Deck 12: Monitoring Outcomes and Use of Data for Improvement

Question 1

When reviewing outcome measurement for clinical use,the reviewers must understand that the data:

A)Identify the improvement required.
B)Identify the cause of the problem.
C)Identify questions to be asked.
D)Identify the results only.

Answer 1

Identify the results only.

Question 2

One of three benefits to using data from patient satisfaction surveys is:

A)Having more free time to spend at the patient's bedside.
B)An increase in number of student nurses.
C)An increase in patient involvement in care.
D)Spending less time spent in charting.

Answer 2

An increase in patient involvement in care.

Question 3

Data provided by studies on patients with community-acquired pneumonia (CAP)have influenced the standards of practice for those patients.Which order should the nurse anticipate on the standard orders as a result of initiatives developed through clinical studies?

A)Obtaining blood cultures within 4 hours of arrival at the hospital
B)Administering antibiotics within 4 hours of arrival at the hospital
C)Administration of aspirin on arrival to the hospital
D)Administration of oxygen at 4 L per nasal prongs

Answer 3

Administering antibiotics within 4 hours of arrival at the hospital

Question 4

What information obtained from hospital data collection can be used for staffing purposes?

A)Patient satisfaction
B)Staff competency
C)Best practice
D)Use of agency nurses

Question 5

What are the benefits to the organization from greater patient satisfaction?

A)Fewer malpractice suits
B)Lower acuity
C)Higher employee benefits
D)Fewer call lights to solve

Question 6

Which of the following data are most important for the nurse to consider when providing care to patients?

A)Best practice standards of care
B)The nurse's personal beliefs and practices
C)Physician specific standing orders
D)Outcomes from previous similar patients

Question 7

Which order should the nurse anticipate on a standard order for community-acquired pneumonia as a result of evidence-based practice research?

A)Administration of antibiotics ASAP
B)Obtain blood cultures prior to antibiotic administration
C)Obtain blood gases
D)Admit patient to an intensive care unit

Question 8

What measure should be taken when patient satisfaction survey results are not as good as expected?

A)Understand there has been a lot of turnover recently.
B)Involve staff in decision-making changes for improvement.
C)Fault the bad weather last quarter that affected staffing.
D)Explain that the physician surgical outcomes were less than expected.

Question 9

Which is a priority action by the nurse when a patient is admitted with a diagnosis of acute myocardial infarction?

A)Administration of antibiotics within 4 hours
B)Chest radiograph
C)Administration of aspirin on arrival
D)Administration of a beta-blocker on arrival

Question 10

The best method for providing information regarding patient satisfaction surveys to the staff is by:

A)Emailing results to all employees.
B)Making an announcement at the next staff meeting
C)Providing results from the most current survey.
D)Providing comparison of current results with previous performance results.

Question 11

Smoking advice/counseling is considered best practice during the admission of patients for acute myocardial infarction.The nurse understands that the best explanation for this standard is that:

A)The nicotine in cigarettes is a powerful vasoconstrictor.
B)The cigarettes' effects on the lungs may interfere with oxygenation.
C)Stopping smoking is one of the recommended behavior modifications for patients with cardiovascular disease.
D)Cigarettes are addictive.

Question 12

What information obtained from hospital data collection can be used for administrative purposes?

A)Unit-specific measures
B)Staffing ratios
C)Turnover
D)Evidence-based practice

Question 13

Which hospital data collection result will most likely affect nursing practice?

A)Changes in staffing patterns
B)Changes in patient acuity
C)Introduction of the needleless system
D)Changes to the interview process

Question 14

Core measures identified by The Joint Commission include standard orders regarding care and data collection for:

A)Infection rates.
B)Community-acquired pneumonia admission rates.
C)Rates of smokers admitted with acute myocardial infarction.
D)Rates of smokers admitted with hypertension.

Question 15

One of the best indicators of clinical performance can be attributed to:

A)Yearly census.
B)Patient satisfaction surveys.
C)Employee satisfaction surveys.
D)Staff turnover.

Question 16

What information obtained from hospital data collection can be used for patient improvement?

A)Infection rates
B)Employee satisfaction
C)Best practice
D)Overtime costs

Question 17

Utilization of data collected from the four nursing domains can influence:

A)Staff assignments.
B)Pass rate on basic life support (BLS).
C)Patient length of stay.
D)Medication reconciliation.

Question 18

Administration of an aspirin on arrival to the emergency department of patients with an acute myocardial infarction (AMI)is considered a best practice standard of care because of the outcomes data collected by the American Heart Association/American College of Cardiology.Which of the following actions by the nurse would require an intervention based on the standards of care practiced by all institutions?

A)Obtaining an ECG
B)Placing oxygen per nasal prongs on the patient
C)Obtaining cardiac enzymes
D)Failing to ask about allergies prior to administering aspirin

Question 19

Nurses recognize that the use of beta-blockers within 24 hours of emergency department arrival for a patient with acute myocardial infarction is a standard of care established by health care regulating agencies based on which known action of this medication?

A)Beta-blockers are antihypertensives.
B)Beta-blockers reduce the workload of the heart.
C)Beta-blockers reduce the heart rate.
D)Beta-blockers reduce the patient's chest pain.

Question 20

The standard for best practice recommended by The Joint Commission for acute myocardial infarction includes administration of aspirin on emergency department arrival based on data supporting what medication action?

A)Aspirin will decrease the size of the heart blockage.
B)Aspirin will prevent platelet aggregation.
C)Aspirin will decrease the pain level.
D)Aspirin will prevent deep venous thrombosis.

Question 21

Which of The Joint Commission ( TJC )core measures would the nurse expect to see used on a postoperative surgical area?

A)Standards for dressing changes
B)Standards for deep venous thrombosis prophylaxis
C)Standards for patient-controlled analgesia
D)Standards for atelectasis prevention

Question 22

Which are benefits to the organization are acquired from greater patient satisfaction?

A)Higher employee satisfaction
B)Lower acuity
C)Higher employee benefits
D)Fewer call lights to solve

Question 23

An example of The Joint Commission core measures would be for the prevention of deep venous thrombosis postoperatively.Which patient would not need prophylaxis postoperatively?

A)A postoperative open-heart surgery patient who is on a ventilator
B)A postoperative total-hip replacement patient who does not get out of bed
C)A postoperative liver transplant patient who is on bed rest because of pneumonia complication
D)A postoperative appendectomy patient who ambulates with his mother three times a day

Question 24

What are the benefits to the organization from greater patient satisfaction? Select all that apply.

A)Improvement in quality of patient care
B)Lower patient acuity
C)Lower mortality rates
D)Improved retention
E)Establishing benchmarks against other institutions

Question 25

Which of The Joint commission ( TJC )core measures would the nurse expect to see used on a nursing unit?

A)Reduction of falls
B)Tracking of unnecessary DNR ( do not resuscitate )
C)Staffing ratios
D)Nurse practitioner prescriptive authority

Question 26

Patient satisfaction surveys may provide information on the clinical performance of the unit as well as the institution.Which areas are included for data collection? Select all that apply.

A)Accessibility of services
B)Number of staff per shift
C)Communication
D)Quality of care
E)Recognition of physician in community
F)Continuity

Question 27

Standards for best practice recommend deep venous thrombosis prophylaxis for all patients admitted to the hospital.The admitting diagnosis and changes in conditions influence the protocol to be used.Which of the following is recommended for patients with coagulopathies?

A)Heparin 5000 units subcutaneously every 8 hours
B)Sequential compression devices
C)Enoxaparin (Lovenox)40 mg daily
D)No prophylaxis for ambulatory patients