quality improvement Flashcards
explain the basic concepts related to quality improvement in health care
Quality improvement seeks to standardize processes and structure to reduce variation, achieve predictable results, and improve outcomes for patients, healthcare systems, and organizations
what are some actions used to promote quality improvement
Set clear, measurable goals for improvement. Collect and analyze data to identify areas for improvement and track progress. Engage stakeholders from all levels of the organization.
what is the use of evidence-based practice and research to promote quality improvement
Evidence-based practice (EBP) and research are utilized to promote quality improvement by providing a foundation of reliable scientific data that informs healthcare decisions, allowing practitioners to implement the most effective interventions and strategies, ultimately leading to better patient outcomes and a higher standard of care across healthcare settings.
difference between quality assurance and quality improvement:
quality assurance
Quality assurance:
- measures against standards
- focus on care providers
- reactive
- fixes problems that have been found
- assures things are working
difference between quality assurance and quality improvement:
quality improvement
- measures processes and systems
- focuses on client care
- proactive-preventive
- improves the process causing the identified problem
- tells what needs to work better
A nurse is using evidence-based practice (EBP) to address the incidence of catheter-associated infections on a surgical unit. According to EBP, which of the following actions should the nurse take first?
identify a clinical problem
A nurse is assisting a quality improvement team that is using the Plan-Do-Study-Act (PDSA) model to address an increase in pressure injuries on a medical unit. Which of the following actions should the nurse identify as an example of the “Do” step of the PDSA model?
implementing a new evidence-based practice protocol
A nurse is assisting with teaching a class about incident reports. The nurse should include that which of the following situations requires an incident report?
a nurse administers the wrong medication to a client
A nurse is explaining National Patient Safety Goals (NPSGs) to a newly licensed nurse. The nurse should include that which of the following is a goal addressed in the NPSGs?
improving staff communication
A nurse is caring for a client who has suction equipment in their room. The client asks the nurse, “Why do you check my suction equipment every day even though I am not using it?”
“it is part of the quality assurance plan of the unit”
A nurse is reviewing a health care facility’s policy that states to use a gauze dressing over IV insertion sites. After completing a literature review, the nurse discovers that evidence-based practice (EBP) indicates to use a transparent dressing over IV sites.
recommend changing the procedure to the policy and procedure committee
A nurse is assisting with teaching a class about types of research studies. The nurse should include that which of the following is an example of a randomized controlled trial (RCT)?
A study arbitrarily assigning people who smoke into either an experimental group or a control group to determine the effects of a new therapy to reduce smoking
A nurse is assisting with teaching a newly licensed nurse about the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) tool.
The HCAHPS tool is issued to measure client satisfaction about health care service.
A nurse is assisting on a quality improvement committee to decrease the number of client falls occurring at night. After identifying the problem, which of the following is the next step the nurse should take?
complete a literature review
A nurse is a member of a committee that is using evidence-based practice (EBP) to decrease the incidence of central line infections. The nurse should identify that which of the following interventions is part of the implementation step of EBP?
incorporating the new practice into client care
A nurse is discussing quality measurement with a newly licensed nurse. The nurse should include that medication reconciliation is an aspect of which part of quality measurement?
process
A nurse is assisting with using the Plan-Do-Study-Act (PDSA) model to decrease client falls in a long-term care facility. The nurse should identify that developing guidelines to decrease falls is included in which of the following steps of the PDSA model?
plan
A nurse is assisting with developing a quality improvement (QI) plan to reduce the incidence of medication errors in an acute care unit. The nurse should recognize that which of the following actions is included in the identifying step of the QI process?
recognize the need for a change
A nurse is assisting with teaching a class about sentinel events. The nurse should include that which of the following situations is a sentinel event?
a nurse infused an incompatible blood product to a client
A nurse is assisting with teaching a class about quality core measures. Which of the following information should the nurse include?
Quality core measures are a standard of care for treatment.
quality improvement
Planning changes in processes or
systems to improve client outcomes, efficacy, and clinical performance
of related healthcare practices.
quality assurance
Reactive, problem-driven measures to
improve client outcomes and healthcare delivery
Plan/Do/Study/Act (PDSA) method
- Plan: Choose the question or
problem; decide what data to
collect and who will collect it. - Do: Make the change or take
action and collect the data. - Study: Review and analyze the
data collected. - Act: Decide upon the next steps to
take and then implement those
steps.
the lean approach
- Focused on efficiency and
decreasing the amount of waste,
whether it is wasting resources or
time for the staff or the client. - Identifies value as a necessary
characteristic, so anything that
does not add value to the process
is minimized or removed. - Can be valuable when analyzing a
process by eliminating repeated or
unnecessary steps that add a time
delay without any added value.
the six stigma
A business problem-solving model developed to reduce variations in
practice and reduce errors
the five steps to the six stigma process
- Definition of the problem
- Measurement of the science: observations, statistics, scientific data
- Analysis of the data
- Improvements are created and attempted
- Control phase: maintain success with plans for reevaluation to avoid losses
cause and effect diagram (fishbone)
identifies possible causes; sorts
ideas into categories
check sheet or tally sheet
used for data collection
control chart or graph
showing changes over time
histogram or bar graph
depicting frequencies
pareto chart or bar graph
shows significance
scatter diagram
used for pairs of numbers looking at relationships
stratification
used for data gathered from several sources to identify patterns
the national database of nursing quality indicators
The National Database of Nursing
Quality Indicators (NDNQI) is a program based on surveying nurses to identify hospital nursing concerns and ways to promote change and quality improvement.
The NDNQI identifies 4 main areas
where hospitals can use this
information for quality improvement.
- Quality of nursing care
- Improvement in data collection and
submitting - Workplace improvement for nurses
- Best practice information for client
health
risk management
Risk management is the process of reducing the risk of errors by understanding the causes and beginning to change the culture with the
communication and collaboration of individual staff and management.
parts of risk management
- Protects clients, staff, and visitors from harm
- Steps are like those in the nursing and QI processes:
- Identifying
- Investigating
- Analyzing
- Evaluating
what does risk management lead to
- Leads to development and implementation of methods for:
* Correcting, Reducing, Managing and Eliminating Risk
root cause analysis
A root cause analysis, also called an RCA, follows the Joint Commission’s
directive to investigate an incident to determine what happened and how to
prevent it from happening again
questions to ask for root cause analysis
- What happened?
- Why did it happen?
- What can be done to keep it from happening again?
incident reports
- Incident reports are the
documentation of errors and the
factors leading up to and including
when an error occurs in the health
care system.
sentinel event
- The Joint Commission defines a
sentinel event as an incident of
unsafe practice that resulted in
extreme harm, short-term harm,
permanent disability, or death of
a client. The term sentinel is
derived from the military and
means to keep watch or on high
alert.
never events
- Never events are medical errors that are identifiable, preventable, and
have the potential for serious risk to clients. The occurrence of a never
event reveals a problem in the safety and credibility of a healthcare facility.
