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Flashcards in Public Health Deck (192)
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What is law of tort?

a civil wrong other than a breach of a contract of tract e.g. negligence, breach of confidentiality


What is negligence?

Where a duty of care existed and it was breached


What is the duty of care?

prevent harm to patients - technically only obliged to act in the hospital


What is consent?

respecting the patients autonomy otherwise it is assault, it guards against exploitation of patients and prevents battery


What is battery?

touching a patient without consent


Who has autonomy?

every adult of sane mine


Types of consent?

implied, oral, written - must be voluntary, informed and be made by someone with capacity


What does the validity of consent depend on?

on the adequacy of explanation given to the patient so they can make an informed decision


Who do you need to tell someone about treatment for consent?

how, what, risks, benefits, alternatives


When was the mental health act created?

1983 and amended in 2007


What does the mental health act mean?

provides compulsory admission, for those cases where their refusal can result in serious injury or death, otherwise competent adults have right to refuse treatment


What is the mental capacity act 2005?

for incompetent adults who lack capacity, unconscious, severe learning difficulties or lack necessary understanding that require treatment and cannot make decisions


What is capacity?

ability to understand (adults are assumed to have capacity)


What is the order of decision making?

previously expressed wishes in a living will, lasting power of attorney, court protection, decision of Dr in patients best interest


When is someone unable to make a decision?

can't understand the relevant info, retain it, weigh up all information or communicate the decision


What is used for consideration of patient's bets interest?

whether the patient could have capacity and when that might occur, the patients past and present wishes and feelings, patients beliefs and values that could influence decision, consultation with carers, family, lasting power of attorney


What is a minor?

everyone younger than 18


What is Gillik competence?

can the child understand the consequence of the decision, including the social and emotional implications , and if so they can consent, if not, parent must consent in best interest of child


What is the welfare of child ACT 1989?

increasing scope for exercise of autonomy to child as they approach the legal minor age


What is confidentiality?

respect for autonomy, hippocratic oath, duty to keep confidentiality


When can you breach confidentiality?

to another health professional, if patient consents, to a court when required by a judge, if others are in harm or if they can't drive or for statutory duty, infectious disease, births and deaths


What is compliance?

the extent to which patients behaviour coincides with the medical health and advice, assuming that patients should follow doctors orders, it is not patient focus, doctor knows best and does not look at the patients issues


What is adherence?

acknowledges the patients belief in the relationship si is more patient centered medicine


What is non adherence?

not taking prescribed medicine, stopping medicine without finishing it, can be unintentional (forgetting, unable to pay, difficulty understanding) or intentional (beliefs about the condition and treatment, preference)


What increases compliance?

good communication


What is concordance?

extension of principles of patient centered medicine, a negotiation between individuals to respect the patients agenda


Barriers to concordance?

lack of communication skills, time constraints


What is a law?

act of parliament or statues or court decisions


What is the difference between private and public law?

public = criminal and constitutional
private = law of contract, property, family law, welfare law, tort law


What is the BME group?

black minority ethnic group - non white descent

minority social groups who share the common experience of discrimination or inequality because of their ethnic origin, language, culture or origin


What are BME's health like in comparison?

worse health generally mainly due to the poorer socio economic position, so are more likely to experience morbidity at a younger age and premature mortality


Why does female genital mutilation occur?

purity to prevent females having sex, unable to marry without it being done, reopened at marriage


Complications of female genital mutilation?

bleeding, wound infection, death, pain, anxiety, PTSD


Law on female genital mutilation?

illegal in the UK, so doctors should be alert for families asking for travel advice to take young girls on holiday if they have FGM in home country, and teachers should be alerted


Problems with professional interpreters, language line and family members translating?

agenda, bias, not confidential, family members may have poor english, limited interpretation


Issues of diagnosing those with limited english?

vocab is different, description of symptoms may be different, undiagnosed disease, unmedicated disease, limited knowledge of disease


What is the largest minority group in the EU?

the roma slovak community, they move from city to city, have short term tenancy arrangements with landlords, high prevalence of hep B in slovakia


How can doctors reduce inequality?

advocacy, activism, education, research, provide best and flexible services for all, especially those who are vulnerable


What is population attributable risk?

the proportion of the incidence of a disease in the exposed and non exposed population that is due to exposure

the disease incidence in the population that would be eliminated if the exposure was eliminated


What health and social problems are worse in unequally rich countries?

physical health, mental health, drug abuse, education, imprisonment, obesity, social mobility, trust and community life, violence and teenage pregnancies


Risk factors of heart disease?

smoking, diabetes, hypertension, obesity, alcohol, age, cholesterol, exercise, psychosocial


What accounts for the biggest differences in socioeconomic?



what are the 3 physiological views on differences in socioeconomic background?

absolutists = all about poverty and absolute measures of socioeconomic deprivation
relativists = think about the relative differences and the larger the differences in society the poorer the outcomes for those worse off
spirit level = think health and social problems are worse in unequal rich countries


Which type of behaviour/personality is a risk factor for CHD?

type A - competitive, hostile, impatient


How can personality/behavior be assessed?

questionnaires, self report, structured clinical interview, assess non verbal, answer content, speech, psychomotor


Psychosocial factors that cause CHD?

mental health problems, low control and high demand at work, shift work, lower rank at work, lack of social support


How can depression be measured?

MMPI, beck depression inventory, general health questionnair, spielbergers state anxiety intervention


primary prevention strategies to prevent STIs?

raise awareness, vaccinations, one to one risk reduction discussions (15-20mins structured discussion, based on CBT), pre and post exposure prophylaxis


secondary prevention strategies to prevemt STIs?

easy access to STI/HIV tests/treatments, partner notification, targetted screening, antenatal screening for HIV and pyphilis, national chlamydia screening programme


tertiary prevention for STIs?

anti retrovirals for HIV, prophylactic antibiotic for PCP, acyclovir for suppression of genital herpes


What is the STI/HIV transition model?

reproduction rate
infectivity rate
partners over time
duration of infection


What is partner notification?

a public health activity that aims to control infection by identifying key individuals and sexual networks, warn the unsuspecting and attempt to break the chain of infection


Why trace partners for STIs?

break the chain of transmission, prevent reinfection of the index patient, prevent complications of untreated infection


How are partners traced for STIs?

patient referral, provider referral from phone, test, letter, internet sites, visit, conditional or contract referral

emphasis on the patients choice and confidentiality


Partner notification challenges?

hard to reach client group (from phoneless, homeless, floor sleepers, social exclusion, criminal activities, chaotic life, health care is low priority)


How to increase partner notification?

MDT with public health, PCT, infectious diseases, GUM and drug and alcohol advisory, partner notification undertaken by specialist community outreach nurse and drug worked, GUM health adviser provided notification training and support and coordinated notification management


When is peak time for gonorrhea diagnosis?



Where do adults get chlamydia and gonorrhea?

urethra, endocervical canal, rectum, pharynx, conjunctiva


Where can neonates get STI?



Symptoms of chlamydia and gonorrhea in males?

dysuria and urethral discharge, complications are epididymoorchitis, reactive arthritis


Female complications of STIs?

pelvic inflammatory disease, tubal factor infertility, ectopic pregnancy, chronic pelvic pain, neonatal transmission, opthalmia neonatorum, atypical pneumonia with chlamydia, Fitz high curtis syndrome (peri hepatitis)


Diagnosis of chlamydia?

nuclei acid amplification tests (NAAT), high specificity and sensitivity (but not 100% sensitive so negative test does not mean not infection)

female - endocervical swab, self collected vaginal swab, first void urine
male - first void urine


Aim of community screening for chlamydia?

reduce complications by reducing the prevalence of the asymptomatic infection (an asymptomatic diagnosis does not mean recent partner change)


Treatment of chlamydia?

partner managment, test for other STIs, azithromycin 1g stat or doxycycline 100mgbd for 7 days


Treatment of chlamydia if pregnant?

Erythromycin 500mg bd for 14 days


gonorrhea diagnosis?

microscopy of gram stained smear of genital secretions looking for gram negative diplococci with cytoplasm of polymorphs, male urethra and female endocervix and urethra, culture on selective medium to confirm, sensitivity testing, NAAT


Treatment of gonorrhea?

partner notification, test for other STIs, continuous surveillance of antibotic sensitivity, single dose treatment preferred, with ceftriaxone 500mg IMI with Azithromycin 1g orally stat


Is chlamydia or gonorrhea more associated with a partner change?

gonorrhea and it has more clinical manifestations, whereas chlamydia can be asymptomatic


What organism cause syphilis?

treponema pallidum subspecies pallidum


What are the stages of syphilis?

early - primary, secondary, early latents
late - late latent, CNS, CVS, gummatous


What STIs are gay men more likely to have?

HIV and syphilis


Symptoms of primary syphilis?

primary chancre normally on genital skin, nipple and mouth
intubation is 9-90days, usually 21-35
dusky macule-papule-indurated clean bases non tender ulcer 50% solitary (genital ulcer is syphilis until proved otherwise)
regional nodes 1-2 weeks after
untreated heals without scarring in 4-8weeks


Symptoms of secondary syphilis?

onset 6-8 weeks after infection, may have primary chancre or none, most present with skin rash

mucus membrane lesions, generalised lymphadenopathy, alopecia, hoarseness, bone pain, hepatitis, nephrotic syndrome, deafness, iritis, meningitis, cranial n palsies, constitutional symptoms


What is the transmission of STIs like?

early syphilis - 40-60% of contactable partners are infected (transmission decreases in early latency and after 4 years)
chlamydia - 70%
gonorrhea - 50-90% women, 20-60% male


What causes death in syphilis?

late benign gummatous, neurosyphilis, cardiovascular


Diagnosis of syphilis?

early moist lesions - identify motile spirochetes on went mount using dark ground microscopy
genital ulcer
use serology for diagnosis


Treatment of syphilis?

penicillin by injection with efficient follow up and partner notification


Why is type 2 diabetes such a public health issue?

causes mortality, disability, co morbidity, reduced quality of life, increasing prevalence, inequality in prevalence and outcomes, linked to obesity and climate change policies


Risk factors for diabetes?

sedentary job, sedentary leisure activities, high calorie diet, low fruit and veg, low fibre, cars, cheap tv watching, expensive fruit and veg, safety of going outside, family eating patterns, age, sex, ethnicity, family history, weight, BMI, waist circumferance, history of gestational diabetes, hypertension, vascular disease, impaired glucose tolerance/fasting glucose


Diabetes tests?

random capillary blood glucose, random venous blood glucose, fasting venous blood glucose, oral glucose tolerance test


Preventing diabetes?

exercise, change diet, weight loss, focus on ethnic minorities and socio economically deprived communities, focus on culturally appropriate interventions, educate, peer support, self monitoring, identify those at risk, diagnosing earlier,


mechanisms that maintain overweightness?

more weight makes it more difficult to exercise due to injurys and stress, low self esteen, guilt, comfort eating, scared of the gym, employment, relationships, social mobility,


What is the runaway weight gain train?

steep slope = obesogenic enviroment
ineffective breaks = knowledge, prejudice, physiology, social
accelerators = ineffective dieting, psychological impact, low socioeconomic status, mechanical dysfunction, psychological dysfunction


How can we diagnose diabetes earlier?

raise awareness of diabetes and symptoms in community and in health professionals, use blood tests to screen before symptoms develop


Why is NHS England putting money into type 2 diabetes prevention?

it is preventable, and easy changes reduces the risk, it is feasible


How is NHS England investing into type 2 diabetes prevention?

healthier you: the nhs diabetes prevention programme with lifestyle education, weight loss support and group physical exercise


What are the basis of medical ethics?

deontology, consequentialism, virture


What is deontology?

the duty of care we owe to each other with the formula of universal law and formula of humanity, to tell the truth but not to be told the complete way


What is the formula of universal law?

could i live this way where everyone acted this way


What is the formula of humanity?

people are always treated as ends in themselves, never as means to an end


What is consequentilism?

consequences are what matters and the means are unimportant, but it is hard to know what the consequences will be and actions can be wrong even in consequences are good


What is virtue?

characteristics that promote human flourishing e.g. compassion, patience, kindness, fidelity, centers ethics on the person and what it means to be human, including the whole persons life


What are the principles of medical ethics?

autonomy - patient can make own decision
beneficence - seeks to benefit patient
non maleficence - no overall harm, reasonable harm can be justified e.g. side effects
justice - no discrimination and efforts should be directed without reference to likes and dislikes


What is the ethical duty of condour?

condour is openness, honesty, transparency

spontaneous without compulsion, applies to disclosure of error or uncertainty and decisions influenced by resources


What is the duty of candour?

longstanding ethical duty, established regulatory duty, recent contractual duty, new statory duty


What is the GMC duty of candour?

MUST be open and honest with patients if things are going wrong
SHOULD put matters right if went wrong e.g. apology


What is whistle blowing?

raising concerns about a person, practice or organisation to make the patient a first concern, shouldn't get int trouble


What makes an effective team?

6 or 8-12 in team size, team dynamic, feeling like you belong, common purpose, identified team leader,


Why is it important to work as a team?

improves decision making, reduces medical error, essential in complex medical modern healthcare


Difficulties in team work in the NHS?

different offices, shifts and rotations, ward based/visiting/based elsewhere, different employers and line managers, part time, full time, other commitments, informal as well as formal contact


Aspects of team working linked to patient safety?

shared decision making, shared knowledge, successful team communication,


Steps to patient safety?

build a safety culture, lead and support your staff, integrate your risk management activity, promote reporting, involve and communicate with the patients and public, learn and share safety lessons, implement solutions to prevent harm


What is the SBAR checklist?

situation, background, assessment, recommendation


Human factors for team work?

communication, leadership and followship, authority gradient, situational awareness, declaring an emergency, train together


Back pain red flags?

55, thoracic pain, persistent at night, night sweats, recent unexplained weight loss, saddle anesthesia, sphincter disturbance, trauma, significant past medical history


What is classed as chronic back pain?

continuous pain for more thna 3 motnhs


predictive factors for lower back pain?

psychosocial factors, pain intensity, episode duration, previous history


How do musculoskeletal disorders affect us?

physical pain, psychological burden (loss of independence, chronic pain), economic implication (loss of income, costs of treatment, costs of care), as a society economic burden (from treatment and loss of work), work place productivity (secondary costs to individuals)


risk factors of back pain?

more common in women, and increases with age, more common in lower social class, probably due to increased manual labour, more obesity, other things to worry about that poor posture, less atcive


Treatment of back pain?

remember the red flags, treat with exercise


What are the most common work related MSK disorders?

back pain
tension neck (10-17% of the population)


what is classed as chronic tension neck?

>6 months


How does thoracic outlet syndrome present?

pain and tingling, wasting of hands, positive Adson's test


What are the different types of thoracic outlet syndrome?

hyperabduction syndrome - pinches nerves that run under the pec minor muscle when you lift your arm overhead

anterior scalene syndrome - pinches nerves and vessels between the scalene muscles and other structures

costoclavicular syndrome - pinches nerves underneath collarbone


What happens in rotator cuff tendinitis?

roatator cuff tears and swells, leading to further infringement beneath arch

test using 'empty/full can jobes' - elevate extended arm against resistance


What is frozen shoulder?

adhesive capsulitis, with equal resistriction of active and passive movements in capsular patterns

at risk if diabetic, thyroid, adrenal dysfunction, parkinsons

more common in females


What test is used for bicipital tendonitis?

the speed test - elbow fully extended, forearm supinated and flexes against resistance


What test is used for subacromial impingement?

hawkins-kennedy test - flexed arm and rotation


What test is used for the AC joint impingement?

cross arm adduction (scarf) test


What is medial and lateral epicondylitis?

medial = pain against resisted flexion of the wrist
lateral = pain against resisted extension of the wirst

aka olecranon bursitis caused by repetitive bending and straightening of the elbow, in those who continuously lean on their elbows


How does carpal tunnel syndrome present?

pain/tingling/numbness in the median nerve distribution in the hand

has TINEL's and PHALEN's signs


Risk factors for carpal tunnel syndrome?

pregnancy, obesity, endocrine disease, COCP/NRT, repetitive wrist movements


What is tenosynovitis?

local tenderness and swelling and pain on resisted movements, seen in manual workers, more common in women


What is DeQuervain's tenosynovitis?

local tenderness and swelling of the tendon sheaths (extensor pol brevis and abductor poll longus), pain on resisted movements, see in manual workers and rowers, more common in women


What is trigger finger?

inflammation and hypertrophy of the retinacular sheath progressively restricting the motion of the flexor tendon


What is Depuytren's?

tissue between the skin and the tendons known as the fascia is thickened due to collagen proliferation. Nodules or cords are formed and the elasticity of the fascia is reduced


What is hand arm vibration syndrome?

when exposed to sufficient vibration, causing finger blanching, pain numbness, tingling, wasting, dexterity, asymmetrical, carpal tunnel syndrome,


yellow flags for back pain chronicity?

a belief that the back pain is potentially disbling
fear avoidance behaviour
reduced activity levels
expectation of passive treatments rather than active
low mood and social withdrawal
problems or dissatisfaction with work
problems with claims/compensation/time off work
overprotective family and lack of support


What is RULA?

the rapid upper limb assessment

a tool to analyse event driven postures when work related upper limb disorders are reported

assesses biochemical and postural loading on the whole body with particular attention to the neck, trunk and upper limps

takes little time to complete and the scoring generates an action list which indicates the level of intervention required to reduce the risk of the injury due to physical loading on the operator


What is static anthropometrics?

measurement of human subjects in rigid, standardized position e.g. static arm length

used in designing a workplace when the body movement is not a major variable e.g. seat breadth, height, head room


What is dynamic anthropometrics?

measurement of human subjects at work or in motion e.g. functional arm reach curves


What is biomechanics?

the measurement of the range, strength, endurance, speed and accuracy of human movements


What is the problem with static anthropometrics?

many factors have variability between groups e.g. average male in USA is 167cm but in vietnam is 152cm


What important factors should be considered in work related MSK disorders?

task, individual, load, enviroment


Why are students at risk of mental health disorders?

unrealistic expectations, finance academic stress, alcohol, peer pressure, lack of support


Which occupations have high stress levels?

managers, nurses, doctors, healthcare professionals


Sources of stress for doctors?

lack of resources, too much work, poor management, ill patients, complaints, too much responsibility, poor relationship at work, too little time


Symptoms of professional burn out?

less contact with colleagues, decreased work commitment, do not seek help, decreased productivity, stereotypic thinking, increased minor illnesses, objectification, feeling of failure


Personality traits susceptible to psychological difficulties?

perfectionism, self criticism, low flexibility, high discipline


What are traits of emotional resilient?

self aware, in control of life, practice acceptance, balanced view of the world


What neurological diseases can be prevented with a vaccine?

polio, tetanus, measles, meningococcus, TB, H.influenze


What is obesity?

a high amount of body fat in relation to lean body mass (BMI 30 or more)


morbiditys associated with obesity?

hypertenision, dyslipidaemia, type 2 diabetes, CHD, stroke, gall bladder disease, osteoathritis, sleep apnoea, respiratory problems, cancer


Factors contributing to weight maintenance?

energy intake, type of food intake, appetite, mood, activity, metabolic rate, genes, drugs


Causes of obesity?

americanisation of diet and society, increased car usage, longer working hours, over consumption of food, grazing replacing meal times, replacement of water with sugary drinks


What makes up an adults energy expenditure?

exercise and non exercise activity thermogensis


what is non exercise activity thermogensis?

spontaneous physical activity (fidgeting), so there are marked individual differences in contribution to daily expenditure


How can you asses the intra abdominal adiposity?

measure waist circumference as it is strongly correlated


What is metabolic syndrome?

high waist circumference plus 2 of:
triglycerides >1.7mmol/L
HDL cholesterol 130/85
FPG >5.6mmol/L


What effect does adipocytes have on the body?

inflammation, atheroscleoris, thrombosis, type 2 diabetes, atherogenic dyslipidaemia, hypertension

caused by increased in hormones


How can patients be assisted for successful weight loss?

assessing weight history, assess motivation, choose weight management strategies, set appropriate targets, behavioural approaches, prescribing issues

patients views and reasons for weight gain, beliefs on food and exercise, socioeconomic influences, previous success, readiness to change, confidence to make changes


What is the multi component intervention for weight loss?

activity - set goals
individual diet advice
behavioural strategies
positive feedback


factors contributing to losing weight?

medication (orlistat, incretin mimetics (GLP1 agonists 9 reducing effect of glucose)), dietry counselling, support, diabetes managment, encouragement, activity, hypo advice, hard work


How do GLP-1 agonists help lose weight?

it is secreted on ingestion of food to enhance glucose dependent insulin secretion, help regulate gastric emptying, decrease glucagon reducing hepatic glucose output, decrease postprandial glucagon secretion and promotes satiety and reduces appetite


How to maintain weight?

low calorie, low fat diet, eat breakfast every day, eat same amount on week days, weekends and holidays, highly active, less depression excess eating and binging, self montioring


When does end of life care occur?

from the diagnosis of a poor prognosis or a deterioration of a chronic disease (around 1-2 years)


What does end of life care aim to do?

increase QoL, give support and palliative care to patient and family, manage pain with psychological, social and practical support, control symptoms but avoid too much investigation and treatment


What must be prepared for end of life care?

focus on patient and family, educate family on last hours to reduce fear, ensure preemptive medications are available, explore a preferred place of care


What are the 5 priorities of care for a dying person?

individual care plan, needs of the family, the dying person, sensitive communication, decisions regularly reviews


How is death verified?

no heart sound or pulse, no breath sounds, no response to painful stimuli, pupils fixed and dilated


What is palliative care?

improving the QoL of patients and families who face life threatening illnesses by providing pain and symptom relief, spiritual and psychosocial support from diagnosis to end of life bereavement


who are involved in specialist palliative care?

consultants, clinical nurse specialists, hospital nurses, specialist social workers, dieticiens, physio


who are general care providers?

Gps, hospital doctors, district nurses, nursing home staff, copd nurses


how is lung cancer palliative care different from copd palliative care?

lung cancer patients receive visits from district nurses, they are more likely to know they might die and get more support from the specialists, less likely to suffer depression and less likely to visit ICU and have a better activities than COPD patients


Difficulties in palliative care for COPD patients?

unpredictable illness trajectory, difficulties in prognostication, patients have poor understanding and poor access to palliative care, there is a stigma against smoking


Challenges of the aging population?

strains on pension and social security, increasing demand for health care, bigger need for trained health workforce, increasing demand for long term care, pervasive ageism that denies older people the rights and opportunities available for other adults


Causes of population aging?

improvement in sanitation, housing, nutrition, medical interventions, falls in fertility, decline in premature mortality, more people reaching an older age while fewer children are being bron


Physical changes in age?

loss of skin elasticity, loss of hair and hair colouring, decrease in size and weight, loss of joint flexibility, increased susceptibility to illness, decline in learning ability, less efficient memory, affected sight, hearing, taste and smell.


How to prevent recurrent hospital admissions for patients?

supporting discharged patients, supporting chronic disease management in the community, providing alternative in acute care in community


Roles of GP?

prevent unnecessary loss of function, prevent and treat problems which adversely affect QoL in old age, supplement the existing system of informal care and prevent its breakdown, give older people a good death as well as a good life


Documents created for patient safety?

organisation with a memory 2000
building a safer NHS 2001
Bristol enquiry
improving safety of patients in England 2003


What is a human error and examples?

failure of a planned action or a sequence of mental and physical actions to be completed as intended or the use of a wrong plan to achieve an outcome

errors of omission - action is delayed or not taken
errors of commission - where the wrong action is taken
professional negligence - actions or omissions do not measure up to the standard of an ordinary, skilled person


What errors are made in medication prescribing?

ordering, transcribing, dispensing, administering

so must be storage, labeling and segregation of high alert medication


What human factors can lead to error?

load theory - how much a brain can process
situational awareness - what else is happening


What is confirmational bias?

the tendancy to look for confirming evidence to suppory a diagnosis rather than diagnosing


What is anchoring?

locking onto salient features in a presentation too early


What is diagnosis momentum?

giving a diagnostic label too early


What is the difference between a latent and an active failure?

latent - not in the practitioners control e.g. organisation of procedures, allocation of resources

active - direct contact with the patient (sharp end)


What are never events?

serious, largely preventable patient safety incidents that should not occur if the available preventable measures are there, they are intolerable and inexcusable


What is an organisational system failure?

involving management, protocols and knowledge


What are technical failures?

external factors


What is an adverse event?

an incident which results in harm to the patient which is not a direct result of their illness


What is a near miss?

an event that arises during care and has the potential to cause harm but failures to develop further, avoiding harm


What is the difference between a skill and knowledge based error?

skill = it is a well known task, that is given little attention, so can be distracted and have a slip

knowledge = incorrect action due to inexperience and insufficient information


What are violations and the different types?

deliberate deviations from practices, procedures, standards and rules which could be routine cut corners, necessary to get the job done or optimizing for self benefit


What limits information processing?

automacity, cognitive interference, selective attention, cognitive bias, positive and negative transfer from previous experiences


Examples of strategies to reduce error and harm?

simplification and standardization of clinical processes, checklists, aide memoires, information technology, team training, risk management programmes, mechanisms to improve uptake of evidence based treatment patterns


What are the 2 approaches to managing error?

the person approach = error is a product of wayward mental processes and focuses on the unsafe acts of people on the front line

the system approach = only occasionally necessary to cause adverse events


What are the benefits of work?

obtaining adequate economic resources, part of society, meet psychosocial needs, an individuals identity, social role and social status, the main drive of social gradient in physical and mental health and mortality


What causes work related illnesses?

MSK, stress, depression, respiratory


Safety issues for work?

have to be safe to do tasks, personal and co worker safety, strict criteria for safety critical job, physical requirements, medical contraindications, so try and match individual to work and task


What is involved in an occupational health physician?

regulation, legal, rehabilitation, well being and lifestyle, obligations to employer, medical examination at employers request