Patient safety, incident reporting, safeguarding
Safeguarding question pattern: a patient discloses abuse and asks you to keep it secret → answer is always to act on the safeguarding concern. A request for confidentiality does not override a duty to safeguard. Document the disclosure and your actions immediately.
Wholly preventable serious incidents. Examples: wrong-site surgery · wrong-route medication (e.g. IV potassium chloride undiluted) · retained surgical item · ABO-incompatible blood transfusion · overdose of methotrexate due to daily instead of weekly dispensing.
NHS digital incident reporting system. All adverse events AND near misses should be reported. Blame-free — purpose is learning and system improvement, not punishment. Incident reports are not part of the clinical record.
Physical · Sexual · Psychological/emotional · Financial/material · Neglect and acts of omission · Discriminatory abuse. Legal framework: Care Act 2014.
Part of the Counter-Terrorism and Security Act 2015. Healthcare workers have a duty to refer individuals showing signs of radicalisation to the PREVENT team. Confidentiality applies unless risk of harm.
Is care Safe · Effective · Caring · Responsive · Well-led? Ratings: Outstanding / Good / Requires Improvement / Inadequate. The CQC can close services rated Inadequate.
Slurred speech or confusion · Extreme shivering or muscle pain · Passing no urine in a day · Severe breathlessness · Skin mottled, discoloured or very pale · Feeling you might die.
(1) Ensure patient safety — assess for harm (2) Report immediately to nurse in charge (3) Complete Datix report (4) Inform patient — duty of candour (5) Document in patient notes (6) Review to learn and prevent recurrence.
Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013. Employers must report: workplace fatalities, specified injuries to workers, over-7-day incapacitation, and dangerous occurrences.