Unit 2 - Communication

Question 1

What changed in 2010?

Answer 1

NHS Constitution came into effect.

Question 2

What is SPIKES and what is used for?

Answer 2

Breaking bad news:
1) Situation - physical prep
2) Patient current perception - what do they know
3) Patient invitation - what do they want to know
4) Knowledge exchange
5) Acknowledging patient emotions
6) Strategy and summary

Question 3

What are the five stages of grief?

Answer 3

Denial (of fact, impact, awareness, cycle)
Anger
Bargaining
Depression
Acceptance

Question 4

what three criteria must be met for consent to be valid

Answer 4

Must have capacity
Must have sufficient information to make decision
Must not be under duress

Question 5

What is material risk?

Answer 5

A reasonable person in the patient’s position would attach significance to the risk or the doctor is aware that particular patient would attach significance to it.

Question 6

What case caused the change in informed consent process?

Answer 6

Montgomery versus Lanarkshire health board

Question 7

What 5 principles make up the mental capacity act 2005?

Answer 7

1. Patient is assumed to have capacity
2. All steps should be made to enable patient to make decision
3. Patients may make an unwise decision
4. If no capacity that decision must be in patient’s best interests
5. Can the purpose be achieved in a way less restrictive to patients rights.

Question 8

How would you judge if a patient didn’t have capacity?

Answer 8

1. Can the patient understand the information
2. Can they retain information
3. Can they weigh up that information in order to make a decision
4. Can they communicate their decision

Question 9

Who can give consent to an under 16 who lacks capacity?

Answer 9

Person with parental responsibility (unmarried fathers do not have automatic rights)
Must be in child’s best interests
Child must be involved in decision process

Question 10

For Gillick competent children under the age of 16 who can give consent?

Answer 10

Child
Parental consent is not legally needed but it is good practice to involve the family in the decision making process

Question 11

Can an optometrist inform the DVLA if a patient continues to drive whilst being belows guidelines?

Answer 11

Yes, College states that if the public interest outweighs the duty of confientiality we can notify the DVLA. Must notify the GP and the patient of the action being taken

Question 12

What is Gibbs reflective learning cycle?

Answer 12

1) description of event
2) Feelings at different stages
3) Evaluation of what went well what didn’t etc
4) Analysis, why did it go well
5) Conclusions, what did you learn, how could have been better.
6) Action plan

Question 13

What did the NHS constitution legislate?

Answer 13

1. Right to accept/refuse treatment
2. No exam without consent
3. If no capacity consent must be in best interests
4. Right to info about your proposed treatment inc risks/benefits etc