This document provides guidance on various clinical procedures and processes. It discusses counseling patients, explaining risks and alternatives, providing information leaflets, and allowing time for questions. It also addresses conducting clinical audits, which involve comparing practices to standards, implementing changes, and re-auditing. Additional sections cover prioritizing patients, risk management, and developing clinical guidelines and protocols.
This document provides guidance on various clinical procedures and processes. It discusses counseling patients, explaining risks and alternatives, providing information leaflets, and allowing time for questions. It also addresses conducting clinical audits, which involve comparing practices to standards, implementing changes, and re-auditing. Additional sections cover prioritizing patients, risk management, and developing clinical guidelines and protocols.
This document provides guidance on various clinical procedures and processes. It discusses counseling patients, explaining risks and alternatives, providing information leaflets, and allowing time for questions. It also addresses conducting clinical audits, which involve comparing practices to standards, implementing changes, and re-auditing. Additional sections cover prioritizing patients, risk management, and developing clinical guidelines and protocols.
This document provides guidance on various clinical procedures and processes. It discusses counseling patients, explaining risks and alternatives, providing information leaflets, and allowing time for questions. It also addresses conducting clinical audits, which involve comparing practices to standards, implementing changes, and re-auditing. Additional sections cover prioritizing patients, risk management, and developing clinical guidelines and protocols.
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Counselling
Explain procedure without medical jargon
Use pictures if possible Interpreter if necessary Explain benefit and alternatives Explain serious (death and serious trauma) and frequent risks (infection + pain) Give information leaflet and time to ask questions E.g.s Missed miscarriage counsel Laparoscopy - counsel Nuchal translucency - councel ABDOMINAL HYSTERECTOMY FOR HEAVY PERIODS Audit A dynamic process that compares clinical practices with a gold standard practice and possibly suggests change to practice that should be implemented and re-audited to complete the loop. 1.Standard (RCOG grade A): 2 MARKs 2.EXPLAIN will involve consultant in charge for audit / audit dept / midwives etc to formulate any other questions / standards to look at with e.g. s 4 marks 3.Then draw up an audit form to fill in (? Use FORMIC software to analyse data sheets) ask medical records for notes via audit dept if possible. Store notes carefully and extract information onto the forms pre-prepared. 2 MARKs Then enter data onto computer / keep data confidential i.e. initials and hosp no only 4.Use Access/excel and powerpoint to present the data and see how measure up to the standard. 1 MARK 5.Disseminate the recommendations from the audit presentation to all in DEPT and set a date for the re-audit process / audit cycle. 1 MARK
Standards
Agreed practice
Disseminate
User
Audit Effect Change
Critical appraisal
Usually a leaflet / patient information
Is it easy to read / non jargon
? simple diagrams
? available in other languages
? does it explain diagnosis / alternative treatments and address pros and cons
does it give a contact number if questions required ?
? who constructed the info leaflet and when will it be updated
Prioritization Labour ward board Gynae emergencies and Obs emergencies Gynae OPD letters and op lists
Make use of all staff and facilities you have available Midwife can suture episiotomies, put in venflons SHO may be career SHO ERPCs / assess obstetric patients Spr ask off going Spr to stay around to help if really busy Cons ask advice but the examiner wants to know you can prioritise
OPD WHEN TO SEE if suspect cancer 2 WEEK WAIT RULE URGENT Vs routine
Op lists consultant should really be present
Risk management How to reduce clinical risk (CNST) LEVEL 1 10% LEVEL 2 20% LEVEL 3 30%
Fill in clinical risk forms
How to make a protocol / guideline Set format see e.g. Evidence based (NICE or RCOG) Review date
Essex Rivers Healthcare NHS Trust
Directorate of Women, Children and Families
Maternity Services
Title of Guideline
Introduction Aims and objectives etc Body Structured and progressive framework Clinical guidelines may be in Table format- including a column for the ACTION and a column for the RATIONALE but alternatively may be in bullet points All headings as section breaks
Action Rationale Put up IV fluid To maintain circulating volume References Harvard referencing (instructions to follow on Harvard System)
As agreed by Obstetric Division (if it is a medical issue) Head of Midwifery (if it is a midwifery issue only)
------------------------------------------- --------------------------------------- Anne Ferris Consultant Obstetrician Head of Midwifery Lead Consultant Delivery Suite If non medical signed by Head of Midwifery Date of guideline: (Month and Year) Review date: (usually 3years later, Month and Year) Compiled by: