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Health and Society Year 3 > General > Flashcards

General Flashcards

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Sociology 101 flashcards
1
Q

Define an audit

A

The systematic critical analysis of the quality of medical care, including the procedures used for diagnosis & treatment, the use of resources & the resulting outcome & quality of life for the patient

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2
Q

5 stages of an audit

A
  • 1: identify current standards
  • 2: measure current performance
  • 3: compare performance vs standards
  • 4: make improvements
  • 5: re-evaluate
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3
Q

3 benefits of an audit

A

improve patient care, financial benefits, assess progress against national standards

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4
Q

5 limitations of an audit

A

only as good as national standard, may have no improvement, costs time/money/resources, only focusses on one thing at a time, improvements focus on current standards and not what might actually be best

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5
Q

How long do you have to complain

A

12 months

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6
Q

3 steps for complaints

A

1st: PALS
2nd: NHS directly or commissioner
3rd: Parlimentary and health service ombudsman

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7
Q

What is PALS

A

Patient advise and liaison service

Independent complaints advocacy service in every trust

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8
Q

Complaining about mental health act?

A

Directly to CQC

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9
Q

Commissioner for hospital and GP

A

Hospital: NHS England
GP: CCG

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10
Q

4 common reasons for complaints

A

Ineffective/unsafe clinical practice
Poor information
To have bad practice investigated & changed
Bad attitudes/ lack of dignity and respect.

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11
Q

Define medical indemnity

A

: legal exemption from liability for damages done to patients under treatment in NHS

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12
Q

4 responsibilities of doctors

A

discuss everything in non-jargon way, recommend alternative treatments, keep good records, ask for second opinion when knowledge is limited

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13
Q

Define adverse effect

A

Undesired harmful effect resulting from medication/procedure.
e.g. prescribing error, surgical error, communication failure, delayed diagnosis

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14
Q

Most common adverse effect in primary and secondary care

A

Primary: delayed diagnosis
Secondary: negligence

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15
Q

Define near miss / active failure

A

can be errors (knowledge/rule/skills based) or violations (routine, reasoned (thought in patient’s best interest), reckless/malicious)

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16
Q

How many near misses are preventable

A

50%

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17
Q

Why are near misses important

A

They’re common, have consequences and we can prevent them by reporting them

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18
Q

Role of the national patient safety agency

A

responsible for handling adverse events, and they can be reported to them e.g. reporting drug reactions/side effects with yellow card at back of BNF

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19
Q

5 barriers to effective learning

A

lack of communication, lack of responsibility, focus on event not root cause, pride/rigid attitude, poor monitoring

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20
Q

7 steps to patient safety

A

Build safety culture, support staff, integrate risk management, promote reporting, communicate public, implement solutions, lean and share

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21
Q

Consent for clinical trials

A

Must be informed and reviewed by ethics committee

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22
Q

3 ethical issues of clinical trials

A

Subjecting some people to risk for the benefits of others: does risk-benefit analysis is main job of ethics committee (non-maleficence and beneficence

Not knowing long term damage so is consent informed

If paid money are they taking advantage of pooper populations, will they provide false information to join, removes altruism

23
Q

What are the 4 stages of a trial

A

1: researchers test a new drug or treatment for the first time in small number of people (20-80) (usually normal, healthy volunteers, to evaluate its safety, determine dosage range, side effects
2: larger groups (100-300) to further assess clinical safety
3: larger groups (1000-3000) to look for s/e
4: performed after drug or treatment has been authorised for medical prescription and has been marketed. Look for long term use.

24
Q

Ethical dilemmas towards healthcare problems in the elderly

A

Conflict of interest, Euthanasia, DNACPR

Consent and capacity

25
Q

Define medically unexplained symptoms

A

Illness or symptom where there is no detectable physical pathology

26
Q

Common MUS

A

Chronic fatigue syndrome
Fibromyalgia
IBS
Repetitive strain

pain, palpitations, fatigue, headache

27
Q

3 ways of dealing with medically unexplained symptoms

A

Rejecting: denies reality of symptoms, patients needs not met
Collusive: sanctioning patients beliefs about symptoms
Empowering: tangible, opportunities for self management, patient understands, removes blame from patient and allies doctor and patient

28
Q

issues for the individual living with MUS

A 
Lack of social support and information
Relationships strained
Often told it's psychological
Guilt and isolation (wasting doctors time and resources)
Iatrogenic harm from investigations
Patients needs often not met
29
Q

Role of the post-mortem

A

Insight into pathological process of disease
Prevention of future patient deaths
Aids teaching and research

30
Q

Legal requirements for a post mortem

A 
Sudden/unexpected death
Unknown cause of death
Unnatural death
Death from industrial disease
Death from negligence
Death during surgery/anaesthesia
Death within 24hrs of admission
Not seen by a doctor in 14 days
Patient detained under mental health act
31
Q

4 criteria to certify a death

A

pupils fixed and dilated
No ventilation/breath sounds for (3 minutes)
No central pulse for (1 minute)
No heart sounds on auscultation (1 minute)

Also look for verbal stimuli, response to pain

32
Q

Reasons to refer to the coroner

A 
In hospital less than 24 hours
Unknown cause
In custody
Suspicious circumstances
Drugs or alcohol involved
Industrial death
Blame 
Accident
Operation
33
Q

When can you fill out a death certificate

A

Seen the patient in the last 14 days
Provided care in the last illness before death
Registered medical practitioner
Knowledge and belief of the cause of death

34
Q

What is the calman-hine framework

A

Highlighted the need to develop strategic cancer networks incorporating primary care, cancer units and cancer centres
Monitors effectiveness of the changes resulting from recommendations

35
Q

Aims of strategic cancer networks

A 
Reduce incidence of cancer
Maximise survival of cancer patients
Enhance QOL of patients
Improve patient experience
Provide a high quality service
36
Q

Role of a cancer unit

A

Diagnose and treat common cancers
Diagnose intermediate cancer and refer to specialists
Provide drug therapy and treatment

37
Q

Role of cancer centres

A

Provide cancer unit services for large areas
Specialist diagnoses and treatment to allow better management of less common conditions (disadvantage of travel and barriers to accessing care)

38
Q

Role of partnership groups in cancer care

A

Combine users of cancer services to improve services

39
Q

Role of cancer registeries

A

Collect analyse and disseminate cancer data to the region
Submit to office of national statistics
Implement the cancer plan through provision of reliable data of incidence, prevalence and survival rates

40
Q

National cancer research network

A

Supports recruitment of patients for trials and improves speech, quality and integration of research into care services
Integrates and supports work from cancer charities

41
Q

Role of the national cancer research institute

A

Promote co-operation between government, charities and industry for patient and public benefit
Maintains a research database that analyses current research and informs future research

42
Q

How are the quality of cancer services measured

A

Clinical service quality measures (CSQM)
Care quality commission (CQC)
National audits
Survival and mortality rates

43
Q

Psychological consequences of cancer treatment for patients and relatives

A

Diagnosis: stressful, family dynamics change, shock, anger, guilt, blame, treated as a death sentence
Treatment: relationship problems, change in identity, scars, unable to work/exercise
Family: relationship, distressing for child, concern for relatives

44
Q

Expectation of a medical student

A

Develop skills and behaviour
Commitment to maintain knowledge and skills for life
Develop skills needed to maintain a strong professional relationship
Work effectively with colleagues
Honest and integrity

45
Q

Attitudes to mental illness in the elderly

A 
Presumptions e.g. technology 
Sx put down to old age
Treatments prioritised to younger people (not looking at physiological age)
Less screening
Different attitude to healthcare
46
Q

Role of social workers

A

Support families through difficult times, review environments and help financially and legally
Child protection

47
Q

Define advocacy

A

Getting support from another person to help you to express your wishes and views and help you to stand up for your rights

  • they will listen, explore options, provide information for informed decisions, accompany you and contact relevant people
  • they will not give you their opinion, solve problems or make judgement
48
Q

Define stigma

A

Something which exists through social relations

49
Q

Explain the social process of labelling

A

Labelling (the label X) > Stereotyping (people who are X are) > othering (us vs them) > stigmatising (devaluing X based on attribute) > discrimination (acting differently to X)

50
Q

Explain the 5 types of stigma

A

Discreditable: keep stigmatising conditions hidden except to close family (HIV)
Discrediting: cannot be hidden e.g. wheelchair, aspegers.
Felt: by patient (shame in STI clinic)
Enacted: by others (schizophrenia removed from bus)
Courtesy: felt by someone who is with someone open to stigma e.g. parent of autistic child, spouse of alzhiemer patient

51
Q

Define internalising

A

absorbing social views of being lower status and the impact on personal beliefs and behaviour

52
Q

How to cope with stigma

A

Passing (pretend like normal)
Covering (non disclosing, blind wear sunglasses)
Withdrawal: social acknowledge and withdraw
Resisting: contesting the stigma

53
Q

Implications of stigma

A

Depression/anxiety
Schizophrenia: people avoid them
Mental retardation: stigmatised as unwanted
Eating disorder: stigmatised as their fault

Health and Society Year 3 (5 decks)

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