Chapter 22 Flashcards
A nurse is explaining the pediatric unit’s QI program to a newly employed nurse. Which of the following would the senior nurse include as the primary purpose of QI programs?
Preparation for accreditation of the organization by The Joint Commission.
Improvement in patient outcomes.
Evaluation of staff members’ performances.
Determination of the appropriateness of standards.
Improvement in patient outcomes.
Your institution has identified a recent rise in postsurgical infection rates. As part of your QI analysis, you are interested in determining how your infection rates compare with those of institutions of similar size and patient demographics. Such a determination is known as:
Benchmarking.
Sentinel data.
Statistical analysis.
Quality assurance.
Benchmarking.
Hospital ABCD is a Magnet hospital. This designation has been applied to Hospital ABCD because it:
Is establishing career ladders for nurses.
Espouses commitment to excellence in patient care.
Facilitates active staff participation in decision-making related to quality nursing care.
Has implemented a graduate nurse orientation program.
Facilitates active staff participation in decision-making related to quality nursing care.
The nurse educator of the pediatric unit determines that vital signs are frequently not being documented when children return from surgery. According to QI, to correct the problem the educator, in consultation with the patient care manager, would initially do which of the following?
Have a group of staff nurses review the established standards of care for postoperative patients.
Document which staff members are not recording vital signs, and write them up.
Talk to the staff individually to determine why this is occurring.
Call a meeting of all staff to discuss this issue
Call a meeting of all staff to discuss this issue
A nursing unit is interested in refining its self-medication processes. In beginning this process, the team is interested in how frequently errors occur with different patients. To assist with visualizing this question, which organizational tool is most appropriate?
Flowchart.
Histogram.
Pareto chart.
Fishbone diagram.
Histogram.
At Hospital Ajax, staff members are reluctant to admit to medication errors because of previous litigation and a culture that seeks to assign blame. This culture demonstrates:
goals that are inconsistent with QM.
QM principles that emphasize customer safety.
a deep concern with improvement of quality and processes.
effective employee orientation and development in relation to QM.
goals that are inconsistent with QM.
As a nurse manager, you know that the satisfaction of patients is critical in making QI decisions. You propose to circulate a questionnaire to discharged patients, asking about their experiences on your unit. Your supervisor cautions you to also consider other sources of data for decisions because:
Patients are reliable sources about their own experiences, but are limited in their ability to gauge clinical competence of staff.
The return rate on patient questionnaires is frequently low.
Patients are rarely reliable sources about their own hospital experiences.
Hospital experiences are frequently obscured by pain, analgesics, and other factors affecting awareness.
Patients are reliable sources about their own experiences, but are limited in their ability to gauge clinical competence of staff.
With the rise of workplace violence in the emergency department, the nurse manager decides that she should work with the risk manager in violence prevention. The nurse manager should:
Request all staff to accept new risk management practices.
Document inappropriate behaviour.
Hold staff accountable for safe practices.
Hire more police security.
Hold staff accountable for safe practices.
A new graduate is asked to serve on the hospital’s quality improvement (QI) committee. The nurse understands that the first step in quality improvement is to:
Determine whether the findings warrant correction.
Identify the standard.
Collect data to determine whether standards are being met.
Implement a plan to correct the problem.
Identify the standard.
The nurse manager is performing a root-cause analysis related to medication administration errors with insulin. A root-cause analysis is very similar to the QI process except that a root-cause analysis is:
Conducted by only one person.
Retrospective.
Prospective.
Legislated for completion with all near-miss events.
Retrospective
Examples of sentinel events include (Select all that apply.)
Short staffing.
Death of patient related to postpartum hemorrhage.
Forceps left in an abdominal cavity.
Patient fall, with injury.
Administration of morphine overdose.
Death of patient related to postpartum hemorrhage.
Forceps left in an abdominal cavity.
Patient fall, with injury.
Administration of morphine overdose
The chief executive officer asks the nurse manager of the telemetry unit to justify the disproportionately high number of registered nurses on the telemetry unit. The nurse manager explains that nursing research has validated which statement about a low nurse-to-patient ratio?
“It promotes teamwork among health care providers.”
“It improves outcomes.”
“It contributes to duplication of services.”
“It increases adverse events.”
“It improves outcomes.”
Which of the following is not a principle of high reliability organizations?
Indeference to expertise.
Sensitivity to operations.
Commitment to resiliency.
Preoccupation with failure.
Reluctance to simplify.
Indeference to expertise.
An example of an effective patient outcome statement is:
“Quality is a desired element in patient transactions.”
“Patients with cardiac diagnoses will be referred to cardiac rehabilitation programs.”
“The hospital will reduce costs by 3% through the annual budget process.”
“Eighty percent of all patients admitted to the emergency department will be seen by a nurse practitioner within 3 hours of presentation in the emergency department.”
“Eighty percent of all patients admitted to the emergency department will be seen by a nurse practitioner within 3 hours of presentation in the emergency department.”
The QI process begins with:
identifying implications for practice.
team assembly.
sustaining the improvements.
identifying the aim
identifying the aim
