Intro to Clinical Governance

Question 1

What is clinical governance?

Answer 1

1. A framework through which NHS organisations are accountable for continuously improving the quality of their services
2. And safe guarding high standards of care by creating an environment in which excellence in clinical care will flourish

Question 2

Why is clinical governance important?

Answer 2

1. About being accountable, taking professional responsibility 2. Having the right systems and processes in place and continuously improving what we do 3. Fundamental element of healthcare practice- continuing process not event

Question 3

WHAT ARE THE SEVEN STEPS IN CLINICAL GOVERNANCE? (IMPORTANT)

Answer 3

1. Patient and public involvement 2. Clinical Audit 3. Risk management 4. Clinical effectiveness 5. Staff and staff management 6. Use of information 7. Premise standards

Question 4

Why do we need to involve patient and public?

Answer 4

1. Service improvement and redesign 2. Practice leaflet 3. Annual patient satisfaction survey 4. Monitor medicines owed and out of stock 5. Complaints and error procedures 6. Make reasonable adjustments in line with disability act (DDA) 7. Co-operate with inspections and reviews from NHS England

Question 5

What is a clinical audit?

Answer 5

Process of improving care of patients by looking at what you are doing, learning from it and if necessary, changing practice

Question 6

What is the clinical audit cycle?

Answer 6

1. Decide criteria, agree standards 2. Data collection 3. Data analysis 4. Identify causes of non achievement 5. Implement changes 6. Monitor progress 7. Decide criteria and agree to the standards

Question 7

Give some examples of audit examples?

Answer 7

1. Advice on inhaler technique 2. As directed instructions for use audit 3. Health promotion travel health audit 4. Lung cancer awareness audit 5. Near misses audit NHS based: 1. audit on smoking cessation 2. how much do you drink? 3. Know your waist measurement

Question 8

What is risk management?

Answer 8

1. Single most important risk factor 2. Can’t eliminate risk 3. Must manage risk

Question 9

Describe the risks to staff in a pharmacy?

Answer 9

1. Health and safety issues 2. Financial loss (fridge failure, stock loss, prescription charge losses) 3. Needle stick and chemical injury 4. Violence in the workplace

Question 10

Describe the risks to patients?

Answer 10

1. Health and safety issues 2. Poor standards of care and advice 3. Poor service 4. Dispensing errors 5. Infection from pharmacy 6. Breach of confidentiality

Question 11

How do you ensure that the risks are managed?

Answer 11

1. Appoint a clinical governance lead- who knows about clinical governance issues 2. Other local NHS services and has authority to make decisions on CG issues

Question 12

What are the robust systems in place to ensure management of stock integrity?

Answer 12

1. Stock expiry date checks 3 months minimum 2. Reputable suppliers and premises suitable for medicines storage

Question 13

What are the robust systems in place to ensure management of equipment maintenance?

Answer 13

1. Fridge temperatures 2. Thermometer calibration 3. Blood pressure, cholesterol monitor service contract/recalibration

Question 14

What are the robust systems in place to ensure management of appropriate waste disposal arrangements?

Answer 14

1. Patient returned waste medicines procedures (infection, needle stick and chemical contamination risk) 2. Clinical waste- sharps and needle stick injury procedures 3. Confidential waste- shredders

Question 15

What are the health and safety issues in community pharmacy?

Answer 15

1. Fire 2. Handling sharps 3. Handling large or heavy objects 4. Slips, trips and falls 5. Dealing with dangerous chemicals 6. Electrical safety 7. Display screen equipment- risk assessment, equipment testing, safe practicing training, documentation

Question 16

Describe incident reporting in relation to risk management?

Answer 16

1. Error and incident reporting- near miss logs 2. Critical event analysis 3. Send incidents to National Reporting and Learning service (NRLS) 4. Timely response to patient safety communications from national patient safety alerting system (NPSAS)

Question 17

What are standard operating procedures and what it’s important for ?

Answer 17

1. Detailed documents that describe the routine method to be followed for specific operation, service or analysis or action 2. Safety 3. quality 4. Delivery 5. Training 6. Cost control

Question 18

What is clinical effectiveness in clinical governance

Answer 18

1. A programme that includes arrangements for ensuring that the appropriate advice is given by a pharmacist in respect of repeating prescriptions or to people caring for themselves or their families

Question 19

What are the systems put into place to ensure clinical effectiveness of prescribing?

Answer 19

1. Medicine use review 2. New medicine service 3. Patient counselling

Question 20

What is a Medicines Use Review and what are the main target groups?

Answer 20

1. Pharmacists undertaking structured adherence-centered review on MULTIPLE MEDICINES 2. This includes medicines for long term conditions 3. Patients taking high risk medicines: NSAIDS, warfarin, anti-platelet 4, Patient recently discharged from hospital who had changes made to their medicines 5. Patients with respiratory disease

Question 21

What is a New Medicine service and what are the main conditions and therapies looked at?

Answer 21

1. New medicine is dispensed and patient is counselled on the medicine through a 3 step process 2. Conditions and therapies include: - Asthma - COPD - Anti-platelet and anti-coagulant therapy - Hypertension 3. Pharmacist must follow up patient at agreed time(s) to assess adherence, identify problems and patients need for further information and support

Question 22

Describe the staffing and staff management in clinical governance?

Answer 22

1. Appropriate induction for new staff and locums 2. Appropriate staff training, trained or undergoing training 3. Qualifications, identity, references checked 4. Identify and support development needs 5. Remedying underperformance

Question 23

How are pharmacists support their own development by doing what task?

Answer 23

1. Commitment to complete mandatory continuing professional development 2. They must complete necessary accreditation: - Essential, enhanced, advanced services - Mandatory CPD for pharmacy services

Question 24

Describe the clinical governance area of use of information?

Answer 24

Data protection and confidentiality - procedures for information management and security information governance - Annual assessment of compliance

Question 25

Describe the clinical governance area of premises standards

Answer 25

1. The premises must be clean and needs to be appropriate to services provided- cleaning rotas and hand washing 2. Appropriate environment 3. Opening arrangements

Question 26

How do you ensure that the pharmacy environment you are working in is appropriate?

Answer 26

Safe, tidy working environment with enough space - Professional healthcare environment - Prescription area must be cleaned and spacious - Buffer area between medicinal and non medicinal goods - Seating area quality - Appropriate levels of privacy and consultation room standards

Question 27

How do you ensure that the pharmacy you are working in has good opening arrangements?

Answer 27

1. Pharmacy must be seen to be open by members of the public during core and supplementary hours 2. Pharmacy locked during opening hours 3. Arrangements made to: provide limited public access, member of staff at door and hatch 4. Allow access inside if needed for confidentiality