Standard 1 - Clinical Governance
Do you know where to find MHS and SESLHD policies and procedures
Intranet also referred to as Sharepoint Online
How do you seek feedback from families, carers and consumers?
Yes Surveys
Compliments and complaints process
Carer experience survey
What infection prevention practices are used on the wards?
-Hand hygiene
-Respiratory etiquette
-Safe waste disposal
-Appropriate use of PPE (when required)
How often should you do the medication fridge temperature checks?
Daily if storing medications, twice daily if storing vaccines.
What assessment is required to be completed to assess risk for Pressure Injuries?
Waterlow Assessment
How is a consumers identity verified in an inpatient setting?
ID band
Photo
If a consumer declines to wear an ID band and have a photo ID taken. 2 x nursing staff to confirm ID through DOB, address, MRN, allergies when giving medications.
What steps would you follow if you had a deteriorating patient physically?
Record vital signs- review frequency
ECG if indicated
BGL/ Ketones if indicated
CR/RR- 2222
A-I Assessment
If further deterioration escalate accordingly RR/Code Blue
CR/RR form must be completed for any
How do you identify and communicate consumer risks?
Safety Huddles
Handover
Debriefs
MDT
How do you ensure consumers understand medical terminology?
- Clear and plain language
- Pause and check if information is understood
- Give opportunity to ask questions
- Medication information leaflets in other languages
- Offer interpreter services
Why is a clean and safe environment important?
-Reduces infection risks
-Prevents harm
-Supports a safe environment for consumers, visitors and staff.
How do you identify if a patient has an allergy and their reaction?
eMR - Patient Summaries - Allergies
What screen needs to be completed for Delirium?
When do you need to check the identity of a consumer?
On admission
When applying the ID band
Each patient encounter e.g medications, clinical procedures
Transfer of care and discharge
How do you document a deterioration in Mental State?
Mental State Examination
Risk Assessment
How do you identify and manage environmental risks?
Safety Huddles
Monthly WHS QARS audit
Escalate to NIC/NUM
Log issue in AFM
Describe all the instances where informed consent is obtained from a consumer in your clinical area?
- Voluntary admissions
- Allied health intervention
- Prior to Pathology or Investigations
- Any general health procedure (Not under MH Act)
You have a consumer who has a known or suspected infectious disease, what are your interventions?
-Contact infectious diseases for guidance
-Isolate the consumer
-Set up donning and doffing stations
-Display signages outside bedroom
-Taking extra considerations around the ward to limit transmission ie provide masks to consumers and visitors
-Ensure discussed at safety huddles and handovers, to raise awareness
Examples of precautions include contact, droplet or airborne precautions
What are the "5 Rights"
Right Patient
Right Drug
Right Time
Right Dose
Right Route
What eMR powerform needs to be completed to screen for Falls Risk?
eFRAMP
What does the acronym ISBAR stand for?
I - Introduction
S - Situation
B - Background
A - Assessment
R - Recommendation
Post any CERS activation, how frequently do vital signs need to be done?
Every Hour for 4 Hours at a minimum
What security and safety systems do you have in place?
Duress alarms
Two way radios
Call 2222
CCTV
Key and swipe access
Anti-barricade doors
How does the service provide culturally appropriate care?
-Aboriginal liaison officer
-Respect cultural and religious beliefs
-Chaplaincy services
-Diet preferences (Halal)
-Offer interpreter services
How do you communicate a consumer's infectious status during care, TOC and DC?
-ISBAR
-Handover
-Care plan
-Electronic Patient Journey Board- PFP
-Signage
-Admission/DC summary on eMR
What is SESLHD Mental Health Services High Risk Medication
Clozapine
What eMR Powerform needs to be completed to screen for malnutrition?
Malnutrition Screening Tool
What processes do we have to ensure safe clinical handover?
ISBAR
Electronic Patient Journey Board- PFP
Safety huddles
MDT meetings
Case conferences
Family meetings
What steps would you take following initiation of a Code Blue?
Record vital signs- review frequency
Call Code Blue 2222
Delegate roles- Scribing, handover for Code Blue team (ISBAR), Emergency trolley, Crowd control
ECG if indicated
BGL/ Ketones if indicated
A-I Assessment
Call Ambulance if needed for transfer 000 (Lights and sirens)
What is CAC?
- Support the improvement of public mental health services
- Ensure the perspectives of mental health consumers are heard and documented
- monitors and evaluates the progress towards goals and improvements
- Facilitate communication between consumers, carers and the health service
- Make education materials that are easy to understand
What strategies do you have to partner with consumers?
Consumer attendance at MDT
Consumer input for Care plans
Consumer Advisory Committee (CAC)
Consumer Advisory Group (CAG)
Charter of healthcare rights visible
Peer support input
What are the 5 moments of Hand Hygiene?
1. Before touching a patient
2. Before a procedure
3. After a procedure or body fluid exposure risk
4. After touching a patient
5. After touching a patients surroundings
What does APINCH stand for
A - Anti-infective (antibiotics and antifungals)
P - Potassium and other electrolytes
I - Insulin
N - Narcotics and other sedatives
C - Chemotherapy
H - Heparin and other anticoagulants
How soon does a physical health assessment need to be done on admission?
How often do vitals need to be attended on the ward?
48 hours
TDS for the first 48hrs and BD there after
How do we involve consumers and carers?
Consumer attendance at MDT
Consumer input for Care plans
Family meetings
What are the timeframes for the different Observation and Engagement Levels? 1-5
Level 1 = Constant Observation. At all times a nurse must be within one metre of the consumer or the consumer must remain under the visual observation of a nurse.
Level 2 = Observation every 15 minutes. Nurses must regularly engage and randomly observe consumers on this level at least every 15 minutes (at a minimum)
Level 3 = Observation every 30 minutes. Random and regular checks of a consumer’s location and activity within the unit at least every 30 minutes (at a minimum)
Level 4 = Observation every hour. Random and regular checks of a consumer’s location and activity within the unit at least every 60 minutes (at a minimum).
Level 5 - Observation every two hours. Random and regular checks of the location and activity of the consumer every two hours (at a minimum).
What are the top 3 risks for Kiloh General and how do we mitigate them?
Top 3 Risks
- Deteriorating patients
- Restraints
- AWOL
Why is it important the Australian Charter of Healthcare Rights are displayed on the wards?
Ensures consumers understand their rights and supports delivery of safe respectful and patient centered care.
-Access, Safety, Respect, Partnership, Information, Privacy and Give feedback
What are the top 3 Risks for MHICU and how do we mitigate them?
- Seclusion and Restraint
- Aggression
- Falls
What are Kiloh Observation Wards top 3 risks and how do we mitigate them?
- Seclusion and Restraint
- Aggressions
- Sexual Safety
What are the top 3 risks for PECC and how do we mitigate them?
- Concerning behaviour
- Self harm
-Delay discharge
What are the top 3 risks for Rehab and how do we mitigate them?
- Medication errors
- Falls
- Deteriorating patient
What are the top 3 risks for Older Persons and how do we mitigate them?
- Falls
-Deteriorating patient
- Medication errors