Nhs 60-100 Flashcards
Clinical governance
Is a set of principles and behaviours that all doctors should adhere to to in order to ensure that they offer patients the best quality clinical care
Clinical governance 1
Their practice is compliant with the latest evidence and keep up to date with their practices to meet guidelines and new evidence from research
Clinical governance 2
Doctors should provide safe care to their patients and ensure not to but patients at risk
Clinical governance 3
Doctors should recognise that they have reach their capacity and ask for help
Doctors should develop their skills
Doctors should be attentive to patients needs
The audit process
Are system examinations of current practice to assess how well an institution or a practitioner is performing against set standards essentially it is a method for reflecting on reviewing and improving practice
Audits are fundamental part of duties of doctors and ensure that doctors are compliant with guidelines
Why are audits important
Identifies weakness
Identifies inefficiencies
And ultimately save resources
Provide training and editing
How do audits work
- Choose a topic for the audit
- Define a standard that you would like to achieve
- Collect data
- compare results of analysis against standard
- Identify changes and implement changes and request
Mid Staffordshire nhs scandals
Patients were unhappy with the care given at the hospitals and led to the campaign of cure the nhs
The healthcare commission report
In the mid Staffordshire report it included
Poor nursing
Lack of effective management systems for emergencies
Failure to identify and act on high mortality’s rates for emergencies patients
The first Francis enquiry
The bullying culture which led to patients being ignored
Board failures
The board failed to appreciate the issues and react to slowly to the problems. High mortality rates were due to coding issues
Staff related issues
Too few consultants and nurses
Change in management so lack of leadership
Lack of attention to patients
Poor communication
Cultural issues
Patients concern about asking for help
Phone use in patients
Low staff morale
Second Francis enquiries
Issues included No patients first Bullying Secrecy Doctors not speaking up to patients Gp not raising a concern etc
Changes due to second Francis
Focus on training to be compassionate
Patient safety
One person should be in charge of a person care
Autonomy
Patients are entitled to their own opinion
Patients cannot demand for the treatment that they want but they can refuse treatment
Beneficence
Best patient interests
Non-malevolence
Not to harm a patients
Justice
Fairness to all patients
Confidentially
Not revealing info on patients
Informed consent
Patients must consent to a procedure or a drugs
Option for treatment or management of the condition like refusing to treatment
Details of the planned procedure any costs that the patients may incur
Info of secondary intervention kk
Information
Patients should be given any appropriate written information such as leaflets explaining the procedure it’s risk and benefits
Only competent patients can give consent
Implied consent as their are many procedures that are done
Implied consent
Only applies to simple tasks and roles with no major risk
Competence of patients
Consent can only be received from competence patient
The capacity to consent for medical treatment needs to be assessed in
Adults
16+ are assumed to be able to consent to all treatment if their do not have any serious mental disorder no other party can consent to them
If the patent has not indicated their. Choose but the doctor must act in the patients best interest
The patients have told earlier
Under 16
They can consent if they are mature enough to understand l. Doctors must consult with guardians before hand if the child refuses guardian involvement then they have the right to not mention the patients
Under 16!compentamve
Gillick competence
Relating to procedure
A ten year old can accept the use of antiseptics but not to do
Amptutation
Best interest
A child cannot refuse for cancer surgery if their parents said yes
Parents and the child
If the parents refuse for the treatment then that will save the child’s life then the doctor can act in their best interest
Thes rules do not apply to
Scotland children can refuse treatment
Confidentiality duty
Cannot tell info unless implied consent have been given by the patient
Information needed by the court
In the best interest in the public
Examples of confidentiality breaching
Child abuse
HIV status to sexual partner
Euthanisia
Active euthanasia ending someone’s life by poisons etc
Passive euthanasia is pulling the life support
Voluntary euthanasia is when the person asks
Non voluntary is when they cannot give consent
Involuntary do not wish to do
Assisted suicide
When someone commits sucicide with someone’s help
The Swiss connection
There are institutions abroad where people go to get euthanised with a cocktail of drugs
For Euthanasia
Patients choice
Lengthy suffering
Free up beds
dignity in death
Arguements
Against religious principles Change in mind People may recover Murder charges Pressure to euthanise self
Legality in euthanasia
Illegal to do euthanasia and assisted sucicide
People who do such as convicted for manslaughter m
Ethical dilemma for doctors
Doctors may be confronted by situations where they may need to draw treatment from an individual such action potentially kill a patients
This treatment is ineffective and not in the best interest in the patients
