B5 Clinical governance Flashcards
(35 cards)
state the basic and official definitions of clinical governance
basic
- system for accountability and continual improvement of care in the NHS
official
- ‘a framework through which NHS organisations are accountable for continuously improving the quality of their services, and safeguarding high standards of care by creating an environment in which excellence can flourish’
why does clinical governance matter to pharmacists?
- part of the NHS Terms of Service for community pharmacies
- requirements within Community Pharmacy Contractual Framework (CPCF)
- legal framework within schedule 4 of the NHS Regulations 2013
- also applies across all NHS and care settings
what does clinical governance support?
safe and effective patient care
what are the 7 elements of clinical governance?
- patients and public
- clinically effective
- clinical audit
- premises standards
- risk management
- staff management
- information governance
explain the element of clinical governance: patients and public
- practice leaflets and satisfactions surveys can be used to inform patients and gain insight on their opinions
- monitoring compliance with Equality Act
- publicising NHS services
explain the element of clinical governance: clinically effective
- arrangements for OTC advice
- appropriate patient counselling
- intervention diary (keep a record of interventions made to have evidence)
explain the element of clinical governance: clinical audit
- pharmacy-based audit, involves whole pharmacy team
- topic relevant to NHS
explain the element of clinical governance: premises standards
- cleanliness
- professional environment
- facilities and equipment safe and maintained
- eg. weighing scales and blood pressure monitors should be regularly serviced to ensure readings are accurate for patients
explain the element of clinical governance: risk management
- stock procurement and handling
- waste disposal
- incident reporting
- near miss logs
- patient safety communications (eg. proper counselling for women taking sodium valproate for epilepsy - it is extremely teratogenic)
- SOPs
explain the element of clinical governance: staff management
- qualifications and references
- induction and training
- performance development plans
- management of poor performance
explain the element of clinical governance: information governance
- procedures for information management and security
- self-assessment of information governance compliance (annually)
why are SOPs legally important?
- integral part of risk management in community pharmacy practice
- professional requirement mandated by the GPhC
- upon inspection, the GPhC will check that you have SOPs in place
what does an SOP specify?
- what should be done
- when it should be done
- where it should be done
- by whom
what should SOPs be?
- in writing and available for use
- individual to each pharmacy
- dependent on the competence of staff working
- applicable at all times (under normal circumstances)
state 8 purposes of SOPs
- ensure good practice
- minimise variation and ensure consistency
- clarify roles and responsibilities of everyone in the pharmacy team
- provide training / information for new and existing staff
- provide an objective standard for feedback and evaluation
- provide a focal point for improvement
- provide evidence of a safe system of work in the event of external challenge
- improve quality and promote patient safety
what 6 stages should an SOP for dispensing contain that ensures it covers the entire process?
- receiving prescriptions
- assessment of prescriptions (clinical and legal)
- making interventions and problem solving
- labelling and assembly of medicines
- accuracy checking
- handing out prescriptions
what 5 things should every SOP contain? describe what is meant by each of these sections
objectives
- what is the procedure trying to achieve?
scope
- areas of work covered
stages of process
- step-by-step description of the task
responsibilities
- person / staff roles responsible for each stage
review
- interval at which ensure process is up to date and objectives are being met
basic definition of audit
‘improving the care of patients by looking at what you are doing, learning from it, and, if necessary, changing practice’
what parts of patient care can be audited?
any part from the medicine prescribed to prescription delivery
state the 6 steps of the audit cycle and what an audit cycle is
audit cycle = formal process
- identify problem or objective
- agree criteria and set standards
- collect data
- identify areas for improvement
- make necessary changes
- re-audit
in practice after uni, where and when are audits completed?
- regularly within all sectors
- community pharmacy (contractual requirement)
- GP pharmacy (evidence for CQC inspection)
- hospital pharmacy (evidence for CQC inspection)
describe what is meant by dispensing incidents
patient receives an item that is:
- incorrect
- out of date
- labelled incorrectly
- counselled incorrectly
- or, is not provided with their intended item
- regardless of whether the patient uses the item or experiences harm
the than dispensing incidents, state some incidents that can happen
- theft of medication
- safeguarding incident
- breach of confidential information
- prescribing error not identified by pharmacist
- incorrect advice regarding OTC medicines
state the steps of the framework for responding to incidents by the Community Pharmacy Patient Safety Group
- duty of candour at its centre (be open and honest)
- report what happened and understand why
- learn from the incident
- share insights
- demonstrate change
- review its effectiveness
