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Flashcards in NHS Service Delivery Deck (12)
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1

Why is Hospital@Home beneficial?

Frees up beds

 

Psycholigical benefits for patients, as they want to be at home!

 

IV therapy at home is 2-3x cheaper than in hospital

 

 

2

What are the potential benefits and risks of just letting patients self administer IV drugs?

Benefits --> Cheap, less nurse time spent

 

Risks --> Patient needs to clean lines and have a high level of responsibility. This can be lots of work for staff to get them to this level

3

What is the 'golden' guide for IV drugs as part of Hospital@Home?

Medusa

4

What are the beneifts/negatives of Hospital@Home doing Bolus's or Infusions?

Bolus --> Quicker (so cheaper), Less volume (best if fluid restricted)

 

Infusion --> Lower risk of infusion rate reactions (eg, red man syndrome), other things can be done at the same time (like dressing changes), but they can damage fragile veins and they have a lower Cmax than boluses

5

When would a peripheral or a central line be used?

Peripheral --> Easy to insert/remove, for short term use

Higher risk of extravasation/infiltration and cant be used for all IV meds

 

Central --> Potential for indefinate use, low risk of extravasation/infiltration and all IV drugs can be given this way

6

What types of drugs can't be given peripherally?

Those with extremes of pH (eg, co-trimoxazole)

 

Macrolides

 

Cytotoxics

 

Those with a high risk of extravasation and infiltration

7

What is NHS 111?

A 24/7 telephone line that is manned by various HCPs, acting as a screening tool to ensure only those that need help get it

 

These are contracts that are given to private companies

 

It's a risk adverse system, meaning that if in doubt, get them seen!

8

What is the Community Pharmacy Consultation Service (CPCS)?

Where 111 directs patients to a community pharmacy to get an emergency supply of a medication for free

 

Still based on pharmacy legislation (so no CDs 1-3 except Phenobarbital)

9

Using the Human Error Theory, influencing which area would be the most effective in reducing errors?

Error Producing Conditions

10

Explain Safety 1 and Safety 2 Approaches

Safety 1 --> The aim to make as few things go wrong as possible

Belief that a chain of events cause errors

Learning from things that have gone wrong!

This is overally simplistic

 

Safety 2 --> Understanding that risks change on a day-by-day basis, and so we need staff to be able to recognise these and adapt things in order to prevent errors

Focussing on learning from what goes right!

11

What are the 5 current never events?

 

And what are the problems with never events in general?

Mis-selection of a strong potassium solution

Administraiton of a medication by the wrong route

Overdose of insulin due to abbreviations or incorrect device

Overdose of methotrexate for non-cancer treatment (eg, RA)

Mis-selection of high strength midazolam during consious sedation

 

Problems --> It's an unabtainable goal as they will happen!! Therefore this is following a safety 1 approach, instead of safety 2

May cause people to not report these events, as well as being demoralising if they do occur

12

What are the 4 most common drug administration errors?

Dose

 

Dilution

 

Rate

 

Completion