The Practice and its Team Flashcards

1
Q

Members of traditional primary healthcare team

A
GP partners 
GP assistants and salaried doctors 
GP registrars 
Practice nurses 
Practice managers 
Receptionists 
Community nurses 
Midwives 
Health visitors 
Nurse practitioners
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2
Q

GP partner role

A

First point of patient contact
Consultations and home visits
Provide complete spectrum of community care - physical, psychological and social components of problems
Work with other professions in teams to help patients take responsibility for health
Responsible for providing adequate premises from which to practice and employing own staff

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3
Q

Practice nurse role

A
Work in GP surgeries and as part of PHCT 
Direct supervision of practice health care assistants 
Blood samples 
ECG 
Minor and complex wound management 
Travel health advice and vaccinations 
Child immunisations and advice 
Family planning and women's health 
Men's health screening 
Sexual health services 
Smoking cessation
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4
Q

District nurse role

A

Visit patients in own homes or residential care homes
Provide increasingly complex care for patients and supporting family members
Teaching and support role
Accountable for own caseloads
Keep hospital admissions and readmissions to a minimum and ensure patient return to own home ASAP
Assess healthcare needs of patients and families
Monitor quality of care receiving
Professionally accountable for delivery of care

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5
Q

Midwife role

A

Provide care during all stages of pregnancy, labour and early postnatal period
Work in community providing services in women’s homes, local clinics, children’s centres and GP surgeries
Work in hospital in antenatal, labour, postnatal and neonatal units

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6
Q

Health visitor role

A

Lead and deliver child and family health services
Work with parents to assess support needs ad develop appropriate programs to give child best start to life
Support and educate families from pregnancy to 5th birthday
Work closely with other professionals and retain overview of health and well-being
Provide ongoing additional services for vulnerable children and families
Contribute to multidisciplinary team services in safeguarding and protecting children

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7
Q

MacMillan nurse role

A

Specialise in cancer and palliative care, provide support and information to people with cancer and family, friends and carers from point of diagnosis onwards
Offer specialised pain and symptoms control, emotional support, care in variety of settings, information about treatments and side effects, advice on members of care team, co-ordinated care, advice on other forms e.g. financial support

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8
Q

Pharmacist role

A

Expert in medicines and their use
Work in hospital, community or primary care pharmacies to ensure patients get maximum benefit of medicines
Advise medical and nursing staff
Provide information to patients
Undertake additional training to prescribe for specific conditions

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9
Q

Dietician role

A

Interpretation and communication of nutrition science to enable informed and practical choices about food and lifestyle in health and disease
Work with people with special dietary needs
Inform public about nutrition
Offer unbiased advice
Evaluate and improve treatments
Patient/client education

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10
Q

Physiotherapist role

A

Help and treat people with physical problems caused by illness, accident or raging
Manual therapy
Therapeutic exercise
Application of electro-physical modalities
Appreciation of psychological, cultural and social factors influencing clients

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11
Q

Occupational therapist role

A
Assessment and treatment of physical and psychiatric conditions using specific activity to prevent disability and promote independent function 
Work with patients to help overcome effects of disability caused by physical or psychological illness, accident or ageing 
Physical rehabilitation 
Mental health services 
Learning disability 
Primary care 
Paediatrics 
Environmental adaptation 
Care engagement 
Equipment for family living
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12
Q

Selected secondary care services

A

Hospital consultants
Diagnostic imaging
Operating services

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13
Q

Factors affecting primary health care team

A

Economic
Politcal
Development of new and extended professional roles
Growing number of ageing patients

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14
Q

Principles of good team work

A

Recognise and include patient/carer/representative as essential member of PHCT at patient-centred team or practice level
Agree team working conditions
Ensure each member understands and acknowledges skills and knowledge of team members
Pay particular importance to communication between members
Select leader of team
Promote teamwork
Evaluate team working initiatives on basis of sound evidence
Ensure sharing of patient info is in accordance with current legal and professional requirements
Take active steps to facilitate inter-professional collaboration and understanding
Be aware of other measures involving national organisations, education, research and general guidance which impact on team working

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15
Q

Who leads chronic disease management?

A

Practice nurse

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16
Q

How can the patient care for themselves?

A

Stopping smoking
Attend reviews and screening
Take medication and notify is side-effects
Hospital if e.g. hypoglycaemic episode or HKK
Recognition of blood glucose being out of control and how to manage this
Exercise ad eat well

17
Q

Management of patient with MRSA

A

Oral or IV antibiotics
Ward staff follow protocol for screening and management
Staff induction in infection control
National and SHA monitoring of hospital infection rates and holding hospital accountable by NHS, media and public

18
Q

7 stages of significant event analysis

A
Awareness and prioritisation of significant event 
Information gathering 
Facilitated team-based meeting 
Analysis of significant event 
Agree, implement and monitor change 
Write it up 
Report, share and review
19
Q

What is appraisal?

A

Development and support process where the doctor reflects on their performance with one of their own peer group

20
Q

What is revalidation?

A

Process is more robust, doctors required to do this to maintain their license

21
Q

Patient satisfaction mainly focuses on

A

Doctor-patient relationship
Communication skills
Empathy received
Service e.g. time to wait, time taken to get an appointment

22
Q

Types of discrimination as defined by 2010 Equality Act

A
Direct discrimination 
Associative discrimination 
Indirect discrimination 
Harassment 
Harassment by a third party 
Victimisation 
Discrimination by perception
23
Q

What does ADL measure?

A

Person’s ability to perform self-care or mobility activities

24
Q

Advantages of self-reported ADL

A

Allows assessment of wide range of activities in home and elsewhere at all times of day and night and over days, weeks and months
Individual can report on important activities to them

25
Q

Advantage of observational ADL

A

More objective

26
Q

Disadvantage of observational ADL

A

Restrictive to what can be carried out in hospital or on brief home visit

27
Q

Items measuring daily function used in Barthel Index of ADL

A
Feeding
Moving from wheelchair to bed and return 
Grooming 
Transferring to and from a toilet 
Bathing 
Walking on a level surface 
Going up and down stairs 
Dressing 
Continence of bladder and bowel
28
Q

Performance is influenced by

A

Actual loss of function
Restriction on function
Premature termination of activity and suboptimal performance

29
Q

Factors included in health-related quality of life

A

Includes physical, emotional, functional and social wellbeing. Based on the gap between real and ideal, hope vs reality

30
Q

Health related quality of life assessment allows comparison of

A

functional health over time and between patients

31
Q

Effects of developing illness

A
Distressing symptoms 
Diminished functionality 
Social isolation 
Dependence on family members 
Feel as though they are burdening loved ones 
Depression, anxiety and grief
32
Q

What is the compression of morbidity principle?

A

Objective of increasing lifespan should be associated at the same time with an increasing quality of life or a reduction in disability - no point in increasing lifespan if disability is high and quality of life is low

33
Q

Quality adjusted life years gives an idea of

A

extra months or years of life in reasonable quality that a person might gain from treatment

34
Q

Disadvantages of QUALYs

A

Patients QUALYs assessed and decisions made on how well treatment went for them, so treatment with most acceptance can be applied exclusively but patients are unique and have individual responses to treatments
Tend to be value-laden and subjective
Resources are finite

35
Q

Interventions for disability prevention

A

Public health e.g. folic acid in early pregnancy
Disease prevention interventions e.g. immunisation, smoking cessation
Disease modifying drugs
Physiotherapy and occupational therapy
Splints and aids
Rehabilitation
Occupational and environmental medicine

36
Q

Factors of primary prevention

A

Prevention of disease onset in health individuals to reduce risk, severity and duration of disease/illness/injury

37
Q

Secondary prevention

A

Early detection of pre symptomatic disease
Screening programmes
Occupational screening
National screening

38
Q

Tertiary prevention

A

Reduce consequences of disease and disability and prevent deterioration
Limit disability and enhance quality of life
Prevent spread of disease

39
Q

Primordial prevention

A

Broader social and environmental circumstances that predispose society to disease
Addresses social and environmental circumstances