What is a critical incident?
an unplanned event or series of events that may result in an undesirable consequence
What is an adverse event?
an event that results in unintended harm to the patient by an act of commission or omission rather than by the underlying disease or condition of the patient
In 2014, what were the top 4 most commonly reported incidents?
- Patient accidents 2. Implementation of care and ongoing monitoring/review incidents 3. Treatment/procedure incidents 4. Medication incidents
What national system is used to upload all locally reported incidents?
National Reporting and Learning System (NRLS)
How can NRLS help to improve the quality of healthcare?
Reports are analysed with expert clinical input to identify common hazards, allowing recommendations to be made and wider patterns of hazards to be identified.
Outline the important steps in blood transfusion.
- Determine the ABO and RhD status
- Antibody screen (for atypical antibodies against RBC antigens) typically use direct and indirect agglutination test to test patient’s blood against red cells from at least 2 group O donors. If positive agglutination further testing is carried out to determine which of the potential 30+ RBC antigens are causing the problem.
- Select appropriate donor blood and cross match by mixing the patient’s serum or plasma against the donor red cells (Often unnecessary if antibody screen was negative).
How long would you have to wait for fully cross-matched blood to be ready to use?
45 minutes
According to a recent European study of PSA testing, what was the number needed to screen to save one life from prostate cancer?
1 in 1000 males screened for 10 years
Where do most prostatic carcinomas arise within the prostate?
Peripheral zone (85%)
How common is breast cancer?
Most common UK cancer
What is the age and location distribution of breast cancer?
46% of female breast cancer is diagnosed in the over 65s, it is slightly less common in women living in the most deprived areas, 6th highest breast cancer rate in Europe, rates have increased by 64% in GB since the 1970s.
How is sensitivity calculated?
This is the likelihood of a test correctly identifying a specific disease (number of true positives divided by the (TP plus the FN))
How is specificity calculated?
This is the likelihood of correctly ruling out a specific disease by a negative result (number of true negatives divided by the true negative and false positive together)
What is the life saved to over diagnosis ratio for breast screening?
1:3 (1521 saved for 2722 over diagnosed)
What factors are most likely to delay a woman presenting with breast cancer?
non-recognition of symptom seriousness, older age, lower educational level, non-white ethnicity
Give 5 reasons why a coroner would need to be involved in assessment of death.
- deceased not seen by a doctor within 14 days prior to death
- suspicious circumstances
- history of violence or accidental death suggested
- death occurred shortly after detention in police custody
- death likely to be due to industrial or occupational disease factors
What is equipoise?
State of regarding to treatments as an equal bet in prospects ( no one treatment is already known to be significantly better)
What months see the greatest proportion of suicides?
April, May and June
