FRACGP Safety and Compliance 2 — Questions and Answers
Question 1: A patient is prescribed warfarin and also takes ibuprofen for knee pain. What is the primary safety concern?
- Reduced warfarin absorption
- Increased bleeding risk due to anticoagulant potentiation and gastric irritation (Correct answer)
- Accelerated warfarin metabolism
- Reduced anti-inflammatory effect of ibuprofen
Correct answer: Increased bleeding risk due to anticoagulant potentiation and gastric irritation
NSAIDs like ibuprofen potentiate warfarin's anticoagulant effect and cause gastric mucosal damage, significantly increasing bleeding risk.
Question 2: Under Australian mandatory reporting obligations, a GP must report to AHPRA when they reasonably believe a registered health practitioner has engaged in:
- Minor documentation errors
- Sexual misconduct with a patient (Correct answer)
- Billing discrepancies
- Disagreements with clinical guidelines
Correct answer: Sexual misconduct with a patient
Sexual misconduct is a notifiable conduct requiring mandatory reporting to AHPRA under the Health Practitioner Regulation National Law.
Question 3: A GP prescribes Schedule 8 medications for a patient with chronic pain. What is the recommended monitoring practice in most Australian states?
- Annual review only
- Regular review with state/territory real-time prescription monitoring and urine drug screening as appropriate (Correct answer)
- No monitoring required if the patient is stable
- Fortnightly blood tests only
Correct answer: Regular review with state/territory real-time prescription monitoring and urine drug screening as appropriate
Schedule 8 prescribing requires regular clinical review and use of real-time prescription monitoring systems (e.g., SafeScript in Victoria) to detect misuse.
Question 4: What is the correct approach when a GP discovers a medication error made by a colleague that did not cause patient harm?
- Ignore it as no harm occurred
- Correct the error quietly without documentation
- Report through the practice's incident reporting system and discuss with the colleague (Correct answer)
- Report directly to the coroner
Correct answer: Report through the practice's incident reporting system and discuss with the colleague
Near-miss and no-harm incidents should be reported through practice safety systems to enable learning and prevent future errors.
Question 5: Which of the following best describes 'duty of candour' in Australian general practice?
- The obligation to maintain patient confidentiality at all times
- The professional and ethical duty to be open and honest with patients when things go wrong (Correct answer)
- The requirement to disclose all clinical notes on request
- The duty to report all adverse events to the media
Correct answer: The professional and ethical duty to be open and honest with patients when things go wrong
Duty of candour requires practitioners to be open, honest, and apologetic when patient care results in harm or unexpected outcomes.
Question 6: A GP suspects a patient has been a victim of domestic violence. The patient denies abuse. What is the most appropriate initial action?
- Report immediately to police without patient consent
- Document concerns, provide safety information and resources, and ensure follow-up (Correct answer)
- Discharge from practice as this is outside GP scope
- Contact the patient's partner to discuss concerns
Correct answer: Document concerns, provide safety information and resources, and ensure follow-up
GPs should document concerns, offer safety planning resources, and build a therapeutic relationship to support future disclosure without breaching patient autonomy.
Question 7: In Australian general practice, what does the '5 Moments for Hand Hygiene' framework primarily aim to prevent?
- Staff burnout
- Healthcare-associated infections (Correct answer)
- Medication administration errors
- Falls in clinical settings
Correct answer: Healthcare-associated infections
The WHO's 5 Moments for Hand Hygiene is designed to prevent the transmission of healthcare-associated infections between patients and healthcare workers.
FRACGP Safety and Compliance 2
A patient is prescribed warfarin and also takes ibuprofen for knee pain.
What is the primary safety concern?