Deck 10: Improving Organizational Performance

Question 1

When using the DMAIC acronym of the Six Sigma quality process improvement model,the nurse understands that the D (define)refers to:

A)The cost of getting a new MRI machine.
B)The patients and their families.
C)The number of dollars in donations.
D)The number of dollars spent on charity.

Answer 1

The patients and their families.

Question 2

Risk management is a hospital program organized to prevent the incidences of preventable accidents,injuries,and errors.Which of the following situations would a hospital risk manager need to investigate?

A)A patient breaks his wrist from a fall caused by a wet floor.
B)A patient receives a dose of subcutaneous heparin 1 hour later than scheduled.
C)A patient who is NPO is not given her morning medications.
D)A patient who is allergic to shellfish is given preprocedure medications to reduce his risk for allergic reaction to the dye being used in the procedure.

Answer 2

A patient breaks his wrist from a fall caused by a wet floor.

Question 3

What is the best method for hospitals to track patient satisfaction?

A)Family buys chocolates for each shift.
B)Family speaks to the charge nurse about how unhappy they are with a particular employee.
C)Family writes a letter to the unit and to the chief nurse officer to thank the staff for providing care and compassion even though their family member died.
D)Patient completes a patient survey after returning home from the hospital.

Answer 3

Patient completes a patient survey after returning home from the hospital.

Question 4

When using the DMAIC acronym of the Six Sigma quality process improvement model,the nurse understands that the I (improve)refers to:

A)Identification of the start and stop dates.
B)Comparison of data to customer surveys.
C)Use of technology to design improvements.
D)Staff training.

Question 5

Patient satisfaction surveys include questions about quality of care.What has the greatest impact on patient satisfaction?

A)Responsiveness of staff
B)Getting pain medication on time
C)Being allowed to go outside to smoke a cigarette
D)The race and gender of the nurses

Question 6

The National Patient Safety Goals of The Joint Commission ( TJC )are established goals to reduce the risks for injuries to patients and provide a safe environment.Which practice has been instituted as a result of these goals established by TJC?

A)Use of the automatic medication dispenser equipment
B)Handwashing to prevent infections
C)Provision of patient information to the nurse covering for breaks
D)Use of two patient identifiers when providing care or treatments

Question 7

What area is included when risk management explores the prevention of accidents,injuries,and errors?

A)Financial risk
B)Quality of care
C)Employee management
D)Employee promotion

Question 8

A unit secretary mistakenly enters the wrong medication into the MAR when transcribing orders.After a root cause analysis,it is determined that the cause is the illegibility of the physician's order.Which measure should be taken to prevent future incidences?

A)The physician is required to carry a typewriter with him to type the orders onto the order sheet.
B)The physician must either write legibly or orders will not be transcribed.
C)The unit secretary must receive more training on transcribing orders.
D)Introduction of a computer entry system for all physician orders will be instituted.

Question 9

A sentinel event is usually one that results in an unexpected outcome for the patient and "signals" the need for investigation and response.Which of the following would be considered a sentinel event?

A)A patient with a brain tumor who falls and breaks his wrist after trying to get up by himself
B)A 32-year-old woman with no significant health history who dies in the operating room during an elective surgical procedure
C)A patient who self-extubates after cardiac surgery
D)A patient who is given the wrong bolus of heparin that is corrected with the first prothrombin time

Question 10

"Lean culture" is a term used for the principle of eliminating waste.Which illustrates the principle that nurses must do more with less?

A)Assigning the night shift RN to restock the rooms.
B)Employing a staff member to stock all patient rooms for frequently used supplies.
C)Assigning all nurses to restock their rooms every day.
D)Placing all frequently used supplies in a central location.

Question 11

The National Database of Nursing Quality Indicators (NDNQI)has established which of the following goals to assist nurses to make practice changes in order to benefit patients?

A)Patient satisfaction
B)Employee satisfaction
C)Unit-specific measures
D)Medication errors

Question 12

When using the DMAIC acronym of the Six Sigma quality process improvement model,the nurse understands that the M (measure)refers to:

A)The development of a data collection plan.
B)Determination of the average LOS.
C)Determination of the average wages.
D)Determination of the ethnicity of admissions.

Question 13

What benchmarks might be expected to be measured for hospital performance? Select all that apply.

A)Average length of hospital stay for cardiac surgery
B)Total admissions for cardiac surgery
C)Infection rates for cardiac surgery
D)Length of surgery
E)Deaths by surgeon

Question 14

A sentinel event is usually one that results in an unexpected outcome for the patient and "signals" the need for investigation and response.Which of the following would be considered a sentinel event?

A)A patient who requires a left leg amputation after developing an arterial occlusion at the access site
B)An elderly patient who falls after trying to get up by herself
C)A patient who receives two doses of amiodarone because the nurse did not chart the first one
D)A patient whose peripheral pulses have not been checked for 2 hours after he returns from a cardiac catheterization

Question 15

A nurse is learning about quality improvement measures taken by the hospital.Root cause analysis is a process for identifying the cause of an error.What is the greatest benefit to establishing the root cause?

A)Prevention of future similar incidents
B)Identification of the responsible person
C)Allows corrective action to be taken
D)Identification of cause

Question 16

Hospital performance improvement standards are primarily focused on the ability of the hospital to:

A)Meet the goals established by the regulating bodies.
B)Develop an atmosphere that meets and exceeds the expectations of the customers and staff.
C)Be known in the community for good care.
D)Provide a shelter for people in a disaster.

Question 17

Which of these is a measured outcome from a performance improvement process perspective?

A)Overtime hours worked by the RNs
B)Identifying the responsible person for a patient's fall
C)Sternal infection rates in cardiac surgery patients
D)Method of shift report

Question 18

The Joint Commission ( TJC )tracks core measures for performance.Which core measures are tracked by TJC? Select all that apply.

A)Heart failure
B)Ventilator days
C)Scheduled sedation vacation
D)Acute myocardial infarction
E)Childhood asthma

Question 19

A nurse has administered the wrong medication to a patient.In investigating the root cause of the error,it is discovered that the nurse was unfamiliar with the medication and that the Pyxis was incorrectly loaded with the wrong medication.What should be the outcome of this process?

A)The nurse should be educated on this medication.
B)Pharmacy should develop a second check of medications prior to loading in the Pyxis.
C)The nurse will not be allowed to pass medications without supervision until deemed safe.
D)An incident report will be completed.

Question 20

A sentinel event is usually one that results in an unexpected outcome for the patient and "signals" the need for investigation and response.Which of these situations would be considered a sentinel event?

A)Patient dies because there is no bed available in the ICU.
B)Patient receives an incorrect dose of medication.
C)Patient consents to be terminally weaned.
D)A patient's family is upset with a physician's approach.