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From Flashcardlet > IDEALS > Flashcards

IDEALS Flashcards

0
Q

Define clinical governance

A

Approach to Maintaining & improving patient care “Framework through which NHS organisations are accountable for continually improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish”

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1
Q

What are the 3 key attributes in clinical governance ?

A
  1. Recognisably high standards of care
  2. Transparent responsibility and accountability for those standards
  3. Constant dynamic improvement
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2
Q

What is information governance ?

A

Set of structures (e.g. Policies, procedures etc) ensuring necessary safeguards for, and appropriate use of, patient and personal information.

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3
Q

If infectious disease breaks out in hospital setting, e.g. c dif. how should you react ?

A 
Suspect a case
Isolate patient 
Gloves and aprons
Hand hygiene (soap and water)
Test for toxin

Use SIGHT pneumonic

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4
Q

What are the caldicott guidelines?

A

Guidelines on data protection in HEALTH SERVICES (1998) extended to social services (2000)

  1. Justify purpose of using confidential info
  2. Only use it when necessary
  3. Use the minimum required (identifier no. Instead of name)
  4. Allow access on need to know basis
  5. Understand your responsibility to respect client
  6. Understand and comply with law (data protection act 1998, police and criminal evidence act 1984, human rights act 1998)
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5
Q

What did the data protection act 1998 outline?

A

Principles on how personal information must be handled and gives clear rules on how any processing of that processing should be carried out
Covers all information which is identifiable, personal and which can be retrieved

  • processed fairly and lawfully
  • obtained for specified and lawful purposes
  • adequate, relevant and not excessive
  • accurate and up to data
    not kept any longer than necessary
  • processed in accordance with the data subjects rights
  • securely kept
  • not transferred to any other country without protection in situ
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7
Q

Describe maslows hierarchy of needs

A 
Theory of human motivation:
(Top to bottom)
- Self actualisation (challenges, intellectual fulfillment)
- Esteem (recognition from peers)
- Social/belonging (acceptance)
- Safety (physical, economic security)
- Physiological (basic needs)
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7
Q

With regards to Belbin’s teamwork theory, someone who presents new ideas and approaches is carrying out which role ?

A

Plant (one of the thought oriented roles)

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8
Q

What are the three action oriented team roles outlined by belbin ?

A

Shaper- challenges team to improve
Implementer- puts ideas into action
Completer finisher- ensures thoroughly, timely completion

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9
Q

In De bono’s theory of teamwork roles, how many ‘hats’ are proposed ?

A

6

White, red, black, yellow, green, blue

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10
Q

Plant, monitor-evaluator and specialist, are roles in team work from which theory ?
What do each involve?

A

Belbin’s teamwork theory - thought orientated roles
Plant- new ideas and approaches
M-E- analyses options
Specialist- specialised skills

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11
Q

Which colour hat is ‘creative’ in de bono’s theory?

A

Green

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12
Q

What role is the blue hat in de bono’s theory ?

A

‘Thinking about thinking’ I.e. Controller of discussion

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13
Q

What is meant by the forming stage of group development ? (Tuckman)

A

Forming of team takes place, get to know each other, form impressions, avoid conflict and controversy. Members work dependent,y, not much gets done.

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14
Q

What are the Tuchman stages of group development?

A

Forming-storming-norming/performing-mourning

Tuchman said these stages were necessary in order for team to grow and deliver results

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15
Q

Which stage if team development (Tuckman) is often most unpleasant ?

A

Storming - conflict, some teams never move past this stage

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16
Q

Most likely problem in norming stage of team development?

A

Focus on preventing conflict that controversial ideas not expressed

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17
Q

When a team can function as a unit, getting jobs done effectively and smoothly, what stage of group development will they be in ?

A

Performing

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18
Q

What is the different between management and leadership ?

A

Management focuses on task, leadership on people

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19
Q

A leader who uses different leadership styles, is responsive to needs and abilities of followers and has good emotional intelligence is what type of leader ?

A

Contingency/situational

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20
Q

Outline transactional leadership

A

Managerial, focus on role of supervision, performance etc.

Leader promotes compliance via rewards and punishments

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21
Q

Outline transformational leadership

A

Enhancement of motivation, morale etc by being a role model for followers, encouraging followers to take greater ownership and by understanding strengths and weakness of followers - give takes to enhance performance

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22
Q

A leader who desires to do good for their followers is using what type of leadership ?

A

Leader as servant

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23
Q

Main point made by the ‘adverse event iceberg’

A

That most errors, including: those considered insignificant, near misses and unnoticed errors, go unreported.

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24
Q

What is force field analysis ? (Lewin)

A

Method for listing, discussing and assessing the various forces FOR and AGAINST a proposed change. Helps to look at bigger picture by analysing all impacting forces (driving & restraining)

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25
Q

Outline the 8 steps of kotters organisational change theory

A
  1. create urgency
  2. Form powerful coalition
  3. Create vision for change
  4. Communicate the vision
  5. Remove obstacles /empower others to act
  6. Create short-term wins
  7. Build on the change/consolidate improvements
  8. Anchor the changes in corporate culture
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26
Q

What is meant by the term ‘error traps’

A

Recurring problem areas -

relevant to incidence reporting I.e. What incidence reporting aims to identify

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27
Q

What are the 4 steps to managing clinical risks ?

A
  1. Identify risk
  2. Assess the frequency and severity if risk
  3. Reduce or eliminate risk
  4. Cost the risk
28
Q

Define advocacy

A

Speaking up for someone else, in particular someone with little power

29
Q

What is the main function of the national reporting and learning system ?

A
  • To identify common risks
  • Improve patient safety
  • Provide feedback and guidance to do so
30
Q

What is direct-advocacy?

A

Where the interests of individual patients/specific groups are represented by advocate e.g. Writing a letter to nursing home on behalf of patient

31
Q

What is public advocacy ?

A

When the advocate is seeking changes to an aspect of the system to benefit patients generally e.g. BMA standing up for patients rights

32
Q

What are the three elements that determine whether we enact a behaviour outlined by the theory of planned behaviour ?

A
  1. What significant others think about the behaviour
  2. Our own beliefs and attitudes towards the behaviour
  3. Perceived difficulty of the behaviour and our perceived ability to cope
33
Q

What is resilience ?

A

A phenomenon or process reflecting relatively positive adaption despite experiences of adversity or trauma

34
Q

An attempt to modify stressful problem or emotion (problem solving) is an example of which or of coping ?

A

Primary control coping

35
Q

What is secondary control coping ?

A

Attempts to adapt via way that we think (cognitive restructuring)

36
Q

What is disengagement coping ?

A

Attempts to redirect attention away from the stressor or emotional reaction (denial, wishful thinking)

37
Q

Give examples of emotional focused coping

A

Distraction, minimisation, seeking meaning about life, expressing sharing feelings, reduce self-blame

38
Q

What is problem focused coping ?

A

Accepting that there is a problem and applying problem solving

39
Q

What are the main three things allowing for good situational awareness ?

A
  1. Perception (knowing what is going on around you)
  2. Comprehension (why things are happening)
  3. Projection (what’s likely to happen next)
40
Q

What is defined as a serious incident ?

A
  • Unexpected or unavoidable death (patients, staff, visitors)
  • Serious harm I.e. Requires life saving intervention, results in permanent harm or shortens life expectancy
41
Q

What is medsin ?

A

A student network and registered charity tackling global and local health inequalities through education, advocacy and community action

42
Q

What is an active failure ?

A

Human factors e.g. Distractions to task, lapse in protocol, mistake

43
Q

What are latent failures ?

A

Errors waiting to occur within healthcare system e.g. Insufficient staffing, inadequate training etc

44
Q

Why may there be variation between providers in the hospital standardised mortality rate (HSMR) ?

A

Variation in standard of care
Variation in coding
Variation in community provision

45
Q

What is the hospital standardised mortality ratio?

A

Expected no. Deaths (within 30 days of adm.) / actual death (x100 for %)
Can be used as measure to compare in-hospital deaths between providers

47
Q

In practice what is the most common reason for variation in hospital standardised mortality rate (HSMR) ?

A

Variations in coding (of deaths)

48
Q

What are the five drivers?

A

1) Be strong
2) Be perfect
3) Try hard
4) Hurry up
5) Please others

6) HLS (huge lad syndrome = dave)

49
Q

What process helps to identify the main contributory factors and lead to effective action planning?

A

Root cause analysis

50
Q

Different ways of performing a root cause analysis?

A

1) Look at contributory factors (Fishbone diagram &
Organisational accident model)
2) look at active and latent failures (Swiss cheese model)

51
Q

List some contributory factors that can lead to a problem within the health care system? Think of the fishbone

A
  • Patient and provider factors
  • Task factors
  • Team factors
  • Equipment factors
  • Organisation
  • Environmental factors and work conditions
52
Q

What acronym is used in helping someone challenge a superior?

A 
P = probe (do you know that...)
A = alert (can we re-assess the situation)
C = challenge (please stop for a minute)
E = emergency (STOP what you're doing)
53
Q

Group or team? ‘members have invested participation in work’

A

Team

54
Q

Group or team? ‘members only take responsibility for their own tasks’

A

Group

55
Q

Group or team? ‘good, easy and informal communication’

A

Team

56
Q

3 broad roles set out by Belbin?

A
  • Action orientated (shaper, implementer, complete finisher)
  • People orientated (Coordinator, team worker & resource investigator)
  • Though orientated (plant, monitor-evaluator, specialist)
57
Q

Which one of De Bono’s six hats is the negative role?

A

Black

58
Q

What does the red hat signify in De Bono’s hats?

A

The emotional role

59
Q

What is the role of the white hat in De Bono’s teamwork theory?

A

Questioner

60
Q

Which colour hat has the positive role in De Bono’s teamwork theory?

A

Yellow

61
Q

What is the trait theory?

A

Is there a set of characteristics which determine a good leader?

  • personality
  • dominance
  • charisma
  • self confidence
  • achievement
  • clear vision
62
Q

4 types of contemporary leadership styles?

A
  • Contingency
  • transactional
  • transformational
  • servant
63
Q

5 different types of role people take up during organisational change?

A
  • Innovators (venturesome)
  • Early adopters (respectable)
  • early majority (deliberate)
  • late majority (sceptical)
  • laggards (traditional)
64
Q

With regards patient safety, which of these should be reported? slips, trips & falls, unavailability of medical records, equipment failures, drug errors, delay in treatment, pressure sores, poor communication…..?

A

ALL of them, need to report all near misses, errors considered insignificant and need to notice the unnoticed errors…

65
Q

What is a crude mortality rate?

A

Number of deaths divided by the number of admission to a healthcare provider in a specified time internal.

66
Q

Which medicines are most frequently associated with severe harm?

A
  • anticoags
  • antibiotics
  • injectable sedatives
  • chemo
  • opiates
  • antipsychotics
  • insulin
  • infusion fluid
67
Q

What 6 things make a good record?

A
  • Clarity,
  • completeness
  • accuracy
  • consistency
  • progression
  • conciseness
68
Q

What type of transactional leadership abdicates responsibility, avoids making decision and maintains status quo?

A

Laissez-faire

From Flashcardlet (22 decks)

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