Flashcards in Law Core Concepts & Skills 2 Deck (12):
What does a clinical check involve?
Identifying potential pharmacotherapeutic problems by collating and evaluating all relevant info. Including patient characteristics, disease states, medication regime, and where possible lab results
Where can you obtain/collect patient information from?
Other records such as Summary Care Records
What patient characteristics would you look out for when clinically screening a prescription?
At risk groups - children, elderly, preg/breastfeeding
Certain Ethnic groups - e.g. initial & max dose of rosuvastatin is lower for Asian patients
Gender - e.g finasteride is contraindicated for women
Co-morbidities - e.g renal, hepatic impairment, heart failure
Patient intolerance - e.g. allergies, dietary (lactose)
What medication factors should be checked when clinically screening a Rx?
Indication - appropriate/compatible ?
Changes in reg meds?
What is Meds Reconciliation?
Process of identifying an accurate list of patient's current meds inc. OTC and herbal and carrying out a comparison of these with the current list in use.
Identify any discrepancies, any changes.
When should a meds reconciliation take place? give 3 examples
When patient moves from one care setting to another
e.g. admitted to hospital, transferred between wards and on discharge
Name the sources of information that can be used when carrying out meds reconciliation? (11)
1. Patient/ Patient rep
2. Patient's meds
3. Repeat prescriptions
4. GP referral letters
5. GP surgery
6. Hospital discharge summaries or outpatient appointment notes
7. Community pharmacy notes
8. Care home records
9. Drug treatment centre records
10. Other healthcare professionals & specialist clinics
11. Patient medical records e.g Summary Care Records
Give examples of incidents where the "wrong culture" contributed to unacceptable failings?
Mid Staffordshire Hospital 2005-2008 (poor care and high morality rates)
Orchid View Care Home (19 deaths due to mismanagement and abuse)
Winterbourne View private hospital (physical and psychological abuse of the disabled )
What is a "just culture"?
A culture based upon fairness and is achieved when attitudes, behaviours and practices are fair.
What is a punitive culture? and whats wrong with it?
Bases upon assigning blame and punishment.
Contributes to creating a culture of fear as they see what happens to others as draconian or unjust.
Stifles reporting and learning. Leads to a reduction in patient safety and quality of care.
What is a no-blame culture and why is it inadequate?
Leads to lack of accountability and this immunity from accountability can be abused.
impact patient safety.