error

A

Focus on the individual

Errors are the product of wayward mental processes

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15
Q

Theory of planned behaviour

A

Intention is the best predictor of behavioural change

  1. Perceived behavioural control
  2. Subjective norms
  3. Individual’s attitudes towards the behaviour
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16
Q

Ways to help turn intention into behaviour

A

BRIDGING THE GAP

Perceived control 
Anticipated regret 
Preparatory actions 
Implementing intentions 
Relevance to self
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17
Q

Theory of planned behaviour - Limitations

A

Lacks temporal element
Does not consider emotions
Assumes attitudes and subjective norms can be measured

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18
Q

Theory of planned behaviour - Advantages

A

Considers social pressures

Useful for predicting intention Can be applied to a variety of behaviours

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19
Q

Capacity assessment

A

Understand
Retain
Weigh-up
Communicate a decision

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20
Q

Libertarian principles for resource allocation

A

Each individual is responsible for their own health and wellbeing

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21
Q

Rule of rescue

A

Perceived duty to save an endangered life wherever possible

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22
Q

Epidemiological health needs assessment

A 
Define problem 
Size of the problem 
Services available - Prevention, treatment and care 
Evidence base 
Models of care 
Existing services 
Recommendations
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23
Q

Comparative health needs assessment

A

Compares services received by a population with services received by others

Health status
Provision
Utilisation
Outcomes

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24
Q

Corporate health needs assessment

A

Consider the opinions of people living within the population
What do they want

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25
Q

Epidemiological health needs assessment advantages and disadvantages

A

Advantages

  • Uses existing data
  • Evaluates trends over time

Disadvantages

  • Data may not be useful
  • Does not consider the opinions of the people
26
Q

Comparative health needs assessment advantages an disadvantages

A

Advantages

  • Quick an cheap if data is available
  • Gives a measure of relative performance

Disadvantages

  • Difficult to find a comparable population
  • Does not indicate the correct level of provision
27
Q

Corporate health needs assessment advantages and disadvantages

A

Advantages

  • Based on felt expressed needs
  • Recognises the knowledge and experience of those working within the population

Disadvantages

  • Need vs demand
  • May be influence by political agendas
28
Q

Criteria for negligence

A

Duty of care
Breach in the duty of care
Somebody came to harm
Harm was caused by the breach

29
Q

Two causes of confusion and agitation

A

UTI

Hypercalcaemia

30
Q

Two nursing strategies for a confused patient

A

Side room
Sleep hygiene
Clocks
One-to-one nursing

31
Q

Medical treatment for confusion and agitation

A

Haloperidol

32
Q

Screening criteria

A

Condition - Important health problem, with a known natural history and pre-clinical phase

Test - Sensitive, specific, inexpensive and acceptable

Treatment - Effective, with an agreed policy on who to treat

Organisation - Facilities in place, with the cost of screening economically balanced in relation to healthcare spending

33
Q

Prevalance

A

Number of existing cases at a set point in time

34
Q

NPV

A

Proportion of people with a negative result who DO NOT have the disease

d / d + c

35
Q

PPV

A

Proportion of people with a positive result who DO have the disease

a / a + b

36
Q

Sensitivity

A

Proportion of people WITH the disease who are correctly identified

a / a + c

37
Q

Specificity

A

Proportion of people WITHOUT the disease who are correctly excluded

d / d + b

38
Q

Incidence

A

Number of new cases which occur in a set period of time

39
Q

Attributable risk

A

Rate of disease in exposed that can be attributed to the exposure

Incidence in exposed - Incidence in unexposed

40
Q

Relative risk

A

Risk in one group relative to another

Incidence in exposed / incidence in unexposed

41
Q

Confounding variable

A

A factor which is associated with the exposure in question and independently influences the outcome

42
Q

Reasons for apparent association between dependent and independent variables

A

Bias
Chance
Confounding
Reverse causality

TRUE CAUSALITY

43
Q

Underlying factors for failure of patient care

A

System failure
Judgement failure

Human factors
Neglect
Poor performance
Misconduct

44
Q

Swiss cheese model

A

Defence against hazard is a series of barriers
Each barrier represented by a slice of cheese
Each cheese contains holes of various sizes and positions

These holes momentarily line up
Creates a trajectory of accident opportunity
Hazard passes through all of the holes
Leads to FAILURE

45
Q

Falls - Predisposing factors

A 
Neurological disease 
Cognitive decline 
Muscle weakness 
Visual deficit 
Incontinence 
Postural hypotension 
Dehydration 
Malnutrition
46
Q

Falls - Complications

A

Rhabdomyolysis
Hypothermia
Pressure sores

47
Q

Falls - Investigations

A

ECG
CK
FBC

Bone biochemistry - Serum calcium, phosphate and vitamin D

Lying/standing BP

48
Q

Medications causing postural hypotension

A 
ACE-I 
Diuretics 
Nitrates 
Beta-Blockers
Alpha-Blockers
49
Q

Human rights in healthcare

A

Article 2 - The right to life
Article 3 - The right to be free from inhuman and degrading treatment
Article 8 - The right to respect for privacy and family life
Article 12 - The right to marry and found a family

50
Q

Resource allocation theories

A

Egalitarian principles
- Provide all care that is necessary and appropriate

Maximising principles
- Maximise public utility

Libertarian principles
- Everyone is responsible for their own health and well-being

51
Q

Requirements for a DoLS application

A
  1. Patient is in hospital or care home
  2. Under continuous supervision and not free to leave
  3. Lacks mental capacity
52
Q

What are the DoLS

A

Deprivation of liberty safeguards

  1. A representative who is given certain rights and is responsible for looking out for and monitoring the person receiving care
  2. Right to challenge a DoL through the court of protection
  3. Provide a mechanism for a deprivation of liberty to be reviewed and monitored regularly
53
Q

What must happen before a DoLS is put in place

A

Age assessment - Patient must be over 18

No refusals assessment - Proposed treatment cannot contradict valid decision made by LPA, deputy, or advanced directive

MCA - Patient must lack capacity

MHA - Different rules apply for MHD

Eligibility assessment - Confirm whether there person is eligible to be deprived of liberty under DoLS

Best interests assessment

54
Q

DoLS guidelines

A

Should be avoided wherever possible
Should only be authorised when in the patient’s best interests and the only way to keep them safe
Should be for as little time as possible
Should be for a particular reason
There is no suitable alternative that would not deprive them of their liberties

55
Q

Advanced care planning

A

Enables a person to make decisions about their future health and social care in the event that they lose capacity

  1. Advanced statements
  2. Advanced decision to refuse treatment
  3. Lasting power of attorney
56
Q

Advanced statements

A

Not legally binding
Should be taken into consideration

Serve as a guide to inform best interests decisions
Can cover any element of future care

Written or verbal
Does not require witness or signature

57
Q

Advanced decision to refuse treatment

A

Legally binding

Enables patient to refuse a particular treatment
Cannot refuse basic care such as food and water

Must be specific to specific interventions
Must be written, signed and witnessed

58
Q

Lasting power of attorney

A

Can refuse treatment BUT cannot demand treatment

Health and welfare
Property and affairs

59
Q

Advantages of advanced care planning

A

Enables better informed best interests decisions

Relatives are more likely to be comfortable with the care of an individual if it was their own choice

60
Q

Disadvantages of advanced care planning

A

Cannot request specific care
Cannot request assisted suicide
Cannot refuse treatment under the MHA

61
Q

IMCA

A

Independent mental capacity advocate

Makes decisions for an individual who does not have friends or family

3A (31 decks)

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