PPD Flashcards
What is an error?
An unintended outcome
List some common issues regarding safety in healthcare:
- Wrong diagnosis -> wrong plan
- Medication reconciliation
- Patient identification
- Patient care handovers
- Medication identification
List the types of error which can occur:
- Intention (failure of planned actions to achieve outcome)
- Action (e.g. wrong blood vessel)
- Outcome (e.g. near miss, death)
- Context (e.g. team factors, accumulation of stressors)
List the 2 perspectives of error:
Person approach (individuals fault): - shortcoming= blame culture
System approach (working conditions):
- errors are common place so adverse events are the product of many causal factors
- error lies in the system rather than individual
List some strategies used to reduce errors and harm:
- Simplification and standardisation of clinical processes
- Checklists - SBAR
- Team training
List some tools used to identify risks:
- Incident reporting
- Complaints and claims
- Audits
- External accreditation
What is a never event?
A serious, largely preventable patient safety incident that should not occur if the available preventative measures have been implemented (e.g. surgery on wrong site, wrong preparation of medicine, mental health= suicide).
List 4 leadership styles:
- Inspirational
- Transactional (communicating)
- Laissez-faire
- Transformational (leadership throughout all levels of organisation)
List 3 mechanisms which can underlie inhumane behaviour:
- Bystander effect
- Situational factors (over-ride value systems)
- Unwillingness to speak out
List 5 types of basic error:
(all these forms of error have a reciprocal skill, behaviour or attribute which is more desirable):
- Sloth (not bothered)
- Loss of perspective
- Communication breakdown
- Poor team working
- Bravado (working beyond competence)
- Ignorance (lack of knowledge)
List 5 reasons why ‘things go wrong’:
- System failure
- Human factors
- Judgement failure
- Neglect
- Poor performance
What 4 questions can be asked to ascertain whether negligence has occurred?
1) Is there a duty of care?
2) Was there a breach of that duty? (would a group of reasonable doctors do the same? - Bolam test)
3) Did the patient come to any harm?
4) Did the breach cause that harm?
What is the Swiss cheese model?
In the Swiss Cheese model, an organization’s defenses against failure are modeled as a series of barriers, represented as slices of cheese. The holes in the slices represent weaknesses in individual parts of the system and are continually varying in size and position across the slices. The system produces failures when a hole in each slice momentarily aligns, permitting “a trajectory of accident opportunity”, so that a hazard passes through holes in all of the slices, leading to a failure
What are the 4 types of learner?
- Theorist (questions ideas)
- Activist (Extroverted)
- Pragmatist (wants feedback)
- Reflector (watches others)
What is Kolbs learning cycle?
1) Experience (activist)
2) Review, reflect of experience (reflector)
3) Conclusions from experience (theorist)
4) What can I do next time? (pragmatist)
What is culture?
Socially transmitted pattern of shared meanings by which people communicate, perpetuate and develop their knowledge and attitudes about life
What is ethnocentrism?
Tendency to evaluate other groups according to the values and standard of ones own cultural group, especially with the view that ones own cultural group is superior to the other groups
What is a stereo type?
Involve generalisations about the ‘typical’ characteristics of members of a group
What is prejudice?
Attitudes towards another person based solely on their membership of a group
What is discrimination?
Actual positive or negative actions towards the objects of prejudice
What model is used to identify what people think causes illnesses?
Kleinmans explanatory model of illness
What is rationing?
Resource is refused because of lack of affordability rather than clinical ineffectiveness
Why have rationing needs increased in health care?
- Shift from acute to chronic illness
- Normal physiological events medicalised
- Increase choice + increase expensive drugs
List 3 allocation theories;
- Egalitarian - all care to everyone
- Maximising principles -maximises public utility
- Libertarian - each responsible for their health
What does the german health care system do to encourage engagement in health interventions?
Provides financial incentives (for routine screening, health promotion and check up programmes).
Issue is that programmes attract/retain higher income groups
What is article 2 of human rights?
2: The right to life
What is article 3 of human rights?
3: the right to be free from inhuman and degrading treatment
What is article 8 of human rights?
8: the right to respect for privacy and family life
What is article 12 of human rights?
12: Right to marry and found a family
List 3 benefits of social media in regards to health:
- More diverse social and professional networks
- Facilitating public access to accurate health information
- Improving patient access to services
List 3 risks of social media in regards to health:
- Loss of personal privacy
- Potential breaches of confidentiality
- Unprofessional behaviour
List the 6 GMC duties of a doctor:
- Make the care of your patient your first concern
- Protect and promote the health of patients and the public
- Provide a good standard of practice and care
- Treat patients as individuals and respect their dignity
- Work in partnership with patients
- Be honest and open and act with integrity
List the 4 stages of wound healing:
1) Vascular response (reduced blood flow)
2) Inflammatory response
3) Proliferation (fibroblasts secrete collagen and glycosaminoglycans)
4) Maturation
Article 4 of human rights:
Prohibition of slavery
Article 5 of human rights:
Right to liberty and security
Article 14:
Prohibition of discrimination
What is Deprivation of Liberty Safeguards?
The procedure prescribed in law when it is necessary to deprive of their liberty a resident or patient who lacks capacity to consent to their care and treatment in order to keep them safe from harm
In what settings does DOLS apply?
In carehomes and hospital.
How long can DOLS be authorised for?
Up to 1 year or until it is no longer needed.
