Quiz 13: Approaches to difficult problems

Please choose the one, most correct answer to each question or statement.

1. Healthcare professionals in South Africa often witness corruption and mismanagement but do not speak out because:
   • They are lazy
   • They feel powerless
   • They are themselves corrupt
   • They cannot tell the difference between corrupt and honest behaviour
2. When witnessing corrupt behaviour, healthcare professionals:
   • Should always speak out
   • Should never speak out
   • May speak out in a way that makes sure they are protected
   • May speak out, but only to their immediate supervisor
3. The “Whistle Blower’s Act” is:
   • An act of parliament designed to protect people who wish to report corruption in the workplace
   • A public service regulation stating that workers may not criticise their employer in public
   • An act of parliament that requires people to speak out even if they feel threatened
   • The regulations around sport in the workplace
4. An employee has made a complaint through the official channels about her supervisor. The supervisor then puts the employee on twice as many weekend shifts as her colleagues, knowing that this is causing problems with childcare:
   • This is only to be expected if you complain about your supervisor
   • She should accept the shifts but then try to swap with her colleagues, who are sympathetic
   • This is victimisation, which is illegal. She should speak with her union representative
   • She should speak with a newspaper
5. Why is it useful to refer to the National Core Standards if you wish to make a complaint within your facility?
   • Managers will respond more quickly, so this approach is useful in an emergency
   • Nobody disagrees with the National Core Standards, so this approach is useful when there is a breakdown in trust
   • The Protected Disclosures Act requires that a complaint must be made using the National Core Standards before it can be taken out of the facility
   • It means you can “depersonalise” a problem and shift attention to compliance with health policies and legislation
6. You are helping a patient to make a complaint about a hospital using the National Complaints Management Protocol but the person has received no response 2 months after writing a letter to the complaints manager:
   • He is entitled to take the complaint to the complaints manager at district or provincial level
   • He should wait up to 6 months before taking the complaint further
   • No response means that the complaints manager has decided the issue is not important and he should just accept this
   • There are no time limits on the length of time the complaints manager should take before responding
7. The professional behaviour of a hospital superintendent is worrying several senior staff members. They have had several unpleasant meetings with her, and there has been no response from the manager at the district office. Which of the following is true?
   • As long as there is no physical threat, the staff members are required to keep their problem within the district health system
   • A complaint to the office of the Public Protector is the next step
   • They are entitled to seek help from an outside body as there has not been a satisfactory response from the district office.
   • They should request conflict resolution counselling
8. The terms “adherence” and “compliance” mean different things when describing how well a patient sticks to a recommended treatment. Which of these statements is true?
   • Compliance means that the recommended treatment has been discussed with and agreed to by the patient
   • Adherence means that the recommended treatment has been discussed with and agreed to by the patient
   • Compliance is a legal requirement but adherence is not
   • Adherence is a legal requirement but compliance is not
9. A person who cannot read is less likely to be adherent to their treatment because:
   • They are more likely to be forgetful
   • They probably have different health beliefs
   • They will have difficulty in following written instructions on the package, and in finding out more about their condition
   • They are more likely to fear side effects
10. Which of the following is most likely to improve adherence to chronic disease treatments?
    • Health education given via the radio
    • Health education pamphlets provided in waiting rooms
    • Asking all patients to bring a family member who can read to the consultation
    • Improving quality and trust in healthcare services
11. The packaging of anti-retrovirals changes as a result of a new supplier. In which group of people is this most likely to result in adherence problems?
    • The stigmatised
    • Those that cannot read
    • Pregnant women
    • Those with different health beliefs
12. Sometimes, small incentives such as food or cash are used to encourage people to attend primary healthcare check-ups and immunisations:
    • This is a bad idea because people should be responsible for their own health
    • This can improve use of primary healthcare, because the incentive makes the visit seem more worthwhile to the patient
    • This is a bad idea because it is not cost effective in public health systems
    • This is a bad idea because patients will be expecting food or cash every time they visit the clinic
13. An elderly patient has high blood pressure that is not responding to treatment. Her daughter says her mother has become very forgetful and she does not think she is taking the pills properly. What is the best way of dealing with this?
    • Add additional pills because her current drugs are not effective
    • Simplify the prescription and show the daughter how to use a pill organiser
    • Educate the mother about the risks of stroke if she does not take her medication
    • Organise a peer support group for elderly patients with high blood pressure
14. What is the difference between a “major incident” and a “disaster”?
    • A major incident can be chaotic, but is manageable, while in a disaster the numbers and types of patients overwhelms the facility
    • A disaster can be chaotic, but is manageable. In a major incident the numbers and types of patients overwhelms the facility
    • Major incidents are man-made while disasters are natural
    • Disasters are man-made and major incidents are natural
15. What does the “all hazards” approach to major incident planning mean?
    • The plan focuses on spills of hazardous materials
    • The plan focuses on the core actions that will be necessary for most types of major incidents and disasters
    • The plan must cover detailed action for all possible hazards
    • The plan focuses on staff safety
16. In a major incident, triage:
    • Can be omitted as there is not time for it
    • Is necessary to sort patients according to the South African Triage Score
    • A major incident triage system is usually used that is harsher than the South African Triage Score for very severe injuries
    • Triage should be done by the most senior person so that they can immediately start resuscitation on the most severe injuries
17. Whom should the security guard call on for support if, in the middle of a major incident, a local MEC insists on being allowed into the emergency centre so that his photograph can be taken with injured patients?
    • The emergency centre medical commander
    • The senior doctor in casualty
    • The emergency centre nursing commander
    • The police
18. During a major incident, a nurse in one of the clinical areas sees that bags of intravenous fluid are going to run out. She should speak with:
    • The porter
    • The pharmacist
    • The hospital nursing commander
    • The emergency centre nursing commander
19. During a major incident, all communication with the “outside world” is through:
    • The emergency centre telephone
    • The communications officer, who should be physically present in the emergency centre
    • The hospital operations centre, which should be physically separated from the emergency centre
    • Two way radios in the emergency centre
20. Debriefing after a major incident:
    • Should be avoided as there is a risk of re-traumatising staff
    • Is important so that things that caused problems can be identified and discussed, and the major incident plan updated
    • Is necessary to “name and shame” those who did not respond
    • Should only involve the senior managers