Exam Extras Flashcards
What are the steps for donning PPE?
1) Wash hands
2) Don apron
3) Don mask
4) Don eye protection
5) Don gloves
What are the steps for doffing PPE?
1) Remove gloves
2) Wash hands
3) Remove apron
4) Remove eye protection
5) wash hands
6) remove mask
7) wash hands
What is a cost benefit analysis?
Whether economic value can justify costs
compare costs of >/= 2 alternatives and review return on investment eg stop smoking interventions
What is a cost utility analysis?
Determine cost in quantity/quality of life eg cost of cancer rx for one extra year of life
utility= year
What is a QALY?
Number of years in a health state x health state weighting
Cost effectiveness
Costs of various approaches to achieve a specific health outcome using specific units
eg DM treatment and kilos lost
Budget Impact Analysis
financial affordability of an intervention eg change in cost to budget holder from f2f to tele appointments
Cost-consequence analysis
comprehensive summary or multiple costs and effects, commissioner/government/budget level
cost consequence
comprehensive comissmioner
Cost minimisation
Only looking at costs, not on impact or other factors
WHOQOL
1) Physical (mobility/pain)
2) Psychological
3) Level of independence (mobility/ADLs)
4) Social relationships
5) Environment (work/home/transport)
6) Spirituality/Needs (perceptions)
EuroQOL 5D
1) Mobility
2) Self care
3) Usual activities
4) pain
5) anxiety/depression
How long is a prescription valid for?
6 months (Controlled drug= 28/7)
What are examples of special category personal data?
Significant risk to rights/freedoms:
Race/ethnicity
Politics
Union
Health
Religion
Sex/orientation
genetic/biometric
What is a subject access request?
Made by pt/3rd party with pt’s consent
private/nhs data
1) verify identity with reasonable means
2) give a copy within 28/7-> extends to 2/12 if complex/many requests
What is a health record?
Any patient contact with a healthcare system
covered by access to health records act
What is the Data Protection Act?
How information is used/what information is held
general data processing guidance
right to access information held about you
Freedom of Information Act
Must ask in writing, with home/address/what you want
within 20 days
all public services
Human Rights Act
eg to life, respect and privacy, freedom of religion/belief
public authorities must follow this
Mental Capacity Assessment components
Understand
Retain
Weigh
Communicate
Dahlgren and Whitehead model of health determinants
1) general/socioeconomic/cultural/environmental
2) living and working
3) Social and Community Networks
4) Individual Lifestyle
5) Age/sex/constitutional factors
Nottingham Health Profile
Part 1 and 2
brief view to survey health problems and measure medical/social intervention
0= worst health
100= best health
Sickness Impact Profile
A-N
measure of health status by ADL performance
SF-36
36 item short form survey looking at QOL measures
Donebedian’s Model
evaluates quality of care
1) Structure (characteristics of the place)
2) Process (what services/investigations)
3) Outcomes (effect on status of individual/population)
Mental Health Act- 131
Informal, voluntary admission (has capacity and consents)
Mental Health Act- 2
Detention for assessment
28 days
AMHP/nearest relative + 2 doctors
2=2 drs, 28 days
3- treatment
Mental Health Act- 3
Detention for treatment
6 months
renewable
AMHP/nearest relative + 2 doctors
Mental Health Act- 4
admission for assessment
72 hours
AMHP + 1 doctor
Mental Health Act 5 (2)
assessment
72 hours
1 doctor
Mental Health Act 5 (4)
assessment
6 hours
1 nurse
4 5 6 (6 hours, 1 nurse)
Mental Health Act- 135
Police
private property 24 hrs
5=private
Mental Health Act- 136
Police
public property
24 hrs
13 fiiive = priivate
13siix- publiic
Mental Health Act 17a
community treatment
1 clinician + AMHP
detain for 72hrs if non compliant
17 a= 72 hours
Humanist
heavier emphasis on learner and their potential
not focussing on methods/materials
meeting own needs and taking control
humanist= heavy emphasis
Behaviourist
learn by observing others
learner is a blank slate, repetition and reinforcement needed
behaviourist- by observing
Cognitivist
Learning occurs when learner breaks down and re-organises new information in their mind
Connectivist
Finding/sifting through information to learn own answers
Existentialist
Explore own interests/passions, not what others tell you to learn
How often is a census performed?
Every 10 years
2 year projections
What is Bloom’s taxonomy
mastery of a subject/higher thinking
1) cognitive (knowledge, can recall/apply)
2) affective (attitude- can receive/respond)
3) skills (imitation/manipulation)
ABC
Blooms, cognitive, affective
What is Miller’s pyramind?
Expert to Novice
1) Knowledge
2) Understanding
Both can be assessed by tests
3) shows how
4) does
Assessed by OSCE/OSATs
Miller’s OSCE
Pendleton’s Rules
Giving Feedback
1) what did you do well?
2) What do I think you did well
3) What do you think could have gone better?
4) What I think could have gone better
5) Agreed action plan
Validity
the ability of an assessment tool to measure what it is intended to measure
4 principles of medical ethics
Beneficence
Non-maleficence
autonomy
justice
Caldicott Guardian
responsible for:
protecting confidentiality
enabling appropriate information sharing
Bolam principle
Not negligent is acting in accordance with accepted practice (medical opinion/body)
Bolitho Principle
extension of Bolam
medical consensus AND logical analysis (not just what opinion/body says, but also logical)
Montgomery ruling
Take reasonable care to ensure aware of material risks and alternatives
‘what a reasonable pt would want to know’
serious risks and common risks
What is commissioning?
Encompasses many actions:
Health Needs Assessment
Service Specification
Contract Negotiation/Procurement
->continuous quality assessment
What is Surveillance?
Ensuring right information is available at the right time and right place to inform:
public health action
programme planning and evaluation
formulating research hypotheses
What is screening?
Identifying healthy people who may be at risk of something
What is a Health Needs Assessment?
Systematic Method of identifying unmet healthcare needs of a population and making changes to meet those unmet needs
Principles of Confidentiality
Minimum necessary
manage and protect information
be aware of responsibility
comply with law
share relevant to direct care
explicit consent if identifiable
tell patient about disclosure
support access to own info
Caldicott Report 1997
Recommend each trust has a guardian
to ensure principles are implemented and monitored
Commissioner’s office
promote and enforce:
FOI
DPA
When to breach confidentiality
in public interest
protect individual/society from serious harm
eg: crime/communicable disease
Who to ask:
Caldicott Guardian
GMC/BMA/MDU
Consent in practice
agreement for health professional to provide care
1) mental capacity
2) enough information and opportunity to discuss
3) free from duress
-withdrawn at any time
otherwise:
Assault/battery
Best Interests
least restrictive option
views/feeling of patient and those close to them
wishes when competent
QoL
belief
current wishes
Fraser Guidelines
Providing SRH care to those <16yo if:
-understand
-cannot be persuaded to tell those with parental responsibility
-will have SI anyway
-health would suffer without
-best interests
Gillick competent: mature enough to consent
Clare’s Law
> 16 can inquire to police to ask re history of abusive behaviour
police can also proactively tell you
Right to ask + Right to know
FGM
Illegal to arrange/assist
illegal to take overseas for
illegal to fail to protect from
<18yo = mandatory reporting
1) Clitoridectomy
2) clitoris and labia minora
3) infibulation
4)Other
Side effect frequency meanings
Very common >1 in 10
Common >1 in 100
Uncommon >1 in 1000
Rare >1 in 10000
very rare <1 in 10 000
frequency not known
