Patient Safety
Error prevention and systems thinking
Patient safety is about systems, not blame. Understand the error chain: prescribing, transcribing, dispensing, administration and monitoring. Know high-risk situations - look-alike/sound-alike names, high-alert medications (insulin, anticoagulants, concentrated electrolytes, chemotherapy), paediatric and renal dosing, and transitions of care.
Contributing factors and defences
Recognise human factors such as fatigue, workload, interruptions and poor handwriting. Learn the standard defences: independent double checks, tall-man lettering, barcode verification, read-back for verbal orders, and standardised concentrations. Understand root cause analysis and the difference between an error, a near miss and an adverse event.
Traps in questions
- Blaming an individual rather than examining the system that allowed the error.
- Confusing a near miss (caught before harm) with an adverse event (harm occurred).
- Assuming double checks eliminate risk - they reduce but do not remove it.
Rule of thumb
For any high-alert medication scenario, the safest answer includes an independent verification step plus clear documentation and patient monitoring.
Worked example
A wrong dose of insulin is prepared but caught before administration. This is a near miss, not an adverse event. The correct response is to report it, examine contributing factors (e.g., similar packaging, interruption) and strengthen the system, not to discipline the individual.
Quality and Professional Communication
Communication skills
Effective communication is a core clinical skill. Understand active listening, open and closed questions, empathy statements and summarising. Know how to adapt communication to health literacy, language, culture, age and sensory impairment, and when to involve an interpreter. Recognise the role of non-verbal cues and the value of a private, distraction-free setting.
Quality and teamwork
Understand quality assurance and continuous improvement - audits, standard operating procedures, key performance indicators and incident reporting. Know the principles of handover communication (structured formats such as SBAR) and interprofessional collaboration with prescribers, nurses and patients.
Handling difficult situations
Be able to describe conflict resolution, managing complaints and disclosing errors. Understand that an apology and explanation are part of professional duty, and that patients should be involved in decisions about their care (shared decision-making).
Traps in questions
- Using jargon with a patient of low health literacy instead of plain language.
- Choosing a response that dismisses a patient's concern rather than acknowledging it.
- Relying on family members as interpreters for sensitive information.
Rule of thumb
When a question asks for the best communication response, choose the option that acknowledges the patient's perspective, uses plain language, checks understanding and involves the patient in the decision.
Worked example
An anxious patient asks about a new medicine. The strongest response uses an empathy statement, plain-language explanation, teach-back to confirm understanding, and an invitation to ask questions - not a rapid list of side effects.