Social sciences Flashcards
(18 cards)
25 yo intellectual disability.
emergency surgery needed but patient says she doesnt want it
next step in management?
involve the patients mother and explain the need for surgery in simple language!
family members, simple language, visual aids important
sponge left in patient after surgery, count discrepancy was already brought to attention as possibility but was dismissed by surgeon.
what intervention is most likely to prevent root cause of this error?
simulation training in team based safety communication!!
having a brief time out before counting can increase situational awarenesss!!
patient thinking that stomach would have to be taken out during cholecystectomy. doctor explains actual procedure. and then patient asks to take forms home to review with family
absence at scheduled follow up visits!!!
these are signs of low health literacy
other signs = not remembering to take meds
asking few or no questions prior to medical procedure
missreading drug vials and administering wrong concentration
interventions focusing on what can help prevent this?
environmental design!!!
look-alike drugs stocked in separate places
what information should be reviewed during time out before a surgery?
procedure to be performed!!!
location
patient details
independent review by multiple team members helps prevent errors during medication reconciliation
informed consent is never obtained retroactively
doctor examines patient and notices leg pain but forgot to mention it during sign out. patient dies of PE. what intervention is appropriate to prevent this error?
implementing documentation protocols!!
not closed loop communication as it cant solve a problem due to omission
complications discussed before a procedure but then something else occured during surgery as a complication, what do you tell patient after?
description of event and subsequent treatment, expected prognosis and consequences, and preventative strategies if was preventable
palliative care. still in pain despite opiate use and resp depression as resp rate is <12
management?
increase morphine until adequate pain control is reached
cardiologist becoming increasingly difficult to reach, unusually late rounding times etc increased irritability
mentions family emergency once
managment?
report to hospital physician health program!
how do you verbally de-escalate a patient eg psychotic before administering medication or physically restraining them?
offer food drink blanket!
patient with borderline personality disorder tells doctor
youre not good at your job, you just order tests for no reason
what should you say to handle?
let me come back with my team and we can review your treatment plan together!!
BPD and splitting - can view someone as all good or all bad. whole team care important
i dont hear voices but i can understand they must be distressing -> dont mention medication is needed too early
exceptions to maintaining confidentiality of minors include suicide ideation and self harming behaviour. adolescents should be encouraged to create a plan to inform their parents
physicians can accept some gifts depending on cost type and timing
but gifts should never be accepted from someone experiencing a mood episode
how do you handle request for physician assisted suicide?
ask the reason for request -> lets talk about how you came to this decision. so you can address concerns and help them
