Patient Management And Health Promotion Flashcards
What are the three roles of epidemiology?
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
What is the definition of prevalence?
Number of disease cases in a population at a given time
What is incidence?
Number of new disease cases developing over a specific period of time in a defined population
What is a risk factor?
A factor that increases the probability of disease if present and reduces the probability of disease if absent
What is the definition of a causative agent?
An external factor that causes/results in disease in susceptible individuals
What is a determinant?
Attribute/circumstance which affects liability of an individual to be exposed to disease
What are the three types of risk index?
Absolute risk
Attributable risk
Relative risk
What is absolute risk?
Incidence of disease in those exposed to the agent
What is the definition of attributable risk?
Difference in incidence in exposed:non-exposed
What is the definition of relative risk?
Measure of proportion increase in disease rates in exposed groups
What is the SIMD?
Scottish Index of Multiple Deprivation
Ranks datazones in order of deprivation 1-5 or 1-10
What is SIMD based on?
Housing
Income
Geographical access to services
Health
Education
Skills and training
Crime
What are the 6 factors of consent?
Valid
Informed
With capacity
Voluntary
Not coerced
Not manipulated
What are the 5 factors of capacity?
Ability to Act
Make a reasoned decision
Understand a decision
Communicate a decision
Retain memory of a decision
What are the four features of a randomised control trial?
Specification of participants (inclusion/exclusion criteria)
Controlled
Randomisation
Blinded/masked
What is absolute risk difference?
The difference in risk between groups
What is the meaning of and calculation for number needed to treat (NNT)
Number of people needed to treat to prevent 1 outcome of disease
1/ARD
What are the stages in changing SoPs?
Identify the problem
Set criteria and standard
Observe practice and collect data
Compare performance with set out standards
Implement change
What are the principles of waste disposal?
Segregation
Storage
Disposal
Documentation
What are the laws and regulations associated with Waste Disposal?
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
What are the features of an amalgam container?
Leak and spill proof
Mercury Vapour Suppressant Lid
White body and red lid drum
What are the signs and symptoms of nicotine withdrawal?
Irritability
Poor concentration
Depression
Restlessness
Increased appetite
Sleep disturbance
What are the oral side effects of smoking?
Staining
Halitosis
Nicotinic Stomatitis
What are the 3A’s
Ask
Advice
Act
What are the 5A’s?
Ask
Advice
Assess
Assist
Arrange follow up
What does AAR stand for?
Ask
Advice
Refer
What are the ABC’s of cessation?
Ask
Brief cessation
Cessation advice
How many ml of alcohol in 1 unit?
10ml
What are the recommended alcohol units?
14 units/week spread over 3 or more days with 2 alcohol free days
What is the calculation for alcohol units?
ABV x Volume /1000
What are the 10 SICPs?
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
What is used for cleaning up blood spillages?
Sodium dichloroisocyanurate
What is the minimum contact time for cleaning up spillages?
3 minutes
How are sharps managed?
Stop
Encourage bleeding
Contact manager
How often is HBV contacted in sharps exposures?
1 in 3
How often is HCV contacted in sharps exposures?
1 in 30
How often is HIV contacted in sharps exposures?
1 in 300
How often is HIV contacted in sharps exposures?
1 in 300
What is the workflow for decontamination?
Wash
Disinfect
Inspect
Pack
Sterilise
Transport
What is the sinners circle?
Time
Temperature
Energy
Chemical
What is the definition of domestic abuse?
Any form of physical, verbal, sexual or psychological abuse that takes place within the context of a relationship between partners/ex-partners
What type of behaviours are considered domestic abuse?
Situational couple violence
Co-ersive and controlling behaviours
What act deals with domestic abuse?
Domestic Abuse Act (Scotland)
What types of abuse are covered in the Domestic Abuse Act (Scotland)?
Physical
Psychological
Emotional
What proportion of women are affected by domestic abuse?
1 in 5
What is gender-based violence?
Violence directed against a person on the basis of gender
What is coercive control?
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
Who is most at risk of domestic abuse?
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
What are the non-fatal outcomes of domestic abuse?
Physical issues
Chronic conditions
Reproductive problems
What are the fatal outcomes of domestic abuse?
Femicide
Suicide
Maternal mortality
What are the behavioural signs of domestic abuse?
Low self esteem
Victims may appear fearful, anxious or sad
Constant phoning or texting partner
Alcoholism
Partner may do all the talking
What are the physical signs of domestic abuse?
Repeated injuries
Bruises at different stages of healing
Dental/maxillofacial injuries
Delay in seeking help
Unlikely explanations for injuries
What are the barriers for screening domestic abuse?
Patient accompanied to appointments
Lack of training
Concern about offending the patient
Cultural norms
Embarrassment
Lack of time
What does AVDR stand for?
Ask
Validate
Document
Refer
What does Ask mean in AVDR?
Ask about abuse in a non-judgemental way
What does Validate mean in AVDR?
A way to show someone that they are not to blame and they deserve better
What does Document mean in AVDR?
Taking clinical notes: specific and detailed descriptions of the injuries
What does Refer mean in AVDR?
Referring the patient to appropriate services
May provide a small card with details
What is the calculation for incidence rate?
Number of new cases/ number of individuals at risk
What is the calculation for prevalence rate?
Number of affected individuals/ total number in population
What is black stream waste for?
Non-infected household waste
What is orange stream bag for?
Low risk waste
Picked up for heat disinfection
How is the orange stream bin managed?
Containers filled to line
Label completed and identified on bin
Picked up by heat disinfection
What is yellow stream waste?
High risk
Body parts, medicine, anaesthetics, sharps, drug vials
How is yellow stream waste managed?
Incinerated
What is red stream waste for?
Amalgam
How is red stream waste managed?
Specialist treatment to recover chemicals
What are the key aspects of a waste transfer note?
Description of waste
Origin
Quantity
Transport and destination
How long is a consignment note kept?
Minimum of three years
What are examples of regulations for waste disposal?
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)
What does AWD stand for?
Automatic Washer Disinfector
What does an AWD do?
Removes prions and proteins
What are the differences between an Ultrasonic cleaner and an automatic washer disinfector?
Ultrasonic does not disinfect or dry
What are the stages of an automatic washer disinfector?
Flush/Pre-wash
Main wash
Rinse
Thermal disinfection
Drying
Discuss the flush/pre-wash?
<35 degrees
Removes gross contamination
Discuss the main wash?
Supplemented by detergent
Discuss rinse?
<65 degrees
Removes residue
Discuss thermal disinfection?
90-95 minutes
Kills micro-organisms with hot water
Discuss drying:
> 100 degrees
Hot air to remove moisture
What are the daily checks for an Automatic Washer Disinfector?
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
What happens during the inspection stage?
Use an illuminated magnifier to check for damage or contamination
What is the journey that dental instruments go on during processing?
Acquisition
Cleaning
Disinfection
Inspection
Packaging
Sterilisation
Transport
Storage
Use
Transport
What happens during the cleaning stage?
Proteins and prions are removed
What PPE is required during cleaning?
Apron
Face shield
Rubber gloves and heavy duty rubber gloves