PMHP Flashcards
What is clinical governence?
systematic approach to maintaining and improving standard of patient care in the health system
What are the dimensions of healthcare?
PSEEET Patient centred Safe Equitable Efficient Effective Timely
What are the 3 divisions of dental healthcare in NHS Scotland?
Primary care - gdp
Public - community
Secondary care - hospital
How many hour of CPD needed per cycle
Under new Enhanced CPD (ECPD) 100 hours verifiable per cycle, 10 hours min per 2 years
+ personal development plan for each individual
+ CPD taken to be tailored to interests and specialisms if applicable
old- 250H, 75 verifiable.
name 6 members of the dental team needing to be registered with GDC
dentist hygienist therapist dental nurse ortho therapist dental technician
List the 9 GDC standards for dental professionals
- Put patients interests first
- Protect patients information
- Maintain and develop skills
- Work well with colleagues in pts best interest
- communicate effectively with patients
- straightforward complaints procedure
- Conduct in professional manner, maintaining pts confidence
- Gain valid consent
- Raise concerns if pt safety at risk
FIRST IS 1 L 2 M 3 N
List the 9 GDC standards for dental professionals
- Put patients interests first
- Protect patients information
- Maintain and develop skills
- Work well with colleagues in pts best interest
- communicate effectively with patients
- straightforward complaints procedure
- Conduct in professional manner, maintaining pts confidence
- Gain valid consent
- Raise concerns if pt safety at risk
FIRST IS 1 L 2 M 3 N
what is an audit
quality improvement process
review of current practice against set criteria to identify areas where change is needed
uses of an audit?
KLAPT identify areas for change in Knowlegde Learning Attitudes Protocol Training
What is the audit cycle?
Select standards -> Observe practice -> Analyse and compare -> Identify areas for change -> Implement changes -> Re-audit ->
What are the stages of a significant event analysis?
- identify event
- collect info
- set meeting to discuss
- meet to discuss
- change + monitor
- write up
- seek external feedback
what are the 4 pillars of ethics
non maleficience
beneficience
patient autonomy
justice
NoBody Punches Julie
what is negligence?
breach of duty or care that results in harm of a patient
an act or omission that would not be done by a “reasonable man”
How long should notes be kept for?
minimum 3 years. ideally 11, or until pt 25+
Give 5 qualities patients notes should possess
confidential current complete accurate legible retrievable retained
CCCALRR
who sits on GDC board?
1 chair
6 dental professionals
6 lay people
what 6 factors make up consent?
informed voluntary non coerced w/ capacity non- manipulative
8 things to discuss for informed consent
cost of tx recommendation alternatives risk of tx prognosis risk of no tx details of procedure length of tx
two types of consent
implied
expressed
informed
signs and symptoms alzheimers?
forgetfulness, confusion, aggression, poor communication skills
signs and symptoms parkinsons?
triad
tremor
rigidity
bradykinesia
complications of alzheimers for dental tx
poor oh
consent
communication
non-compliant pt
What are the principles of the Adults with Incapacity Act ?
What year?
AWI Act 2000
BMW- CR
Must BENEFIT patient MINIMAL intervention Must act in patient's past WISHES CONSULT relevant others Encourage RESIDUAL capacity
What is capacity
the ability to understand relevant info about the tx (risk, benefits, consequences of no tx), retain the information, make a decision and communicate the decision
Who can consent under AWI Act
Welfare Power of Attorney
Welfare Guardian
What is the English equivalent of the AWI 2000
Mental Capacity Act 2005
Recommended daily allowance of alcohol
Men + women 14 units a week, with 2 alcohol free days
What makes consent valid?
informed, capacity, non-coerced
current
specific
recent
continuous
what is the care index and how is it calculated?
The percentage of teeth with obvious decay experience in a population that have been treated restoratively (filled).
= ft/ d3mft x100
where ft is filled teeth
and d3mft is number of teeth with obvious decay experience (obvious decayed, filled, or extracted)
What does d3 mean?
obvious decay: when the disease process clinically appears to have penetrated dentine on a tooth surface.
includes pulpal decay
visual methods only
what does d3mft mean
Obvious Decay Experience (D3MFT)
The sum of teeth which have decay into dentine (including teeth with fillings which require further treatment), filled teeth and teeth that are missing (extracted) due to decay/
simd?
scottish index of multiple deprivation
a tool for identifying areas of poverty and inequality across Scotland
at population level name 3 fluoridation methods
water fluoridation, school water fluoridation , School milk, fluoridated salt
how to analyse a leaflet?
PICO - mnemonic for parts of a well built clinical question
population/problem
intervention
comparison
outcome
give 3 type of study
Cohort → prospective.
Case Control → retrospective.
Case study → one patient
Case control: one group compared against control retrospectively to find risk factors association
how to make a study random?
randomised control trial
computer generated assignment
how would you know if results were significant?
If confidence interval overlaps 0 = NULL hypothesis
results not significant
areas to consider when reviewing study
The size of the study, The duration of the study, The population investigated in the study
type of study that provides highest evidence?
four aspects of this kind of study
Systematic review of randomised control trials - Cochrane review
randomised, inclusion/exclusion criteria, control, blinding.
incidence?
Number of new cases over a specific time
prevalence?
Number of cases at a time
5 factors influencing deprivation?
unemployment, income, education, housing, access to healthcare, environment, crime.
benefits of split mouth study design?
disadvantages?
:) Both control and intervention exposed to same environment.
:( pt cannot be blinded
confidence interval?
Representation of study findings to real world population. worked out using the effect size and the sample size
relative to the true population. 95% likelihood of repeat results.
confidence interval overlaps of importance?
FOR ARR – IF CONFIDENCE INTERVAL RANGE OVERLAPS 0 = NULL HYPOTHESIS
FOR RR – IF CONFIDENCE INTERVAL RANGE OVERLAPS 1 = NULL HYPOTHESIS
what is the p value?
Statistical significance of results, usually null hypothesis. <0.05 is significant
how might an anxious pt present in practice
Negative, neurotic, low pain threshold, depressive, fidget, sweaty, upset
cycle of behaviour change?
Precontemplation, contemplation, preparation, action, maintenance with progress or relapse at any stage.
primary appraisal in stress?
secondary?
Initial assessment of stressor as → 1. Irrelevant 2. Benign 3. Harmful/threat 4. Harmful/challenge.
Reaction to primary appraisal → 1. Harm 2. Resistance 3. Exhaustion.
4 responses to stress?
- Direct action 2. Seek information 3. Do nothing 4. Coping
what is burnout/
Disengagement and exhaustion. Often negative and dissatisfied. (flashback)
4 examples of coping mechanisms for stress
Work/life balance, exercise, education on stress, set own goals, know own limits.
