Deck 20: Patient Safety

Question 1

A nursing manager explains to a group of newly hired graduate nurses that maintaining situational awareness means :

A) being aware of possible problems encountered in patient situations.
B) remaining aware of patient status and how it can change quickly.
C) the ability to recover quickly from mistakes once they do occur.
D) understanding how everyone's role is related to patient outcomes.

Answer 1

understanding how everyone's role is related to patient outcomes.

Question 2

A nurse manager in a hospital receives Joint Commission sentinel event alerts.When one is received that concerns a process that occurs in the manager's facility, the best action by this manager is to:

A) consult with other managers to see whether this has been a problem.
B) create a file and add related information as it becomes available.
C) initiate a new policy to address the shortcomings of the process.
D) investigate how this process has been affecting patient safety.

Answer 2

investigate how this process has been affecting patient safety.

Question 3

A nursing manager is concerned about professional sanctions that might result if several near-miss episodes are reported to a Patient Safety Organization (PSO)under the Agency of Healthcare Research and Quality (AHRQ).The chief nurse executive explains to the manager that under the Patient Safety and Quality Improvement Act of 2005,

A) certain critical errors or near misses can be penalized under law.
B) PSOs only provide safety initiative information data to the AHRQ.
C) state legislatures are able to sanction facilities under the 2005 Act.
D) this information is confidential and protected from legal action.

Answer 3

this information is confidential and protected from legal action.

Question 4

A nurse is working with a patient who seems changed from earlier in the shift.The nurse cannot pinpoint exactly what has changed but is concerned that the patient is getting worse.The best action by the nurse would be to:

A) call the physician and voice concerns about the patient's status.
B) consult with the charge nurse and ask for his or her opinion.
C) continue monitoring the patient, looking for distinct changes.
D) document the findings and reassess the patient in an hour.

Question 5

A chief nursing officer (CNO)has been hired to develop a healthy work environment and culture of safety in a hospital with a long record of safety problems and poor patient outcomes.The best initial action by the CNO would be to:

A) create a policy where any nurse can stop procedures for a safety check.
B) design team-building events and basic communications in-services.
C) have all nurses in the facility reapply and interview for their jobs.
D) inform nurses that it is their job to report potential safety problems.

Question 6

In the 2000 Institute of Medicine's milestone report To Err Is Human: Building a Safer Health System, how many patients were estimated to die each year as a result of errors occurring in a hospital setting?

A) 25,000
B) 35,000
C) 50,000
D) 98,000

Question 7

A manager is counseling a nurse who has violated safety protocols several times.The most appropriate action by the manager is to:

A) allow the nurse to continue working only under direct supervision.
B) have the nurse prepare an educational in-service on safety protocols.
C) maintain a confidential file on the nurse's actions and outcomes.
D) report the behavior to the state board of nursing for discipline.

Question 8

The nurse knows that the purpose of the Department of Health and Human Services (DHHS)is to:

A) prioritize patient safety regulations.
B) promote use of research in practice.
C) protect the health of all Americans.
D) provide guidance on hospital policy.

Question 9

A manager is concerned with the number of medication errors occurring on their unit.The manager determines that these errors represent latent errors when an investigation reveals that:

A) many nurses are not using two different forms of patient identification.
B) nurses do not take the time to have high-risk medications double checked.
C) the medication bar codes are often unreadable by the computer scanner.
D) to save time, nurses gather all their patients' medications at one time.

Question 10

The nursing executive attempting to incorporate the American Association of Critical-Care Nurses' (AACN's)Healthy Work Environment Standards would formulate which policy? The manager would create a policy to:

A) encourage all nurses to return to school to complete degrees.
B) limit environmental hazards currently present in the facility.
C) provide discounts to a local fitness center for all employees.
D) use a standard "handoff" report format at change of shift.

Question 11

The nurse defends DHHS reporting of successful medical error reduction initiatives to Congress by summarizing that:

A) Congress has oversight when safety is poor.
B) congressional members oversee state reporting.
C) laws are created to meet patient safety needs.
D) increasing patient safety is national priority.

Question 12

A nursing executive wishes to implement a new policy based on initial National Patient Safety Goals 2002 to eliminate wrong patient, wrong site, and wrong procedure.Which action by the executive would best meet one of the goals?

A) Collaborate with the laboratory for timely reporting of laboratory values.
B) Formulate a time-out policy.
C) Mandate that all fall-prone patients be clearly identified.
D) Reevaluate workflow design and patient-staffing ratios.

Question 13

The nursing manager understands that the phrase "active failure" in regard to patient safety means a(n):

A) system process is actively injuring patients and needs modification.
B) workplace practice is actively contributing to poor patient outcomes.
C) error has actively caused a patient to have a negative consequence.
D) unsafe act was committed by someone in direct contact with patients.

Question 14

The nurse executive explains to a group of newly hired nurses that the major responsibility for preventing errors in patient care lies with the:

A) individual because of legal obligations for safety.
B) individual, because that is who makes the error.
C) system, because it is responsible for employee acts.
D) system, because process designs can lead to errors.

Question 15

An accreditation body visitor is touring a facility that has been designated as a high reliability organization (HRO).The visitor could reasonably conclude that this facility's nursing staff:

A) is highly reliable in preventing errors.
B) has a reliable patient safety record and is a model for hospitals.
C) is constantly alert for systems processes that could lead to errors.
D) reliably reports all patient care errors to the appropriate body.

Question 16

A nurse asks the manager why the nursing staff seems to have the bulk of the responsibility for preventing errors in patient care.The manager explains that the primary reason nurses are best situated to recognize and prevent errors is because they:

A) are leaders on the health care team.
B) have refined communication skills.
C) interact with patients so frequently.
D) provide the majority of risky care.

Question 17

A nursing manager explains to the executive committee that reducing errors requires:

A) disciplining staff members who continue to make errors.
B) focusing on systems problems and not blaming individuals.
C) having an anonymous error reporting procedure for staff.
D) holding individuals responsible for the errors they commit.

Question 18

A hospital has significantly reduced the number of errors and near-miss episodes it has in the past 2 years.An accreditation body visitor might conclude that error and near-miss reductions are most directly related to:

A) remediation of individual employees who make errors.
B) policies and procedures that have been created to avoid problems.
C) facility strategies to detect and address any potential problems.
D) staff education in facility patient safety processes.

Question 19

A nursing manager wants to investigate the best practice research on a specific patient safety issue.The best action by the nursing manager would be to:

A) consult with other facilities to see what their related practices are.
B) convene a work group to develop related policies and procedures.
C) read recent issues of a nursing management journal for research.
D) research the literature, paying special attention to synthesis work.

Question 20

The nurse knows that the primary purpose of the Patient Safety and Quality Improvement Act of 2005 was to:

A) create a government agency that tracks all patient safety problems.
B) encourage sharing of information to promote a culture of safety.
C) mandate patient safety programs and prescribe penalties for errors.
D) require hospitals create quality improvement initiatives for safety.

Question 21

The practicing nurse knows the following factor contributes to more patient injuries and death than the other factors.

A) Communication failures
B) High-technology equipment
C) Medication administration
D) Performing high-risk tasks

Question 22

A nurse applying for a job in a hospital notes that administration promotes accurate and timely reporting of errors and near misses.The facility has a multidisciplinary team to analyze this information as it becomes available and design solutions to identified problems.This nurse could infer that:

A) nurses in this facility have a high degree of ownership in patient safety.
B) nursing staff has been penalized in the past for reporting safety protocol violations.
C) the hospital has had some significant issues with patient safety in the past.
D) this facility's culture would be considered "immature" related to safety.

Question 23

A chief nursing officer (CNO)has implemented a model for teamwork training in the facility.The model seems to be working in some areas but not in others.The best action by the CNO would be to:

A) assess for formal and informal leaders who oppose the plan.
B) inform the staff that teamwork improves safety and is expected.
C) provide more education and training on benefits of the model.
D) rotate staff between areas with different levels of acceptance.

Question 24

A nursing manager for a cardiac unit wishes to improve collaborative teamwork to improve patient care outcomes.Which action by the manager would best accomplish this goal?

A) Create permanent nurse-aide work groups.
B) Formulate nurse-cardiologist work teams.
C) Implement daily multidisciplinary rounds.
D) Require face-to-face reports between nurses.

Question 25

A chief nursing officer (CNO)wishes to integrate the Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS)model of teamwork training into the hospital where the CNO works.The first action by the CNO should be to:

A) design training for onsite trainers.
B) determine readiness for such training.
C) investigate specific training models.
D) pick high-risk areas to start training.

Question 26

The nurse explains that benefits of the Patient Safety and Quality Improvement Act of 2005 include: (Select all that apply.)

A) being able to learn from the mistakes of others.
B) finding trends amenable to quality improvement.
C) financial rewards to facilities that reduce errors.
D) having data that can be aggregated into trends.
E) tax breaks if facilities show quality improvement.

Question 27

The nurse working in health care today understands the ways in which the Patient Affordable Care Act (ACA)will affect patient safety.Which are the ways this is true? (Select all that apply.)

A) Create incentives for hospitals to participate in patient safety organizations (PSOs).
B) Exempt hospitals from participating in the Patient Safety and Quality Improvement Act.
C) Mandate that hospitals begin reporting safety events to patient safety organizations (PSOs).
D) Permit hospitals to discipline employees for safety failures and near misses.
E) Require hospitals establish a patient safety evaluation system.

Question 28

A newly hired graduate nurse is asking the preceptor why the facility uses a standardized template for change-of-shift reports.The preceptor explains that this template is used to:

A) decrease communication failures at a risky time.
B) decrease reports containing frivolous information.
C) ensure all nurses get the same patient information.
D) make it easier for nurses to remember what to say.

Question 29

A nurse is explaining to a student that SBAR is a type of:

A) format for conducting a debriefing.
B) process for multidisciplinary meetings.
C) standardized patient chart template.
D) structured communication strategy.