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Nursing 104 > Unit 12 > Flashcards

Unit 12 Flashcards

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1
Q

What are two significant nursing functions that closely influence patient safety and quality?

A

Monitoring for early recognition of adverse events, complications, and errors

Initiating deployment of appropriate care providers for timely intervention and response/rescue of patients in these situations

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2
Q

Providing care that does not vary in quality because of personal characteristics, such as gender, ethnicity, geographic location, and socioeconomic status

A

EQUITABLE

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3
Q

Serious adverse events during an inpatient stay that should never occur or are reasonable preventable through adherence to evidence-based guidelines

A

never events

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4
Q

An unexpected occurrence involving patient death or serious physical or psychological injury or the risk thereof.

A

Sentinel Event

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5
Q

Reducing waits and sometimes harmful delays for both those who receive and those who give care

A

timely

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6
Q

Embodies the principles of believing in people; treating everyone in the workplace with dignity, trust, and respect

A

All One Team

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7
Q

Providing services based on scientific knowledge to all who could
benefit, and refraining from providing services to those not likely to
benefit

A

Effective

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8
Q

Providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions

A

Patient-centered

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9
Q

A nonprofit organization with a mission of advancing and disseminating scientific knowledge to improve human health

A

IOM

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10
Q

Preventing injuries to patients from the care that is intended to help them.

A

Safe

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11
Q

Six competencies to nursing practice that have been incorporated into nursing education standards and the nurse licensure examination so that all nurses will be held accountable for being competent in these six areas.

A

QSEN

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12
Q

Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient’s preferences, values, and needs

A

Patient-centered care

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13
Q

An evidence-based teamwork system aimed at optimizing patient outcomes by improving communication and teamwork skills among health care professionals

A

Team Stepps

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14
Q

Minimizes risk of harm to patients and providers through system effectiveness and individual performance

A

safety

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15
Q

Preventing waste, including waste of equipment, supplies, ideas, and energy

A

Efficient

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16
Q

Measurable items that reflect the quality of care provided and demonstrate the degree to which desired clinical outcomes are accomplished

A

Clinical Indicators

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17
Q

Method of problem solving that helps to identify how and why an event occurred

A

RCA
Root Cause Analysis

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18
Q

Integrate best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care

A

Evidence-Based Practice

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19
Q

Function effectively within nursing and interprofessional teams, fostering open communication, mutual respect, and shared decision making to achieve quality patient care

A

Teamwork and Collaboration

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20
Q

Emphasizes that to make significant improvements in an organization’s processes, decisions must be based on sound, valid data, and the people managing the processes must have a clear understanding of the nature of variation in processes.

A

Scientific Approach

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21
Q

Use information and technology to communicate, manage knowledge, mitigate error, and support decision making

A

Informatics

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22
Q

Details the six guiding aims for improvement that should be adopted by every individual and group involved in the provision of health care.

A

Quality Chasm Report

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23
Q

the FIRST national agency that conducts surveys of inpatient and ambulatory facilities and certifies their compliance with established quality standards
First agency to recognize QI principles as a requirement in hospitals

A

TJC
The Joint Commission

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24
Q

Providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions

A

Patient-centered care

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25
Q

Nurses, physicians, and other health professionals partner with patients and families to ensure that

A

Health care decisions respect patients’ wants, needs, and preferences
Patients are educated and supported to make decisions about and participate in their own care

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26
Q

Patient-Centered Care is more than a nursing care delivery model it is considered a _________ of care

A

philosophy
PCC should be incorporated as an essential component of any nursing care delivery model

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27
Q

Who recommends that nurses utilize the SHARE approach?

A

Agency for Healthcare Research and Quality (AHRQ)

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28
Q

What is the SHARE approach?

A

S- Seek your patients participation
H- Help your patient explore and compare treatment options
A- Assess your patients values and preferences
R- Reach a decision with your patient
E- Evaluate your patients decision

29
Q

A patient receives care for heart failure on a nursing unit in which the interprofessional team members—including nurses, physicians, and therapists—are committed to including the patient and spouse in change of shift reports and to seeking their input in all decisions affecting the patient’s care. What type of care model is represented in this unit?

A. Primary care
B. Functional care
C. Case management
D. Patient-centered care

A

D is correct because patient-centered care is to provide care that is respectful of and responsive to individual patient preferences, needs, and values and that patients and family members are involved in all care decisions.
A is incorrect -primary nursing care is delivered by an all RN staff
B is incorrect -functional care is the provision of care by nursing and nursing ancillary staff rather than by personnel from across departments.
C is incorrect -case management is a model of care delivery in which an RN case manager coordinates the patient’s care throughout the course of an illness but does not supervise daily care activities.

30
Q

The Institute of Medicine (IOM) came out with a report that defines a new vision for improving the quality of our nations healthcare. What was the name of this report?

A

Crossing the Quality Chasm

31
Q

What was in the IOMs 2000 report To Err is Human?

A

98,000 patients die each year from preventable medical errors
Poor quality care is a MAJOR problem in US

32
Q

What are the contributing factors in the IOMs 2000 report, To Err is Human?

A

*Overuse of expensive invasive technology
* Underuse of inexpensive care services
*Error-prone implementation of care that could harm patients and waste money

33
Q

Quality Chasm Report
What is going to help cross the Chasm?

A

Guiding aims for improvement
STEEEP

34
Q

What does STEEEP stand for?

A

Safe- preventing injuries
Timely- reducing waits and delays
Effective- services to those who benefit
Efficient- Preventing waste
Equitable- providing unvaried care based on personal characteristics
Patient-centered- individual patient needs, values, and preferences

35
Q

Even after all these years after those articles were posted, there still is a signifigant problem in areas such as: (AHRQ)

A

Adverse drug events
Health-care associated infections
Falls
Obstetric adverse events

36
Q

10 rules to guide improvement: Care is based on continuous healing relationships-

A

You need to continue healing your patient no matter where you are. (internet, telephone, etc)

37
Q

10 rules to guide improvement: Care is customized according to patient needs and values-

A

You need to meet the most common needs (food, water, etc) but with patients preferences in mind

38
Q

10 rules to guide improvement: The patient is the source of control-

A

The patient has the ability to choose health care decisions being done to them and they should be given all of the information about there treatment

39
Q

10 rules to guide improvement: Knowledge is shared and information flows freely-

A

Patients should have access to their medical info

40
Q

10 rules to guide improvement: Decision-making is evidence based-

A

Patients should receive care based on the best knowledge and care should not vary

41
Q

10 rules to guide improvement: Safety is a system priority-

A

Patients should be safe

42
Q

10 rules to guide improvement: Transparency is necessary-

A

The system should give patients and parents information about everything with the patient so they can make informed decisions

43
Q

10 rules to guide improvement: Needs are anticipated-

A

The system should anticipate patient needs rather than react to events

44
Q

10 rules to guide improvement: Waste is continually decreased-

A

Don’t waste resources

45
Q

10 rules to guide improvement: Cooperation among clinicians is a priority-

A

Clinicians should engage is collaboration so there is an appropriate exchange of patient information

46
Q

What are the cornerstones of quality management?

A

Quality
Scientific Approach
“All one team”

47
Q

What is Quality Improvement? (QI)

A

Assessment and improvement of work processes while focusing on what customers need and want

48
Q

What are the TJC key areas in level of performance?

A

Patient safety
Patient rights
Patient treatment
Infection control

49
Q

What is the “Gold seal of approval”?

A

Results in TJC accreditation affirming greatness in quality and safety standards.

50
Q

How was National Hospital Inpatient Quality Measures founded?

A

The TJC and CMS worked together to form standardized measures

51
Q

How is the National Hospital Inpatient Quality Measures used?

A

Measures + Patient satisfaction + other clinical measures= pay for performance
Instead of just paying for doing the service to paying for the service, quality, and outcomes

52
Q

What is Value-Based Purchasing? and who started the program?

A

The CMS (Centers for Medicare and Medicaid Services) authorized to begin this program.
Medicare payments are reduced annually by 1-2%
Value= quality measures+ Patient experience+ Cost of care

53
Q

Why is it important for nurses to have awareness of the quality measures and value-based purchasing?

A
  • Support overall management of patient care throughout length of stay
    *Collaborate with other healthcare professionals to initiate changes
    *Monitor ongoing effectiveness of care provided
54
Q

What are standardized processes also known as? and what are they?

A

“Best known methods” or “best practices”
It is the process of implementing the best known methods of improvement until better ways are found
It is the foundation for improvement in the clinical care setting

54
Q

A patient understands that the hospital where he is currently having a procedure done is “Joint Commission” accredited. The patient asks the nurse how accreditation ensures that patients receive the best care possible. The nurse informs the patient that there are several quality initiatives required by The Joint Commission in order for the hospital to be accredited. One of these quality initiatives is known as:
A. Pareto charts
B. Never events
C. National Hospital Inpatient Quality Measures
D. PDSA cycle

A

C is correct because The Joint Commission initiated the performance measurement and improvement initiative known as “National Hospital Inpatient Quality Measures” intended to support organizations in their quality improvement efforts as well as supplement their accreditation process.
A is incorrect because Pareto charts are bar graphs, with the height of bars reflecting the frequency with which events occur or the effect events have on a process problem, and are used in analyzing quality improvements initiatives but not required as part of The Joint Commission Accreditation process.
B is incorrect because Never Events were initiated by The Centers for Medicare and Medicaid and are serious adverse events during an inpatient stay that should never occur or are reasonably preventable through adherence to evidence-based guidelines.
D is incorrect because the PDSA cycle is one type of quality improvement model and not specified as required by The Joint Commission.

55
Q

What are clinical and critical pathways? who developed them?

A

Helps define the timing by nurses, physicians, etc. when providing care for a specific diagnosis or procedure
It was developed through a collaborative effort of the interprofessional team

56
Q

What are some of the benefits in clinical pathways?

A
  • Reduction in variation of the care provided
    *Facilitation and achievement of expected clinical outcomes
  • Reduction in care delays and lengths of stay in the inpatient setting
    *Improvements in cost-effectiveness of the care delivered while maintaining or increasing patient and family satisfaction
57
Q

How are Clinical protocols/algorithms different from clinical pathways?

A

Because clinical protocols represent more of a decision path that a practitioner might take during a particular episode or need

58
Q

What is the Institute for Healthcare Improvement (IHI)?

A

Voluntary organization formed to help health care leaders improve quality
*Ask 3 fundamental questions
*Implement Plan-Do-Study-Act (PDSA)

59
Q

What are the IHI’s 3 questions to improve quality?

A

*What are we trying to accomplish?
*How will we know that a change is an improvement?
*What changed can we make that will result in improvement?

60
Q

What is the Institute for Safe Medication Practices (ISMP)?

A

*Non profit organization
Education is all about the prevention of medication errors
Expert review of reported errors

61
Q

Improve patient safety program: TJC Sentinel Event Standard-

A

requires organizations to carry out designated steps to fully understand the factors and systems associated with adverse patient events (medical care harming patients)

62
Q

Improve patient safety program: TJC National Patient Safety Goals-

A

Promote specific improvements in patient safety with the goals highlighting problematic areas and evidence-based solutions to the problems with system-wide solutions wherever possible

63
Q

What are some TJC National Patient Safety goals?

A

Identify patients correctly
Improve staff communication
Use medicines safely
Use alarms safely
Prevent infection
Identify patient safety risks
Improve health care equity
Prevent mistakes in surgery

64
Q

Never Events/serious reportable events VS. Hospital-Acquired Conditions

A

Never Events- Errors in health care that should never happen
HAC- Reasonably preventable

65
Q

What 2 nursing functions closely influence patient safety and quality?

A

*Monitoring for early recognition of adverse events, complications, and errors
*Initiating deployment of appropriate care providers for timely intervention and response/rescue of patients in these situations

66
Q

What is the National Database of Nursing Quality Indicators (NDNQI)?

A

Voluntary database
*Link between nurse staffing and patient outcomes
*Compares and measures the nursing quality among national, regional, and state hospitals of similar type and size

67
Q

What is TeamSTEPPS? what does it stand for?

A

*Developed as an evidence-based teamwork system aimed at optimizing patient outcomes
*Helps improve communication and teamwork skills among health care professionals
S-Strategies &
T-Tools to
E-Enhance
P-Performance &
P- Patient
S- Safety

68
Q
A

Nursing 104 (5 decks)

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