Lecture 15 - Clinical Governance

Question 1

What is clinical governance?

Answer 1

a framework through which NHS organisations are accountable for continually improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care with flourish

Question 2

Patient centres strategy?

Answer 2

mutually beneficial partnerships between patients, their families, and those delivering healthcare services which respect individual needs and values, which demonstrate compassion, continuity, clear communication and shared decision making

Question 3

Clinically effective?

Answer 3

the most appropriate treatments, interventions, support and services will be provided at the right time to everyone who will benefit and wasteful or harmful variation will be eradicated

Question 4

Safe quality strategy?

Answer 4

there will be no avoidable injury or harm to patients from healthcare they receive and an appropriate clean and safe environment will be provided for the delivery of healthcare services at all times

Question 5

What is the medication process?

Answer 5

prescribing

dispensing

administration

monitoring

Question 6

What is prescribing?

Answer 6

ordering a given medicine and dose

Question 7

What is dispensing?

Answer 7

preparation/supply of medicines

Question 8

What is administration?

Answer 8

administering the dose of medicine by the appropriate route and method

Question 9

What is monitoring?

Answer 9

checking the administration and effect of a medicine

Question 10

What can go wrong with administration?

Answer 10

incorrectly prepared

wrong patient

wrong drug

missed doses (poor compliance, patient not on ward)

wrong route

Question 11

Human factors affecting work?

Answer 11

individual characteristics (disorganised, poor communication)

individual circumstances (worries in personal life, fatigue, illness)

working conditions (distractions, workload)

inexperience

Question 12

Safe and reliable system design?

Answer 12

simplify

standardise = across hospitals there is one standard in patient hospital prescription chart

use protocols and checklists

access to information at point of need

improve communication at handover

Question 13

Safer prescribing?

Answer 13

medicines reconciliation

electronic prescribing

Question 14

Safer medicines administration?

Answer 14

missed doses

Question 15

high risk medicines?

Answer 15

insulin

Question 16

Meds rec in hospital?

Answer 16

taking a medication history when a patient comes into hospital

Question 17

What is an emergency care summary?

Answer 17

record of the patients medicines held online which is accessible to hospitals and out of hours

Question 18

What does electronic prescribing do?

Answer 18

gives us a closed loop of electronic medicines information

all the information the prescriber needs is in one place

Question 19

How many adults in scotland are dispensed 5 or more medicines?

Answer 19

1 in 5

Question 20

How many items are issues in primary care?

Answer 20

101 million

Question 21

How many prescribing errors are there?

Answer 21

~4 million

Question 22

How many dispensing errors are there?

Answer 22

40,000 to 3.4 million

Question 23

How many non selective hospital admissions occur due to medicines?

Answer 23

61,000

Question 24

How many prescribing errors occur in secondary care?

Answer 24

32,500 with up to 200 causing patient harm

Question 25

How many items are prescribed in an acute 500 bed hospital in secondary care?

Answer 25

435,000

Question 26

How many dispensing errors happen in secondary care?

Answer 26

35 to 85

Question 27

How many preventable deaths across all acute hospitals are due to medicines?

Answer 27

up to 280q

Question 28

How many patients admitted to all acute hospitals experience an adverse effect due to medicines?

Answer 28

15,000