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Finals > Patient Management And Health Promotion > Flashcards

Patient Management And Health Promotion Flashcards

1
Q

What are the three roles of epidemiology?

A

Measure the amount of disease
Measure the distribution and natural history of disease
Assess peoples risk of disease, health care needs assessment and service planning

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2
Q

What is the definition of prevalence?

A

Number of disease cases in a population at a given time

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3
Q

What is incidence?

A

Number of new disease cases developing over a specific period of time in a defined population

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4
Q

What is a risk factor?

A

A factor that increases the probability of disease if present and reduces the probability of disease if absent

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5
Q

What is the definition of a causative agent?

A

An external factor that causes/results in disease in susceptible individuals

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6
Q

What is a determinant?

A

Attribute/circumstance which affects liability of an individual to be exposed to disease

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7
Q

What are the three types of risk index?

A

Absolute risk
Attributable risk
Relative risk

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8
Q

What is absolute risk?

A

Incidence of disease in those exposed to the agent

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9
Q

What is the definition of attributable risk?

A

Difference in incidence in exposed:non-exposed

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10
Q

What is the definition of relative risk?

A

Measure of proportion increase in disease rates in exposed groups

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11
Q

What is the SIMD?

A

Scottish Index of Multiple Deprivation
Ranks datazones in order of deprivation 1-5 or 1-10

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12
Q

What is SIMD based on?

A

Housing
Income
Geographical access to services
Health
Education
Skills and training
Crime

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13
Q

What are the 6 factors of consent?

A

Valid
Informed
With capacity
Voluntary
Not coerced
Not manipulated

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14
Q

What are the 5 factors of capacity?

A

Ability to Act
Make a reasoned decision
Understand a decision
Communicate a decision
Retain memory of a decision

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15
Q

What are the four features of a randomised control trial?

A

Specification of participants (inclusion/exclusion criteria)
Controlled
Randomisation
Blinded/masked

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16
Q

What is absolute risk difference?

A

The difference in risk between groups

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17
Q

What is the meaning of and calculation for number needed to treat (NNT)

A

Number of people needed to treat to prevent 1 outcome of disease
1/ARD

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18
Q

What are the stages in changing SoPs?

A

Identify the problem
Set criteria and standard
Observe practice and collect data
Compare performance with set out standards
Implement change

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19
Q

What are the principles of waste disposal?

A

Segregation
Storage
Disposal
Documentation

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20
Q

What are the laws and regulations associated with Waste Disposal?

A

Health and Safety at Work Act 1974
The Controlled Waste Regulations 2012
The Hazardous Waste Directive 2011
Control of Substances Hazardous to Health (COSHH) 2002

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21
Q

What are the features of an amalgam container?

A

Leak and spill proof
Mercury Vapour Suppressant Lid
White body and red lid drum

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22
Q

What are the signs and symptoms of nicotine withdrawal?

A

Irritability
Poor concentration
Depression
Restlessness
Increased appetite
Sleep disturbance

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23
Q

What are the oral side effects of smoking?

A

Staining
Halitosis
Nicotinic Stomatitis

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24
Q

What are the 3A’s

A

Ask
Advice
Act

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25
Q

What are the 5A’s?

A

Ask
Advice
Assess
Assist
Arrange follow up

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26
Q

What does AAR stand for?

A

Ask
Advice
Refer

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27
Q

What are the ABC’s of cessation?

A

Ask
Brief cessation
Cessation advice

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28
Q

How many ml of alcohol in 1 unit?

A

10ml

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29
Q

What are the recommended alcohol units?

A

14 units/week spread over 3 or more days with 2 alcohol free days

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30
Q

What is the calculation for alcohol units?

A

ABV x Volume /1000

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31
Q

What are the 10 SICPs?

A

Patient Placement and Assessment
Hand Hygiene
Respiratory and Cough Hygiene
PPE
Safe Management of Linen
Safe Management of Waste (in sharps)
Safe Management of Blood and Bodily Fluid Spillage
Safe Management of the Care Environment
Safe Management of Care Equipment
Occupational Safety, Prevention of Exposure

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32
Q

What is used for cleaning up blood spillages?

A

Sodium dichloroisocyanurate

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33
Q

What is the minimum contact time for cleaning up spillages?

A

3 minutes

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34
Q
A
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35
Q

How are sharps managed?

A

Stop
Encourage bleeding
Contact manager

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36
Q

How often is HBV contacted in sharps exposures?

A

1 in 3

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37
Q

How often is HCV contacted in sharps exposures?

A

1 in 30

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38
Q

How often is HIV contacted in sharps exposures?

A

1 in 300

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39
Q

How often is HIV contacted in sharps exposures?

A

1 in 300

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40
Q

What is the workflow for decontamination?

A

Wash
Disinfect
Inspect
Pack
Sterilise
Transport

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41
Q

What is the sinners circle?

A

Time
Temperature
Energy
Chemical

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42
Q

What is the definition of domestic abuse?

A

Any form of physical, verbal, sexual or psychological abuse that takes place within the context of a relationship between partners/ex-partners

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43
Q

What type of behaviours are considered domestic abuse?

A

Situational couple violence
Co-ersive and controlling behaviours

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44
Q

What act deals with domestic abuse?

A

Domestic Abuse Act (Scotland)

45
Q

What types of abuse are covered in the Domestic Abuse Act (Scotland)?

A

Physical
Psychological
Emotional

46
Q

What proportion of women are affected by domestic abuse?

A

1 in 5

47
Q

What is gender-based violence?

A

Violence directed against a person on the basis of gender

48
Q

What is coercive control?

A

A pattern of behaviours that aims to isolate someone from their family and friends
The person is degraded to a point of low self esteem with micro regulation overall aspects of life: money, dress, surveillance

49
Q

Who is most at risk of domestic abuse?

A

Women aged 16-24
Men aged 16-19
Those with long term illness or disability (x2), mental health problems
Women who are separated or pregnant

50
Q

What are the non-fatal outcomes of domestic abuse?

A

Physical issues
Chronic conditions
Reproductive problems

51
Q

What are the fatal outcomes of domestic abuse?

A

Femicide
Suicide
Maternal mortality

52
Q

What are the behavioural signs of domestic abuse?

A

Low self esteem
Victims may appear fearful, anxious or sad
Constant phoning or texting partner
Alcoholism
Partner may do all the talking

53
Q

What are the physical signs of domestic abuse?

A

Repeated injuries
Bruises at different stages of healing
Dental/maxillofacial injuries
Delay in seeking help
Unlikely explanations for injuries

54
Q

What are the barriers for screening domestic abuse?

A

Patient accompanied to appointments
Lack of training
Concern about offending the patient
Cultural norms
Embarrassment
Lack of time

55
Q

What does AVDR stand for?

A

Ask
Validate
Document
Refer

56
Q

What does Ask mean in AVDR?

A

Ask about abuse in a non-judgemental way

57
Q

What does Validate mean in AVDR?

A

A way to show someone that they are not to blame and they deserve better

58
Q

What does Document mean in AVDR?

A

Taking clinical notes: specific and detailed descriptions of the injuries

59
Q

What does Refer mean in AVDR?

A

Referring the patient to appropriate services
May provide a small card with details

60
Q

What is the calculation for incidence rate?

A

Number of new cases/ number of individuals at risk

61
Q

What is the calculation for prevalence rate?

A

Number of affected individuals/ total number in population

62
Q
A
63
Q

What is black stream waste for?

A

Non-infected household waste

64
Q

What is orange stream bag for?

A

Low risk waste
Picked up for heat disinfection

65
Q

How is the orange stream bin managed?

A

Containers filled to line
Label completed and identified on bin
Picked up by heat disinfection

66
Q

What is yellow stream waste?

A

High risk
Body parts, medicine, anaesthetics, sharps, drug vials

67
Q

How is yellow stream waste managed?

A

Incinerated

68
Q

What is red stream waste for?

A

Amalgam

69
Q

How is red stream waste managed?

A

Specialist treatment to recover chemicals

70
Q

What are the key aspects of a waste transfer note?

A

Description of waste
Origin
Quantity
Transport and destination

71
Q

How long is a consignment note kept?

A

Minimum of three years

72
Q

What are examples of regulations for waste disposal?

A

Special Waste (Amendment) Regulations 2004
Health and Safety at Work Act 1974
COSHH 2002
Environmental Protection Act 1990
Health and Safety Executive (HSE)
Scottish Environmental Protection Agency (SEPA)

73
Q

What does AWD stand for?

A

Automatic Washer Disinfector

74
Q

What does an AWD do?

A

Removes prions and proteins

75
Q

What are the differences between an Ultrasonic cleaner and an automatic washer disinfector?

A

Ultrasonic does not disinfect or dry

76
Q

What are the stages of an automatic washer disinfector?

A

Flush/Pre-wash
Main wash
Rinse
Thermal disinfection
Drying

77
Q

Discuss the flush/pre-wash?

A

<35 degrees
Removes gross contamination

78
Q

Discuss the main wash?

A

Supplemented by detergent

79
Q

Discuss rinse?

A

<65 degrees
Removes residue

80
Q

Discuss thermal disinfection?

A

90-95 minutes
Kills micro-organisms with hot water

81
Q

Discuss drying:

A

> 100 degrees
Hot air to remove moisture

82
Q

What are the daily checks for an Automatic Washer Disinfector?

A

Verify condition of load carrier
Check that the spray arms spin freely
Check that the spray jets are not blocked
Ensure there is no debris on the strainer/filter
Check the condition of the door seal
Verify there is suitable chemical levels
Record the disinfection temperature of the first cycle

83
Q

What happens during the inspection stage?

A

Use an illuminated magnifier to check for damage or contamination

84
Q

What is the journey that dental instruments go on during processing?

A

Acquisition

Cleaning
Disinfection
Inspection
Packaging
Sterilisation
Transport
Storage
Use
Transport

85
Q

What happens during the cleaning stage?

A

Proteins and prions are removed

86
Q

What PPE is required during cleaning?

A

Apron
Face shield
Rubber gloves and heavy duty rubber gloves

87
Q

What are the requirements for manual cleaning?

A

Dedicated sinks: 1 for manual cleaning, 1 for rinsing
Standard tap water: between 30-35 degrees
Enzymatic or pH neutral detergent

88
Q

Why should standard tap water be less than 35 degrees?

A

> 35 degrees: protein coagulation

89
Q

What is manual cleaning?

A

Instruments scrubbed below the surface of the water with a long handed soft-bristled brush

90
Q

Why does manual cleaning take place underwater?

A

To minimise splashing and aerosols

91
Q

When should you manual wash?

A

Specifically recommended in the manufacturers instructions
No alternative available

92
Q

How does the ultrasonic bath work?

A

Uses high frequency sound waves to produce bubbles that implode causing a scouring effect

93
Q

How does cavitation work?

A

As sound waves pass through the water, they cause the formation of micro bubbles
The fluctuation in pressures produced by the sound waves leads to bubbles rapidly expanding and collapsing

94
Q

How is the ultrasonic machine set up?

A

Set to 20-30 degrees
Filled with tap water to marked volume
Chemical added based on manufacturers instructions
Cycle ran for period of time specified at validation

95
Q

What is a Degas cycle?

A

Before ultrasonic used- it is ran on a cycle filled with detergent

96
Q

Why is a Degas cycle used?

A

To remove air/gas bubbles in the water as the ultrasonic bubbles will collapse into them and this reduces the efficacy of the ultrasonic

97
Q

What values should be recorded when cleaning instruments?

A

Date
Detergent Added
Time
Cycle Number
Temperature
Operator Name

98
Q

What takes place after manual cleaning or ultrasonic cleaning?

A

Rinsing in a separate sink

99
Q

What should be checked during inspection?

A

Check functionality
Remove excess moisture (lint free drying cloth)

100
Q

What are the benefits of manual cleaning?

A

More force than washer disinfector
Some items can only be manually washed

101
Q

What are the benefits of an ultrasonic cleaner?

A

Ferocious
Good at removing contamination

102
Q

What are the downsides of manual and ultrasonic cleaning?

A

Staff member must be present
Risk of aerosol production
Risk of contaminating environment
Potential inconsistency: human error
High risk of sharps injury
Ultrasonic can damage some instruments
No automatic water changes in ultrasonic bath
No thermal disinfection targeting microorganisms

103
Q
A
104
Q

What tests can be carried out on a type B steriliser?

A

Steam penetration tests: Bowie dick or helix

105
Q

What is the active ingredient in alkaline peroxides?

A

Sodium perborate

106
Q

When are prions and proteins removed during cleaning?

A

Pre-wash
Main wash

107
Q

What are the settings for sterilisation?

A

134-137C for minimum 3 minutes

108
Q

When can tap water be used in decontamination?

A

Mechanical cleaning
Washer disinfected

Finals (20 decks)

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