key issues and topics you need to know about Flashcards
Harold Shipman case
HS was a practicing GP and was convicted of the murder of 15 patients and forging a will
what was the consequences of Harold Shipman case
- A move away from single-handed GP practices
As Shipman was working on his own, there were few opportunities for colleagues to check on what he was doing. As a result, he was able to murder many without questions being asked
- Tighter regulations on the use of controlled drug
- Tighter regulation of death certification
- Review of the revalidation
MMR vaccination and the 2013 measles epidemic
surgeon Andrew Wakefield published a researcher paper showing that there was a link between the administration of the Measles
called for th suspension of MMR until further research could be done
suggested parents opt for single jabs agains measles mumps e.t.c separated by gaps of one year
what happened as a result of Wakefield’s statement
manyh parents around the world became worried about their child developing autism as a result of the MMR vaccination and decided against giving the vaccine to their child
0 resulted in more cases of measles being reported in 2008 than any year since 1997
more than 90% of those infected had not been vaccinated
the structure of medical training
step 1: foundation year
-after leaving medical school
2 years designed to help young doctors get used to working as “proper” doctors
step 2 core training
-give trainees a good basis in their area of interest
step 3: specialist training
-ranges form 4-9 years
clinical govermance
it is a concept familiar to all doctors
essentially set of principles and behaviours that all doctors should adhere to in order to ensure that they offer their patients the best quality clinical care
what are the fundamental principles of clinical principles
- doctors should ensure that their practice is compliant with the latest evidence
- Doctors should provide safe care to their patients and ensure they do not place their patients at risk
- doctors should ensure they recognise when they have reached their limitations and should be willing to ask for help if necessary
audit process
systematic examination of current practice to assess how an institution/ practitioner is performing against set standards
why are audits important
main purpose of an audit is to identify weaknesses in your practice and increases the quality of service provided to users
provide opportunities for training and education
how does the audit process occur
referred to as the “audit cycle”
- chosse a topic for the audit
- define standard that you would like to be achieved
- collect relevant data
- compare results of analysis against standard
- identify changes that need to b*complete loop) several months later to measure the impacts of the change
the four ethical principles
- autonomy
- patients are entitled to their opinion and to make decisions for themselves, In particular, patients have the tight to choose the treatment that they feel is best for them and also have the right to refuse treatment - beneficence
doctors have to have the best interest of their patients - justice
patients who are in the same position should be considered in the same way
4.right to confidentiality
informed consent
they have the right to procedure with treatment
after been given all the relevant information
competence of a patient
consent can only be taken form patients who are deemed competent
in other words, they understand the information given to them and are able to make rational decisions themselves
competencey is assessed by Doctors and nurses
when are adults deemed competent
adults and children aged 16-17 are deemed competent unless proven otherwide
If an adult is not comprtent e.g. because they have a serious mental disorder, no other party can give consent on their behalf their are two options
what are the two options
- if a parent issued a living will at an earlier date stating how the wich to be treated if they are at some point unable to make decisions themselves
- if patients have not indicated any particular wishes, it is up to the doctors to act in the best interest of the patient
children below the ages of 16
deemed competent if they are shown to be mature enough to understand information given to them about the procedure and its consequence
however doctors have the responsibility to discuss with the child the possible involvement of the parents/ legal discussion
if the child does not wish to involve their parents then they should respect this as it would be a breach of confidentiality (unless child is deemed not competent or id the child is in danger)
what happens if both of the parents disagree for a life or death procedure
if both parents refused to give consent on behalf of their child for a life-saving procedure, doctors would need to act in the best interest of the child
If possible, they should get a court order to impose treatment
If time is of the essence they should do the treatment first and justify that decision later if needed
when can you breach confidentiality
when it is in the public interest to protect the patients and others
-where the interest to society or others of disclosing the information without the patient’s consent outweighs the benefit to the patient of keeping the information confidential
suspected case of child abuse or neglect
what are is the best way to answer a question
S- What is the context of the story
T - What was the aim
A - What did you do
R - what was the end result
R - what did you feel you did well, what would you have done differently, what skills did you demonstrate
how do you answer questions relating to doctors
Clinical - patient care
Academic - teaching and research
management - managing others, running
and developing services
Personal - personal attributes and hobbies
example of using CAMP
Clinical - they have meetings to discuss complex cases and they invest time in keeping up yo date e.g. reading journals
Academic - they teach medial students, trainees and professionals. They also undertake research
Management they manage and support other collegues
Personal they try and have their own life
