PMHP Flashcards
GDC standards
Put patients interests first
Raise concerns if patients are at risk
Obtain valid consent
Coomunicate effectively with patients
Clear and effective complaints procedure
Maintain, develop and work within abilities
Maintain and protect pt info
Work with colleagues in a way that puts patients interests first
Make sure personal behaviours maintain confidence in you and dental profession
Socio-econmic factors
income
housing
crime
employment
access to healthcare
education
health satus
Capacity
ability to make decision
able to understand decision
able to retain decision
able to communicate decision
Protected Charactersitcs
age
gender
disability
marriage
race
relgion
sexual orientation
gender reassingment
pregnancy
4 pillars of ethics
Justice
Beneficence
Pt autonomy
non malifienance
Consent must be
valid
informed
voluntary
not manipulated
not cocerced
with capacity
Internal lotus of control
own resposibility
External lotus of control
to do with luck
Fluoride given in
milk
water - 1ppm
salt
varnishes - 22600ppm
gels - 12300ppm
toothpaste
mouthwash - 225ppm <7years no
<0.3ppm in water tablets
0-6 mnonths - 0,g
6-3years - 0.25mg
3-6years - 0.50mg
+6 years 0 1mg
<0.6ppm in water tablets
0-6months = 0mg
6-3 years = 0mg
3-6years = 0.25mg
6+ years = 0.50 mg
What is clinical goverance
a systemic approach to maintaining and improving the qulaity of patient care within a healtchare system
6 dffierent areas of clincal governace
openess
clinical audit
clinical effectivness
research and devlopment
risk mangement
education and training
Dimensions of clincal governance
Person centred
Safe
Efficient
Effective
Equitable
Safe
Veriable hours of CPD
100 hours
What are mandotory CPD sections
medical emergencies
decontamination
radiology and radiation protection
Extra areas of CPD sections
complaints handling
oral cancer - early detection
Legal and ethical
7 steps of critical incident review
identify event
collect and collate info
set up meeting and discuss
make and undertake structure analysis
implement changes and monitor
write up significant event anaylsis
seek external feedback
What is a clinical audit
quality improvement process that improves pt care and outcomes through sytstmeic review of care against criteria
Clinical audit cycle
identify problem or issue
set criteria and standards
observe current practice
compare performance with standards
identify changes ad implement
repeat audit at set intervals
What does a clincial audit observe gaps in
knowledge
attitude
protocol
trianing
learnining
Prevalence
measure of individuals with a disease at a time (devlopment of a hypothesis)
Incidence
number of new diseases developing over a time
Confounding vairiables
particular type of extranesous variable that has been left uncontrolled
Null hypothesis
general statement suggesting no statistical significance in set of data
Absolute risk difference
overlap 0 = unsufficient evidence
Risk factor/ odd ratio
overlap 1 = unsifficent evidence
Confiidence interval
shows how confident you can be with an estimate
Narrower = better
Wider confidence = smaller sample
P value
small <0.05 - significant strong evidence
RCT
gold standard - exlcusion/ inclusion
blinding
comparison
radomisation
Highest level of cochrane study
cochrane review
(systemic review and meta analysis)
Reduce bias by
double blinding
radomisation
Type of bias would blinding prevent
selective bias
What is a systemic review
type of literatre review that uses systemic methods to collect secondary data, crtically apparise and synthesis studies
Key characterstics of systemic review
well formulated questions
comprehensive data search
unbiased selection and abstraction process
assessment of papers
sythesis of data
Meta analysis - forest plot
process of using statisitical methods to combine results of different studies
improves precision
What do weights in meta analysis account for
number of study participtants
number of events
standard deviation of outcomes mseasure
Weights higher in meta analysis when
more particptiants
less variation
Drink dirivng limit
80mg/100ml
Screening tools for alcohol
CAGE
Fast alcohol screening test
Alcohol use disroders identification
CAGE
Feel need to cut down
Annoyed at critisim of drink
guility about drinking
take early morning drink
> 2 = alcohol issue
Medical and dental issues with alcohol
GI - liver and kidney issues
stomach or bowel cancer
oral cancer
heart problems
cirrhosis in hep c
excessive bleeding
poor wound healing
xerostomia
glossitis
angular chilitis
oral ulcerations
NCTSL
Stages of change
pre contemplation
Contemplation
Preparation
action
Maintanance
FRAMES - brief motivational intervention
Feedback
Responsibilty
Advice
Method of options
Empathetic
Self efficacy
Tobacco triangle
Emotional attahcment
Habit
Chemical addiction
Oral side effects of smoking
xerostomia
poor wound healing
perio
oral cancer
nictoninic stomatitis
hallitosis
blakc hairy tongue
discolouration
smokers melanosis
General side effects of smoking
COPD
lung cancer
heart attack
stroke
stomach cancer/ulcer
5 A’s for quitting smoking
Ask
Advise
Assess
Assist
Arrange a follow up
% R’s for thinking quitting smoking
Relvance
Risk
Rewards
Roadblocks
Repititon
Type of domestic abuse
verbal
emotional
physical
sexual
fincial
Most at risk of domestic abuse
Women - younger
Pregnancy
women seperated
mental health issues
long term illness/disability
Behavioural signs of domestic abuse
low self esteem, anxious, unease
alcohol
constant phoning or texting partner
missed appts
insist on female clincians
inapporpraite clothing to hide trauma
Victims of domestic abuse signs
repeated injuries
TMJ problems
brusies at different stages of healing
orofacial pain
delay seeking help for injury
marks on ears
facial brusing or stange marks around neck
AVDR domestic abuse
Ask - non judgemental, private setting
V - validate - show them you are concerned
D - document - use pts own words, be speific and detailed
R - refer - signpositing (Scottish domestic abuse helpline, scottish womens aid)
Clinical negligence
the dentist owed a duty of care
the duty was breached
that breach caused or materially contributed to damage (causation)
the damage was reasonably foreseeable and had negative consequences and effects
Physical symptoms of stress
exhasution
GI issues
sleep issues
shortness of breath
skin issues
aches/pain
Psychological symptoms of stress
touchy and irritable
lethargy
outburts of anger
screaming/shouting
Burnout
a prevouisly commited professional disengages from their work in repsonse to stress and strain in their job
Resilence
a process of adapting well in the face of adversity, trauma, tradgey, threats
Direct discrimination
treating people less fairly because of a protected characterstic
indirect discrmination
putting people witha protected charactersitc at an unfair disadvantage
associate discrimination
because of another person’s protected characterstic
Percieved discrimnation
when it is believed that a person has a protected characterstic
Harrassement
through violating a person’s dignity or a degrading, humilitary, hostile or offensive environemnt
Victimisation
detriment to a person who is making use of the equality act 2010 or is thought to be doing so
