ICM - Professional OSCE

Question 1

Critical Incident Reporting

Answer 1

IntroductionsChecks if junior wants anyone else presentAllows junior to tell the storyExplains this is a ‘critical incident’Investigation not to apportion blame but to ensure it does not happen againMechanism for critical incident reportingError is a ‘never event’Must be reportedSupport - ES, college tutor, MDUWill need to reported on revalidation Non-judgementalCloses

Question 2

Failed discharge

Answer 2

Outreach systemsReview on wardsMeeting with ward staff if unhappy

Question 3

Refusal of treatment

Answer 3

IntroductionsOffer to have someone else present (family, nurse)Establish what the patient knowsExplain treatment or procedureExplore reasons for refusalExplain severity or problemDuty bound to provide all information to patient and help them make a decision

Question 4

NG tube misplacement

Answer 4

IntroductionsAnyone else present?Allow junior to explain circumstancesSerious never eventIncident formInvestigation to find out causes, failing in system - not apportion blame

Family of patient will be informedInvestigation All parties will be given findingsJunior will need to declare it on their validation/ARCPOffer supportInterim action - senior to check NG placements