Using an example of an adverse event from your own clinical environment1, trace and describe its detection,

Investigation, management and outcomes. In addition, with reference to the literature, critically analyses the effectiveness of the risk management strategies and the utility of the outcomes in preventing future adverse events. You are expected to draw strongly on the peer reviewed literature to undertake this critical analysis and to compare the management of your chosen event with both recommended best practice and existing research. It is expected that there will be extensive use of the extant literature. Please do not simply quote from government websites.

Please ensure that confidentiality is strictly maintained and that all exemplars and data provided are carefully de-identified.

Structure

Part A (Approximately 400 words)

Detailed DE-IDENTIFIED description of the adverse event including

how the event was detected.

15 Marks

Part B (Approximately 2900 words)

Three sections as the following:

• Detailed account of the investigation process, including critical

analysis of efficacy against the peer refereed literature outlined above (1100 words)

35 Marks

• Detailed account of the management of the adverse event

(including where appropriate aspects such as open disclosure),

including critical analysis of efficacy against the literature against the

peer refereed literature outlined above (1100 words)

35 Marks

• Critical appraisal of the outcomes of the adverse event, both for

the patient and the organization, with specific reference to the utility in preventing future similar adverse events (700 words)

15 Marks