Miscellaneous Flashcards
(29 cards)
Freedom of information
20 days to respond to a written request telling whether have the info and providing it if no exemption
Purple lidded sharps bin
cytotoxic and cytostatic (slows/stops growth of cells) drugs
includes all oestrogen and progesterone and testosterone drugs, including HRT and OCPs, and MIFE and OXYTOCIN
Mental health act
3 components of valid consent
- Have capacity to make a particular decision.
- Received sufficient information to make decision.
- Not be acting under duress.
Capacity criteria
> 16 are assumed to have capacity
– Ability to comprehend
– retain information
– way up information.
– use information to make decision
4 principles in ethics
- Respect for autonomy.
- Beneficence (find benefits and balance risks)
- Non-maleficence (do not harm)
- Justice (fairness)
8 Caldicott principle
– Justify using confidential information
– don’t use confidential data unless absolutely necessary
– Use minimum personal data necessary
– access to confidential data on need to know basis
– those were the access aware of their responsibilities.
– understand and comply with the law.
– duty to share info can be as important as duty to protect patient’s confidentiality
– informed patients How info used
Definition of maternal death?
Death during pregnancy or within 42 days of end of pregnancy, including miscarriage, abortion, childbirth.
Must be related or aggravated by pregnancy or its management including complications. Accidents are excluded from the definition.
Dealing with spills of blood or bodily fluid (CSF, amniotic fluid, semen, vagina secretions, breastmilk, any bodily fluid) excluding urine
Apply chlorine granules or towels with 10,000 parts per million chlorine to spill
Allow time 3 mins
Discard in healthcare waste bag
Clean area with disposable towels and cleaning solution & warm water
Hand hygiene
Dealing with spills of urine, faeces, vomit, sputum?
DO NOT use chlorine releasing Gent directly on urine…soak up using disposable towels or gelling agent
Decontaminate with 1,000 parts per million chlorine or combined cleaning solution
Sharps bins (purple, orange, yellow)
Purple ––> cytostatic/cytotoxic
Orange ––> NOT contaminated with meds
Yellow ––> contaminated with meds
Clinical waste bags:
Yellow
Yellow + black stripes
Orange
Yellow + purple
Yellow - highly infectious (suspected infections +/- contamination meds)
Yellow + black stripes -
Orange -
Yellow + purple -
Clinical waste bags:
Yellow
Yellow + black stripes
Orange
Yellow + purple
Yellow - highly infectious (suspected infections +/- contamination meds) dressing, PPE, swabs, IV bags with meds in them (incinerated)
Yellow + black stripes - unpleasant but not infectious (nappies, tampons) (landfill)
Orange - infectious, same as yellow but minus meds contamination, dressings, swabs, saline IV bags
Yellow + purple - cytotoxic/cytostatic, IV bags, (incinerated)
Postnatal depression screening tool?
Edinburgh postnatal depression scale (EPDS)
10 self reporting questions.
Screening tool NOT diagnostic.
Use ante/postnatal.
Asks re symptoms in last 7 days.
Each question 0 - 3, Max 30
10 or more suggestive of depression
PN depression is within 1 year of delivery
PHQ-2
Patient health questionnaire
PHQ 2 screening for depression
97% sensitivity
67% specificity
- During past month bothered often by feeling down, depressed or hopeless?
- During past month bothered by having little interest/pleasure in doing things?
PHQ-9
Diagnosing depression, grade severity and response to tx
Sensitivity 67%
Specificity 94%
X9 self reported questions
Asks re past 2 weeks
Each question 0-3, max 27
Question re suicide risk
Antidepressants in pregnancy
- 1st SSRI (sertraline/paroxetine in BF)
- but if clinically indicated benefits may outweigh risks of any drug
- monitor infant in hospital for withdrawal
- avoid venlafaxine (risk miscarriage, PTB, birth defects)
Screening program criteria
– Important condition natural hx understood
– acceptable test for population
– treatment available
– financially viable cost-effective
– evidence base
– must not cause harm
Montgomery principles
Supersedes Bolam test (acted within medical opinion)
Regarding informed consent
Process of understanding, dialogue and shared decision making
– Provide information about all material risks.
– disclose any risk to which a reasonable person would attach significance 
Mental Capacity
Presumed to have capacity >16
Time and decision dependent
- Understand relevant information
- Retain information
- Weigh up info to make decision
- Communicate decision
England & Wales Mental capacity act 2005
Scotland adults with incapacity act 2000
** Northern Ireland mental capacity act 2016**
- presumed unless proven otherwise
- Support to make decisions.
- Can make unwise decisions.
- Action taken best interest
- decisions if lacking capacity must be least restrictive 
Mental health act 1983
Section 136 remove from public by police to place of safety for assessment
section 131 voluntarily admitted as inpatient
Section 2 assessment for up to 28 days
Section 3 treatment order up to 6/12 (psych x2 docs and AMHP) renewal for further 6/12, subsequent orders 12/12
Section 4 emergency order lasts 72 hours, by x1 doctor and AMHP
section 5 voluntary inpatient 72’
Duty of candour
Health and social care act 2008
GMC and CQC
Doctors open and honest with patients
Statutory of candour - if death, severe or moderate harm - legal duty and notifiable safety incident, applicable to the trust (not individual)
Professional duty of candour applicable to individual, to be honest about mistakes, inform and apologise take steps to put things right
Clinical effectiveness
- Monitoring and improving outcomes
- HCP up-to-date and supervised
- Implement guidelines and quality standards
- Local and national audit
- Evidence based approach to quality improvement
- Improve health outcomes
- Reduce variation and inequalities
- Assess cost of effectiveness
Hawthorne effect bias
Patiente aware being studied
E.g. typical vs perfect use of contraception
