Lecture 15 - Clinical Governance Flashcards
What is clinical governance?
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
Patient centres strategy?
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
Clinically effective?
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
Safe quality strategy?
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
What is the medication process?
prescribing
dispensing
administration
monitoring
What is prescribing?
ordering a given medicine and dose
What is dispensing?
preparation/supply of medicines
What is administration?
administering the dose of medicine by the appropriate route and method
What is monitoring?
checking the administration and effect of a medicine
What can go wrong with administration?
incorrectly prepared
wrong patient
wrong drug
missed doses (poor compliance, patient not on ward)
wrong route
Human factors affecting work?
individual characteristics (disorganised, poor communication)
individual circumstances (worries in personal life, fatigue, illness)
working conditions (distractions, workload)
inexperience
Safe and reliable system design?
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
Safer prescribing?
medicines reconciliation
electronic prescribing
Safer medicines administration?
missed doses
high risk medicines?
insulin
Meds rec in hospital?
taking a medication history when a patient comes into hospital
What is an emergency care summary?
record of the patients medicines held online which is accessible to hospitals and out of hours
What does electronic prescribing do?
gives us a closed loop of electronic medicines information
all the information the prescriber needs is in one place
How many adults in scotland are dispensed 5 or more medicines?
1 in 5
How many items are issues in primary care?
101 million
How many prescribing errors are there?
~4 million
How many dispensing errors are there?
40,000 to 3.4 million
How many non selective hospital admissions occur due to medicines?
61,000
How many prescribing errors occur in secondary care?
32,500 with up to 200 causing patient harm
How many items are prescribed in an acute 500 bed hospital in secondary care?
435,000
How many dispensing errors happen in secondary care?
35 to 85
How many preventable deaths across all acute hospitals are due to medicines?
up to 280q
How many patients admitted to all acute hospitals experience an adverse effect due to medicines?
15,000
