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Ideals/C2C/RESS/I and P ATS > IDEALS > Flashcards

IDEALS Flashcards

1
Q

What is clinical governance?

A

a systemic approach to maintaining and improving quality of patient care with in a health care system.

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2
Q

When did clinical governance become important?

A

after the bristol heart scandal

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3
Q

What 3 key attributes does clinical governance aim to embody?

A
  1. recognise high standards of care
  2. transparent responsibility and accountability for those standards
  3. constant dynamic of improvement
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4
Q

What are drivers?

A

characteristic ways of behaving which are usually strengths but may become weaknesses under stress

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5
Q

What are the 5 drivers?

A
  1. be strong
  2. be perfect
  3. try hard
  4. hurry up
  5. please others
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6
Q

What is root cause analysis?

A

analysis of the root cause of a problem

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7
Q

What are examples of root cause analysis methods?

A
  1. fishbone diagram

2. organisational accident model

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8
Q

What are the 3 R’s of root cause analysis?

A
  1. react
  2. record
  3. respond
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9
Q

What is the sight mnemonic and when is it used?

A 
S - suspect case
I - isolate patient
G -gloves and aprons
H - hand hygiene with soap and water
T - test for toxin

when handling something that could be potentially very infectious

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10
Q

How do you challenge a superior and what does it stand for?

A

PACE

P - PROBE - DO YOU KNOW THAT?
A - ALERT - CAN WE RE-ASSESS THE SITUATION?
C - CHALLENGE - PLEASE STOP WHAT YOU ARE DOING
E - EMERGENCY - STOP WHAT YOU ARE DOING!

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11
Q

What is information governance? (IG)

A
  • term used to encompass the set of multi-discinplinary structures, policies, procedures, process and controls
  • implemented to manage information at an enterprise level,
  • supporting an organisation’s immediate and future regulatory, legal, risk, environmental and operational requirement.
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12
Q

What are Caldicott guidelines?

A

How to follow confidentiality.

  1. justify the purpose of using confidentiality
  2. only use it when absolutely necessary
  3. use the minimum required
  4. allow access on a strict need-to-know basis
  5. understand your responsibility
  6. understand and comply with the law
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13
Q

What does quality improvement (QI) address?

A
  • the gap between what care is being delivered and what care we should be delivering.
  • the difference between ‘should’ and ‘is’
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14
Q

What is a group? (5)

A
  1. more likely to work independently
  2. may communicate poorly
  3. sink or swim by themselves
  4. lack commitment
  5. only take responsibility for their own tasks
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15
Q

What is a team? (6)

A
  1. individuals collaborating towards a common goal
  2. good, easy and informal communication
  3. invested participation in work
  4. advice and support across team members
  5. shared commitment to all members of the team and specific goals
  6. responsibility, blame and success are shared
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16
Q

What is Maslow’s hierarchy of needs? (5)

A
  1. self-actualisation
  • challenging projects
  • opportunities for innovation
  • intellectual fufillment
  1. esteem
  • investment in important projects
  • recognition from peers
  1. social (belonging)
  • acceptance
  • embraced by group
  1. safety and security
  • physical safety
  • economic security - pay
  • freedom from threat - bullying
  1. Physiological
    - basic needs - water, food and sleep
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17
Q

What is Belbin’s team roles? (3)

A

ACTION ORIENTATED ROLES

  1. Shaper - challenges the team to improve
  2. Implementer - put ideas into actions
  3. Completer finisher - ensures thorough and timely completion

PEOPLE ORIENTATED ROLES

  1. coordinator - chairperson
  2. team worker - encourages cooperation
  3. resource investigator - explores outside opportunities

THOUGHT ORIENTATED ROLES

  1. plant - presents new ideas and approaches
  2. monitor/evaluator - analyses the options
  3. specialist - provides specialised skills
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18
Q

What is Tuckman’s model and what is it in regards to? (4)

A
  1. forming
  2. storming
  3. norming/performing
  4. mourning/adjusting

Group development

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19
Q

What are the 6 De Bono’s hats?

A
  1. white - questioner role
  2. red - emotional role
  3. black - negative role
  4. yellow - positive role
  5. green - creative role
  6. blue - thinking about thinking role - CONTROLLER
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20
Q

What is trait theory and what is this difference between a manager and leader?

A
  • is there a set of characteristics that determine a good leader?

Manager - focuses on the task

Leader - focuses on the people

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21
Q

What are the contemporary leadership styles? (4)

A
  1. contingency/situation - leaders need followers
  • flexible
  • not a fixed series of characteristics
  • importance in emotional intelligence
  • responsive to needs/abilities of followers
  1. transactional leadership
  • managerial leadership
  • supervision
  • organisation
  • group performance
  • promotes compliance of his followers through both rewards and punishment
  1. transformational leadership
  • motivation, morale and performance through a variety of mechanisms
  • connects the followers sense of identity and collective identity of the organisation
  • role model for followers
  • inspires them
  • challenges followers to take greater ownership of their work
  • understands strengths and weaknesses of followers hence this leader assigns tasks to their strengths
  1. Leader as a servant
  • desire to do good for one’s followers
  • based on idea that leadership originates from desire to serve others
  • appropriate in medicine
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22
Q

What is involved in introducing organisational change?

A
  1. identifying organisational culture
  2. motivators, barriers and changing roles
  • force field analysis (Lewin)
  • method of weighing pros and cons
  1. processes affecting change
  • organistaion change theory (Kotter)
  • supporting changing roles during organisational change s
\+ innovators - venturesome
\+ early adopters - respectable
\+ early majority - deliberate
\+ late majority - sceptical 
\+ laggards - traditional
23
Q

What are Kotters 8 funky steps to leading change?

A
  1. establish a sense of urgency
  2. form a powerful guiding coalition
  3. create a vision
  4. communicate the visions
  5. empower others to act
  6. plan for and create short-term wins
  7. consolidate improvements
  8. institutionalise the new approach
24
Q

What is the adverse event iceberg in regards to patient safety?

A

Pyramid

Tip to base

  1. serious errors
  2. errors that cause harm
  3. errors considered insignificant
  4. near misses
  5. unnoticed errors
25
Q

What should you report? (18)

A
  1. slips, trips and falls
  2. theft
  3. violence and aggression
  4. breach in confidentiality
  5. unavailability of hospital records
  6. administrative error
  7. manual handling injuries
  8. Equipement failures
  9. drug errors
  10. lost samples
  11. hospital acquired infections
  12. misdiagnosis
  13. delay in treatment
  14. misdiagnosis
  15. pressure sores
  16. poor communication
  17. poor discharge arrangements
  18. sharps/needlestick injuries
26
Q

What are hazards?

A

things that could cause harm

27
Q

What is risk?

A

the likelihood that an incident would occur and how bad the consequence would be

28
Q

What is the primary function of an incident reporting system?

A

to identify recurring problem areas known as ERROR TRAPS

29
Q

What are the four step process to manage clinical risks?

A
  1. identify the risks
  2. assess frequency and severity of the risk
  3. reduce or eliminate the risk
  4. cost the risk
30
Q

What is the national reporting and learning system?

A
  • clinicians and safety experts analyse reports to identify common risk and opportunities to improve patient safety
  • provide health organisations with feedback and guidance to improve patient safety
31
Q

What is advocacy?

A

speaking up for someone else especially someone with little power

32
Q

What is direct advocacy?

A
  • the interests of individual patients or specific groups of names patients are represented to decision makers
  • either by an advocate or through self-advocacy
  • writing a letter to housing authority on behalf of the patient
  • ensuring rights of a disabled patient is met - informed consent
33
Q

What is public policy advocacy?

A

the advocate is seeking changes to an aspect of the system to benefit patients generally or particular group of patients.

  • medical colleges standing up fro patient rights
  • doctors holding up rights fro asylum seekers
34
Q

At what level of advocacy is required for inadequate housing for a family?

A

individual level

35
Q

At what level of advocacy is required for disability access at a primary school?

A

public health level with in community

36
Q

At what level of advocacy is required for the insufficient provision of day care facilities for the elderly and those with mental health problems?

A

Public health within city

37
Q

At what level of advocacy is required for:

  • breast feeding, poverty, rights of incapacitated individuals, rights of the homeless and children rights
A

Public health level nationally

38
Q

What is Medsin?

A

EDUCATION

  • of students and the wider community about health inequities and how we can tackle them

ADVOCACY

  • for action by local, national and global actors to remove barriers to health for all

ACTION

  • at the grass-roots level within communities, mobilising students to take action
39
Q

What is the theory of planned behaviour?

A
  • the ability to think before behaving
40
Q

What 3 elements determine whether we will enact a behaviour?

A
  1. what our significant others think about the behaviour
  2. our own beliefs and attitudes towards the behaviour
  3. perceived difficulty of the behaviour and our perceived ability to cope (self-efficacy)
41
Q

What is resilience?

A

a phenomenon or process reflecting relatively positive adaptation despite experiences of adversity or trauma.

42
Q

What are the 3 ways of coping?

A
  1. primary control coping - attempts to modify stressful problem or emotion - problem solving
  2. secondary control coping - attempts to adapt via way that we think - cognitive restructuring
  3. disengagement coping - attempts to redirect attention away from the stressor or emotional reaction (denial, wishful thinking)
43
Q

What is emotion focused coping?

A
  1. distraction or minimisation
  2. wishful thinking
  3. self control of feelings
  4. seeking meaning about life
  5. reduce self - blame
  6. expressing/sharing feelings
44
Q

What is problem focused coping?

A
  1. accept there is an issue

2. apply problem solving

45
Q

What does a serious incident result in?

A
  1. unexpected or avoidable death

2. serious harm

46
Q

What are examples of never events?

A
  1. wrong site surgery
  2. retained instrument post-operation
  3. wrong route administration of chemotherapy
  4. misplaced naso-gastric tube
  5. inpatient suicide using non-collasable rails
  6. escape from within the secure perimeter of medium or high security mental health services by patients who are trasnfereed prisoners
  7. inhospital maternal death from postpartum haemorrhage after elective c-section
  8. intravenous administration of mis-selected concentrated KCL
47
Q

What is crude mortality rate?

A

the number of deaths that occurred divided by the number of admissions to a healthcare provider in a specified time interval.

  • often multiplied by 100 to give a percentage
48
Q

What are hospital standardised mortality ration (HSMR)?

A

The HSMR is a calculation used to monitor death rates in a trust.

The HSMR is based on a subset of diagnoses which give rise to 80% of in-hospital deaths

49
Q

What is the summary hospital-level mortality indicator? (SHMI)

A

It is different from HSMR as it is derived from all admissions to a secondary care organisation and is not a subset like HSMR.

  • based against the previous 3 years national data - includes all deaths at 30 days not just those in hospital.
50
Q

What should you have to have good situational awareness?

A
  1. perception - knowing what is going on around you
  2. comprehension - knowing why things are happening
  3. projection - knowing what is likely to happen next
51
Q

What is NPSA?

A

medicines most frequently associated with severe harm

52
Q

Examples of NPSA

A
  1. anticoagulants
  2. antibiotics - allergy related
  3. injectable sedatives
  4. chemotherapy
  5. opiates
  6. antipsychotics
  7. insulin
  8. infusion fluid
53
Q

What are never events?

A

serious, largely preventable patient safety incidents

Ideals/C2C/RESS/I and P ATS (3 decks)

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