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3A > CotE and PH past paper questions > Flashcards

CotE and PH past paper questions Flashcards

(61 cards)

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1
Q

Pressure ulcers - Predisposing factors

A 
Immobility 
Smoking 
Dehydration 
Poor nutrition 
Sensory impairment

Alzheimer’s
Parkinson’s

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2
Q

Pressure ulcers - Risk assessment

A

Warterlow tool

Braden tool

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3
Q

Pressure ulcers - Prevention

A

SSKIN

Supportive surfaces - Mattresses and cushions made of viscoelastic foam
Skin assessment - Barrier creams, pressure redistribution, repositioning, regular skin assessment
Keep moving
Incontinence and moisture management
Nutrition and hydration

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4
Q

Osteoporosis risk factors

A

SHATTERED

Steroids 
Hyperthyroidism. hyperparathyroidism, hypocalcaemia 
Alcohol 
Thin
Testosterone LOW
Early menopause 
Renal failure 
Erosive - IBD 
Dietary intake and drugs
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5
Q

Fracture risk assessment

A

FRAX score

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6
Q

Osteomalacia

A

Softening of bones
Due to impaired metabolism
Calcium and phosphate deficiency

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7
Q

Osteoporosis non-pharmacological treatments

A

Increase calcium intake
Vitamin D supplements
Exercise and weight bearing
Stop smoking

Falls prevention
Home OT assessment

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8
Q

Osteoporosis medical treatment

A 
Bisphosphonates 
Strontium ranelate 
Raloxifene 
Calcitonin 
Denosumab
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9
Q

Discharge planning

A 
Care package 
OT and PT assessment 
Social worker assessment 
Follow-up with community OT and PT 
Active recovery
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10
Q

Healthcare evaluation - Donabedian

A

Structure - What is available

Process - What happens

Outcome - 5Ds

  • Death
  • Disability
  • Disease
  • Discomfort
  • Dissatisfaction
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11
Q

Qualitative methods of healthcare evaluation

A

Focus groups
Interviews
Surveys and questionnaires
Observations

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12
Q

Never event reporting

A

National Reporting and Learning Systems - NRLS

Strategic Executive Information Systems - SEIS

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13
Q

System approach to error

A

Focus on working conditions

Errors are commonplace
Adverse events are the product of many causal factors

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14
Q

Person approach to error

A

Focus on the individual

Errors are the product of wayward mental processes

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15
Q

Theory of planned behaviour

A

Intention is the best predictor of behavioural change

  1. Perceived behavioural control
  2. Subjective norms
  3. Individual’s attitudes towards the behaviour
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16
Q

Ways to help turn intention into behaviour

A

BRIDGING THE GAP

Perceived control 
Anticipated regret 
Preparatory actions 
Implementing intentions 
Relevance to self
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17
Q

Theory of planned behaviour - Limitations

A

Lacks temporal element
Does not consider emotions
Assumes attitudes and subjective norms can be measured

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18
Q

Theory of planned behaviour - Advantages

A

Considers social pressures

Useful for predicting intention Can be applied to a variety of behaviours

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19
Q

Capacity assessment

A

Understand
Retain
Weigh-up
Communicate a decision

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20
Q

Libertarian principles for resource allocation

A

Each individual is responsible for their own health and wellbeing

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21
Q

Rule of rescue

A

Perceived duty to save an endangered life wherever possible

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22
Q

Epidemiological health needs assessment

A 
Define problem 
Size of the problem 
Services available - Prevention, treatment and care 
Evidence base 
Models of care 
Existing services 
Recommendations
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23
Q

Comparative health needs assessment

A

Compares services received by a population with services received by others

Health status
Provision
Utilisation
Outcomes

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24
Q

Corporate health needs assessment

A

Consider the opinions of people living within the population
What do they want

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25
Epidemiological health needs assessment advantages and disadvantages
Advantages - Uses existing data - Evaluates trends over time Disadvantages - Data may not be useful - Does not consider the opinions of the people
26
Comparative health needs assessment advantages an disadvantages
Advantages - Quick an cheap if data is available - Gives a measure of relative performance Disadvantages - Difficult to find a comparable population - Does not indicate the correct level of provision
27
Corporate health needs assessment advantages and disadvantages
Advantages - Based on felt expressed needs - Recognises the knowledge and experience of those working within the population Disadvantages - Need vs demand - May be influence by political agendas
28
Criteria for negligence
Duty of care Breach in the duty of care Somebody came to harm Harm was caused by the breach
29
Two causes of confusion and agitation
UTI | Hypercalcaemia
30
Two nursing strategies for a confused patient
Side room Sleep hygiene Clocks One-to-one nursing
31
Medical treatment for confusion and agitation
Haloperidol
32
Screening criteria
Condition - Important health problem, with a known natural history and pre-clinical phase Test - Sensitive, specific, inexpensive and acceptable Treatment - Effective, with an agreed policy on who to treat Organisation - Facilities in place, with the cost of screening economically balanced in relation to healthcare spending
33
Prevalance
Number of existing cases at a set point in time
34
NPV
Proportion of people with a negative result who DO NOT have the disease d / d + c
35
PPV
Proportion of people with a positive result who DO have the disease a / a + b
36
Sensitivity
Proportion of people WITH the disease who are correctly identified a / a + c
37
Specificity
Proportion of people WITHOUT the disease who are correctly excluded d / d + b
38
Incidence
Number of new cases which occur in a set period of time
39
Attributable risk
Rate of disease in exposed that can be attributed to the exposure Incidence in exposed - Incidence in unexposed
40
Relative risk
Risk in one group relative to another Incidence in exposed / incidence in unexposed
41
Confounding variable
A factor which is associated with the exposure in question and independently influences the outcome
42
Reasons for apparent association between dependent and independent variables
Bias Chance Confounding Reverse causality TRUE CAUSALITY
43
Underlying factors for failure of patient care
System failure Judgement failure Human factors Neglect Poor performance Misconduct
44
Swiss cheese model
Defence against hazard is a series of barriers Each barrier represented by a slice of cheese Each cheese contains holes of various sizes and positions These holes momentarily line up Creates a trajectory of accident opportunity Hazard passes through all of the holes Leads to FAILURE
45
Falls - Predisposing factors
``` Neurological disease Cognitive decline Muscle weakness Visual deficit Incontinence Postural hypotension Dehydration Malnutrition ```
46
Falls - Complications
Rhabdomyolysis Hypothermia Pressure sores
47
Falls - Investigations
ECG CK FBC Bone biochemistry - Serum calcium, phosphate and vitamin D Lying/standing BP
48
Medications causing postural hypotension
``` ACE-I Diuretics Nitrates Beta-Blockers Alpha-Blockers ```
49
Human rights in healthcare
Article 2 - The right to life Article 3 - The right to be free from inhuman and degrading treatment Article 8 - The right to respect for privacy and family life Article 12 - The right to marry and found a family
50
Resource allocation theories
Egalitarian principles - Provide all care that is necessary and appropriate Maximising principles - Maximise public utility Libertarian principles - Everyone is responsible for their own health and well-being
51
Requirements for a DoLS application
1. Patient is in hospital or care home 2. Under continuous supervision and not free to leave 3. Lacks mental capacity
52
What are the DoLS
Deprivation of liberty safeguards 1. A representative who is given certain rights and is responsible for looking out for and monitoring the person receiving care 2. Right to challenge a DoL through the court of protection 3. Provide a mechanism for a deprivation of liberty to be reviewed and monitored regularly
53
What must happen before a DoLS is put in place
Age assessment - Patient must be over 18 No refusals assessment - Proposed treatment cannot contradict valid decision made by LPA, deputy, or advanced directive MCA - Patient must lack capacity MHA - Different rules apply for MHD Eligibility assessment - Confirm whether there person is eligible to be deprived of liberty under DoLS Best interests assessment
54
DoLS guidelines
Should be avoided wherever possible Should only be authorised when in the patient's best interests and the only way to keep them safe Should be for as little time as possible Should be for a particular reason There is no suitable alternative that would not deprive them of their liberties
55
Advanced care planning
Enables a person to make decisions about their future health and social care in the event that they lose capacity 1. Advanced statements 2. Advanced decision to refuse treatment 3. Lasting power of attorney
56
Advanced statements
Not legally binding Should be taken into consideration Serve as a guide to inform best interests decisions Can cover any element of future care Written or verbal Does not require witness or signature
57
Advanced decision to refuse treatment
Legally binding Enables patient to refuse a particular treatment Cannot refuse basic care such as food and water Must be specific to specific interventions Must be written, signed and witnessed
58
Lasting power of attorney
Can refuse treatment BUT cannot demand treatment Health and welfare Property and affairs
59
Advantages of advanced care planning
Enables better informed best interests decisions | Relatives are more likely to be comfortable with the care of an individual if it was their own choice
60
Disadvantages of advanced care planning
Cannot request specific care Cannot request assisted suicide Cannot refuse treatment under the MHA
61
IMCA
Independent mental capacity advocate Makes decisions for an individual who does not have friends or family

3A (31 decks)

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