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Public Health > Fundamentals > Flashcards

Fundamentals Flashcards

1
Q

Teams in the NHS

A

Tradition in certain areas eg operating theatres
Community care and GP teams
NHS plan
Service reconfigurations

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2
Q

Why are teams important

A

Efficient
Improves decision making
Reduces medical error
Essential in complex, modern healthcare

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3
Q

What percentage of medical errors are due to breakdowns in teamwork

A

70%

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4
Q

A good healthcare team

A

Clear roles and understanding of each team member’s role
Mutual awareness of team member’s role
Knowledge sharing
Effective communication
Shared goals
Mutual respect and trust
Positive attitude

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5
Q

7 steps to patient safety

A

Build a safety culture
Lead and support staff
Integrate your risk management activity
Promote reporting
Involve and communicate with patients and public
Learn and share safety lessons
Implement solutions to prevent harm

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6
Q

Problems with teams in NHS

A

Healthcare teams are not all the same
Delivered by individuals from different professions
Medics often seen as outliers
Difficult to monitor

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7
Q

Obstacles to teams in the NHS

A

Environmental barriers:
Organisational- shifts/rotations
Location
Management

Other commitments of team members and professional specific goals
Complex leadership

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8
Q

SBAR communication checklist

A

Situation
Background
Assessment
Recommendation

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9
Q

Error

A

Any preventable event that may cause or lead patient harm

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10
Q

Types of human error

A

Errors of omission
Errors of commission
Professional negligence
Skill based errors
Rule/knowledge based

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11
Q

Errors of omission

A

Required action is delayed or not taken

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12
Q

Errors of commission

A

Wrong action taken

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13
Q

Professional negligence

A

Actions or omissions do not meet the standards of an ordinary, skilled professional who has competence

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14
Q

Skill based errors

A

Mistakes during routine tasks due to poor concentration/distraction

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15
Q

Rule/knowledge based errors

A

Inexperience leading to incorrect course of action, often in complex tasks

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16
Q

2 outcomes of medical errors

A

Adverse event
Near miss

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17
Q

Near miss

A

An event during care which has potential to cause harm but fails to develop

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18
Q

Adverse event

A

Incident that results in harm to a patient , not a result of illness

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19
Q

Violations

A

Deliberate deviations from practices, procedures, standards or rules

20
Q

Types of violations

A

Routine
Necessary
Optimising

21
Q

What are violations due to

A

Attitudes, motivations , contextual influences rather than cognitive limitations

22
Q

Information processing limitations

A

Automaticity
Cognitive interference
Selective attention
Cognitive biases
Transferring expectations

23
Q

Automaticity

A

Doing tasks without thinking

24
Q

Cognitive interference

A

More complex task requires higher demand

25
Q

Selective attention

A

Limited additional resources
Information overload

26
Q

Cognitive biases

A

Effects of long term memory and previous exoerienes

27
Q

Transferring expectations

A

Positive or negative
From familiar objects.situations to similar new ones

28
Q

Approaches to managing error

A

Person
System

29
Q

Person approach to managing error

A

Focuses on the unsafe acts of professionals

30
Q

Shortcomings of person approach to managing error

A

Anticipation of blame promotes cover up
No way of uncovering repeated errors
Relies on trust in reporting errors

31
Q

System approach to managing error

A

adverse events are products of many causal factors
Efforts are directed at removing error traps and strengthening defences

32
Q

Latent conditions

A

Lie dormant within the system before they combine with active failures and local triggers to create an accident opportunity, can be identified and remedied

33
Q

Active failure

A

Hard to foresee

34
Q

Reducing error and harm

A

Simplification and standardisation of clinical practices
Checklists and aide memoire
IT and softeware
Team training
Risk management programmes
Mechanisms to improve uptake of evidence based treatment patterns

35
Q

Tips for junior doctors when reducing errors

A

Develop internal alarm bells
Seek help when overwhelmed
Use clinical guidelines
Always document thought process, actions and plans
Checking results and recorded information
Speaking up if an error is suspected

36
Q

Why is safety compromised so often

A

Complex, high risk environment especially in hospitals
Resource intensive
Often shared responsibilities

37
Q

Ethics - Richard Norman 1998

A

Attempt to arrive at an understanding of the nature of human values
How we ought to live and what constitutes right conduct

38
Q

Ethical arguments

A

Top down deductive
Bottom up inductive

39
Q

Top down deductive

A

Where one specific ethical theory is consistently applied to each problem

40
Q

Bottom up inductive

A

Using past medical problems to create guides to practice

41
Q

Morality

A

Concern with distinction between good and evil, right and wrong (universal)

42
Q

Ethics

A

A system of moral principles and a branch of philosophy
Defines what is good for individuals and society
Differs in different cultures

43
Q

Doctrine of dual effect

A

Harmful effect is inseparable from the good effect
Nature of act is good and intention is good
Good effect outweighs the bad effect

44
Q

Meta-ethics

A

Nature of ethics and moral reasoning
Exploring fundamental questions
Right/wrong defining the good life

45
Q

Normative ethics

A

Determining the content of our moral behaviour
Focus is on the act itself, the person performing it and its consequences

46
Q

Applied ethics

A

Attempting to deal with the specific realms of human action, crafting criteria for discussing issues
Emergence of ethical investigation in specific areas
Environmental, medical and public health

Public Health (7 decks)

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