Chapter 5

Question 1

Which of the following contribute to improved patient safety? (Select all that apply.)
Patient involvement in own care.
Leadership capability.
Data collection.
Increased staff mix

Answer 1

Patient involvement in own care.
Leadership capability.
Data collection.

Question 1

The nursing manager changed the current model of implementing nursing rounds of patients each day at 1200 hours to implementing interdisciplinary rounds of patients at 1000 hours. This change reflects:
Delegation of responsibility from nursing to other health care professionals.
An inappropriate time to complete patient rounds and will probably not work.
Lack of consultation among the nursing staff.
A patient-centred care initiative

Answer 1

A patient-centred care initiative

Question 2

Approximately what percentage of Canadian hospital admissions can be expected to include an adverse event?
10
12.5
5
7.5

Answer 2

7.5

Question 3

Which of the following is the CPSIs flagship program?
Safer Healthcare Now.
Patient Safety Culture Improvement.
Safe Healthcare for All.
Patients Are First.

Answer 3

Safer Healthcare Now

Question 4

What is the focus in a culture of safety?
Effective systems and team work
Professional nursing standards and ethical codes
Employee safety.
Investigating who is making health care errors.

Answer 4

Effective systems and team work

Question 5

During review of back injuries, it is determined that mechanical lifts and transfer belts are not being properly used. In addressing this concern, the unit manager:
Meets individually with nurses, who are observed using the lifts incorrectly, to review the correct procedure.
Blames the system for inadequate funding for resources.
Reviews the system of reporting adverse events to ensure that appropriate reporting is occurring.
Consults with the staff about the review to determine how best to proceed

Answer 5

Consults with the staff about the review to determine how best to proceed

Question 6

In an effort to control costs and maximize revenues, the Rehabilitation Unit at Cross Hospital reduces the number of its nursing managers. Within a year the number of adverse events on the units has doubled. This may be attributable to:
Fewer clinical leaders and advocates for necessary resources.
A change in reporting systems.
Inability of staff at the bedside to make good choices.
The overload of work for staff nurses.

Answer 6

Fewer clinical leaders and advocates for necessary resources.

Question 7

Having team “huddles” each day on the nursing unit is a reflection of:
Nurses’ need to socialize.
Creating a culture of safety.
Ensuring distribution of equal workloads.
The manager’s need to talk with staff nurses on a daily basis.

Answer 7

Creating a culture of safety.

Question 8

Which attribute is a common feature of a culture of safety?
Individual-focused policies.
Organization behaviour.
Voluntary reporting of incidents.
A nonpunitive approach to adverse event reporting and analysis.

Answer 8

A nonpunitive approach to adverse event reporting and analysis.

Question 9

Which of the following represents a potential use of nurse-sensitive outcomes?
Accountability for nursing behaviours.
Informing best practices.
Maintaining the status quo.
Performance appraisals.

Answer 9

Informing best practices.

Question 10

Which of the following is a CPSI safety competency?
Assess nurse staffing and skill mix.
Optimize human and environmental factors.
Analyze nurse-sensitive outcomes.
Practise patient-centred care.

Answer 10

Optimize human and environmental factors.

Question 11

Traditional approaches to ensuring patient safety have focused on:
Hiding errors from potential litigation.
Instituting best practices in response to errors.
Finding solutions to systems issues.
Assigning blame

Answer 11

Assigning blame

Question 12

On the basis of a review of increased falls with injury and increased use of restraint during evening hours, you as the unit manager are most likely to:
Continue your current practices and procedures.
Review the safety of ambulation devices.
Schedule continuing education for all staff members.
Review daytime and evening staffing mixes.

Answer 12

Review daytime and evening staffing mixes.

Question 13

Organizational changes that promote systems thinking, collective accountability, and team-based care are examples of:
Outdated practices that are not grounded in current evidence.
Activities that promote patient-centred care.
Accreditation standards that hospitals must meet.
Quality improvement initiatives

Answer 13

Activities that promote patient-centred care.

Question 14

Having access to information, evidence, and research is an important driver for quality and;
Nurse safety.
Organizational policy development.
Patient-centred care.
Patient safety.

Answer 14

Patient safety.

Question 15

Rose a new nursing graduate chose hospital X for its culture of safety. Which of the following attributes contribute to this culture of safety? (Select all that apply.)
Trusting and open communication
A system rather that an individual approach to safety
Organizational learning
Teamwork

Answer 15

Trusting and open communication
A system rather that an individual approach to safety
Organizational learning
Teamwork

Question 16

What is the primary purpose of nursing standards?
To educate other health care professionals about the role of the nurse.
To identify the desired level of performance.
To inform the courts in relation to negligence and malpractice cases.
To inform performance appraisals at the unit leve

Answer 16

To identify the desired level of performance.

Question 17

In designing a high-quality, safe health care environment, the primary emphasis needs to be on:
Informatics.
The patient.
Staffing.
Evidence-informed practice

Answer 17

The patient.

Question 18

As the nurse was about to administer an oral mediation, the patient states, “That pill is the wrong colour.” The nurse goes back to the medication administration area to check the medication and realizes that it is indeed the wrong pill. Does this situation require the completion of an adverse event report?
No; it was the patient who stopped an error from occurring.
No; there was no actual error.
Yes; an error almost occurred, and close calls are to be reported.
It is up to the nurse to decide whether to complete an adverse event report.

Answer 18

Yes; an error almost occurred, and close calls are to be reported.

Question 19

Robert, an experienced nurse, discovered a medication order was incorrectly translated.
The pharmacist filled the medication and sent it to be administered to the patient. When the medication arrived Robert questioned the dose and consulted with the nurse manager. The order was clarified with the physician and changed to the correct dose. When reviewing the incident the nurse manager determined the near miss was related to which of the following?

System error.
Attributed to increased workload.
An individual and system error.
Individual error.

Answer 19

An individual and system error.

Question 20

Which of the following depicts a nursing-sensitive outcome?
Implementation of informatics at the patient’s bedside.
Programming that increases individual nurse competency to offer smoking cessation programs.
Staff–manager conferences to review reporting of adverse events.
Patient council meetings to review food, recreation, and nurse–patient relations.

Answer 20

Programming that increases individual nurse competency to offer smoking cessation programs.

Question 21

As a patient care advocate, you regularly coach patients in how to stay safe in health care by educating them about:
The need to understand and record all medications being taken.
Washing hands frequently while in a health care environment and using a hand sanitizer.
Bringing their own linens and other personal items to the hospital.
Following closely the directions and orders of health care providers.

Answer 21

The need to understand and record all medications being taken.

Question 22

After consulting with practice environments about quality and safety concerns in health care, the Dean of Health Programs at a Canadian university develops:
Programming that stresses discipline-based research.
An interdisciplinary program for nurses, pharmacists, and medical practitioners that emphasizes collaborative learning teams.
A nursing program that emphasizes the development of a strong disciplinary identity.
Partnerships with health care professionals to develop software for reporting of adverse events

Answer 22

An interdisciplinary program for nurses, pharmacists, and medical practitioners that emphasizes collaborative learning teams.

Question 23

Gathering information on patient outcomes leads to which of the following? (Select all that apply.)
Increasing quality of nursing care.
Having a positive impact at the individual, unit, and organization levels.
Decreasing nursing autonomy.
Evaluating different approaches to care.

Answer 23

Increasing quality of nursing care.
Having a positive impact at the individual, unit, and organization levels.
Evaluating different approaches to care.

Question 24

Gail, a senior nursing student, consults with her preceptor about a patient who has refused his medication. When speaking with the patient he expresses that he does not believe the medication is helping with his pain level. From a nursing sensitive outcome, which outcomes are addressed in this situation? (Select all that apply.)
Symptom management.
Functional status.
Patient satisfaction.
Quality of nursing care.

Answer 24

Symptom management. Patient satisfaction.

Question 25

Which of the following represents an activity that supports patient-centred care?
Reserved parking spots at the main hospital entrance for physicians
Creating e-health stations on each inpatient unit
Regular staff surveys to monitor organizational satisfaction
Posting of visiting hours on the entrance way to each hospital unit

Answer 25

Creating e-health stations on each inpatient unit