Deck 8: Safety and Quality Improvement in Professional Nursing Practice

Question 1

How do best practices contribute to quality and safety?

Answer 1

Best practices contribute to quality and safety in numerous ways, creating a framework for organizations to deliver services and products that meet or exceed expectations while minimizing risks to both consumers and staff. Here's how they play a crucial role:

1. **Standardization**: Best practices provide a set of standardized procedures that ensure consistency in operations. This consistency is key to maintaining quality, as it reduces variability in products or services, which can lead to defects or safety issues.

2. **Continuous Improvement**: Best practices often stem from continuous improvement methodologies like Lean or Six Sigma. These methodologies focus on reducing waste and errors, which directly enhances quality and safety by ensuring processes are efficient and effective.

3. **Risk Management**: By following best practices, organizations can proactively identify potential risks and implement measures to mitigate them. This preemptive approach to risk management helps prevent accidents, injuries, and other safety incidents.

4. **Compliance**: Regulatory bodies often establish best practices that organizations must follow to remain compliant with laws and regulations. Compliance ensures that the minimum standards for safety and quality are met, protecting consumers and employees.

5. **Training and Competence**: Best practices include comprehensive training programs that ensure employees are competent and knowledgeable about their roles. Well-trained employees are less likely to make mistakes that could compromise quality or safety.

6. **Benchmarking**: Best practices allow organizations to benchmark their performance against industry standards or competitors. This benchmarking can highlight areas for improvement in quality and safety, driving organizations to strive for excellence.

7. **Accountability**: When best practices are in place, there is a clear expectation for performance. This accountability ensures that all members of an organization understand their role in maintaining quality and safety, and they are more likely to adhere to the established protocols.

8. **Customer Satisfaction**: Implementing best practices often leads to higher quality products and services, which in turn increases customer satisfaction. Satisfied customers are likely to be repeat customers, and they may also provide positive referrals.

9. **Reputation Management**: Organizations known for following best practices and delivering high-quality, safe products and services are likely to have a strong reputation in their industry. This reputation can be a significant competitive advantage.

10. **Cost Savings**: While implementing best practices may require an initial investment, over time, they can lead to significant cost savings by reducing the need for rework, decreasing waste, avoiding accidents, and preventing costly legal issues related to non-compliance or safety failures.

In summary, best practices are integral to ensuring that organizations operate in a manner that prioritizes high quality and safety. They provide a structured approach to business processes that can lead to improved performance, customer satisfaction, and a better bottom line, all while safeguarding the well-being of consumers and employees.

Question 2

How can the commitment to quality improvement be integrated throughout all roles and at all levels of professional nursing practice?

Answer 2

The commitment to quality improvement can be integrated throughout all roles and at all levels of professional nursing practice by creating a culture of continuous improvement. This can be achieved by providing ongoing education and training on quality improvement principles and practices for all nursing staff, from entry-level nurses to nurse leaders. Additionally, incorporating quality improvement initiatives into performance evaluations and setting clear expectations for all staff to actively participate in identifying and addressing areas for improvement can help to ensure that the commitment to quality improvement is ingrained in the nursing practice at all levels. Furthermore, fostering open communication and collaboration among all members of the healthcare team can facilitate the sharing of best practices and the implementation of evidence-based quality improvement strategies. By making quality improvement a priority and providing the necessary support and resources, nursing professionals can work together to continuously enhance the quality of care provided to patients.

Question 3

A nurse is caring for a patient admitted to an acute care unit who is experiencing a sickle cell crisis. Which activity required of the nurse to meet the Joint Commission's National Patient Safety Goals?

A) Identify the patient correctly.
B) Use alarms safely.
C) Reduce surgical mistakes.
D) Identify the patient correctly and reduce surgical mistakes.
E) Identify the patient correctly and use alarms safely.

Answer 3

E

Question 4

A nurse discovers that a patient returning to the unit received the wrong procedure. The nurse should report this sentinel event. Which of the following are also included in the Joint Commission list of sentinel events?

A) Medication errors
B) Criminal events
C) Natural disaster events
D) Medication errors and natural disaster events
E) Medication errors and criminal events

Question 5

Which organization has linked quality indicators and safety in health care to hospital payment?

A) The Joint Commission
B) National Quality Forum
C) Centers for Medicare and Medicaid Services
D) Institute of Medicine

Question 6

Which of the following publications introduced performance expectations to create a system where patients are assured safe, timely, effective, efficient, equitable, and patient-centered care?

A) Crossing the Quality Chasm: A New Health System for the 21st Century
B) Keeping Patients Safe: Transforming the Work Environment of Nurses
C) Preventing Medication Errors: Quality Chasm Series
D) To Err Is Human: Building a Safer Health System
E) None of these is correct.

Question 7

The nurse should provide health services for individuals that increase the likelihood of desired health outcomes and are consistent with current professional knowledge. Which term best describes this type of care?

A) Safety
B) Quality
C) Effective
D) Patient-centered
E) Timely

Question 8

Which competencies that the nurse practicing according to the American Nurses Association (ANA) standard of professional performance should possess to contribute to quality nursing practice?

A) Collecting data to monitor quality
B) Collaboration to implement quality improvement plans
C) Cooperation in quality improvement endeavors
D) Cooperation in quality improvement endeavors and collaboration to implement quality improvement plans
E) Collecting data to monitor quality and collaboration to implement quality improvement plans

Question 9

Which of the following refers to the process in which data is compared to determine performance level and uses a systematic method to identify a problem, select best practices, determine how best practice fits the unit or organization, initiate a change process, and evaluate outcomes?

A) Continuous quality improvement
B) Benchmarking
C) Data standardization
D) Medical record audit
E) None of these is correct.

Question 10

Which pathway in the quality improvement process should the nurse consider?

A) Analysis of data that is regularly collected and monitored
B) Set time to collect and analyze data every three years for accreditation
C) Identification of a problem outside of the routine data monitoring system
D) Analysis of data that is regularly collected and monitored and set time to collect and analyze data every three years for accreditation
E) Analysis of data that is regularly collected and monitored and identification of a problem outside of the routine data monitoring system

Question 11

Which current data collection efforts reflects the contribution of nursing to patient outcomes?

A) National Database of Nursing Quality Indicators
B) CAHPS Hospital Survey
C) National Voluntary Consensus Standards for Nursing-Sensitive Care
D) All of these are correct.
E) None of these is correct.

Question 12

Which data set is a repository for unit-level nursing-sensitive indicators?

A) National Database of Nursing Quality Indicators
B) CAHPS Hospital Survey
C) National Voluntary Consensus Standards for Nursing-Sensitive Care
D) All of these are correct.
E) None of these is correct.

Question 13

Which of the following questions related to nursing are included in the HCAHPS survey?

A) How often did nurses treat you with courtesy and respect?
B) How often did nurses listen carefully to you?
C) How often did nurses explain things using jargon?
D) How often did nurses listen carefully to you and how often did nurses explain things using jargon?
E) How often did nurses treat you with courtesy and respect and how often did nurses listen carefully to you?

Question 14

A nurse and the hospital where the nurse is employed are committed to providing equitable care. Select the characteristics of the care provided.

A) Care that does not vary in quality based on characteristics such as ethnicity, gender, socioeconomic status, or geographic location
B) Care based on evidence to all who could benefit and refraining from providing services to those not likely to benefit
C) Care that avoids waste
D) Care that is responsive to patient preferences, needs, and values
E) All of these are correct.

Question 15

Nurses are involved in quality improvement initiatives at all levels of practice. Select the focus of quality improvement for the nurse.

A) Processes
B) Satisfaction
C) Cost outcomes
D) All of these are correct.
E) None of these is correct.

Question 16

Crossing the Quality Chasm: A New Health System for the 21st Century outlined rules for redesign of the healthcare system. Select the rules for redesign included in the report.

A) The physician is the source of control.
B) Decision making is evidence based.
C) Care is based on continuous healing relationships.
D) The physician is the source of control and decision making is evidence based.
E) Care is based on continuous healing relationships and decision making is evidence based.