Question 1

Areas in which nurses can make quality improvement efforts that have a positive impact include:
A) Direct care processes
B) Healthcare financing
C) Shifting organizational cultures from toxic to healthy
D) Teaching methods in nursing education
E) All of the above

Accepted Answer

Nurses can make quality improvement efforts in various areas, including direct care processes, by implementing evidence-based practices to improve patient outcomes. They can influence healthcare financing by participating in policy development and advocating for cost-effective care. Nurses can also play a crucial role in shifting organizational cultures from toxic to healthy by promoting a positive work environment and teamwork. Additionally, they can improve teaching methods in nursing education by incorporating innovative and effective teaching strategies. Therefore, all the options listed are areas where nurses can make significant quality improvement efforts.

Question 2

Calling upon nurses to be positive agents of change arises from the recognition of all of the following things about nurses EXCEPT:
A) They are the largest workforce in healthcare
B) They are predominantly women
C) They have indispensable knowledge and skills
D) They are present at every interface of healthcare delivery

Accepted Answer

The call for nurses to be positive agents of change is based on their professional capabilities, presence across the healthcare delivery spectrum, and their numbers in the workforce, not their gender composition.

Question 3

The IOM report The Future of Nursing: Leading Change, Advancing Health contained all of the following messages about the roles nurses should play EXCEPT:
A) Be full partners, with physicians and other healthcare professionals, in redesigning healthcare in the United States
B) Maintain command-and-control management over nurse assistants
C) Achieve higher levels of education
D) Practice to the full extent of their training and education

Accepted Answer

The IOM report emphasizes collaboration, education, and practicing to the full extent of their abilities for nurses, not maintaining command-and-control management over nurse assistants.

Question 4

The Transforming Care at the Bedside (TCAB) program resulted in nurses doing all of the following EXCEPT:
A) Spreading successful methods to other departments
B) Generating ideas for solutions
C) Resorting to tried-and-true methods
D) Identifying problems

Accepted Answer

The Transforming Care at the Bedside (TCAB) program encourages innovation and the generation of new ideas rather than merely resorting to tried-and-true methods.

Question 5

Ethical contradictions that nurses have regarding what they can share with patients regard all of the following EXCEPT:
A) Company operations
B) Unsafe medical practices
C) Names of staff members
D) Poor staffing

Accepted Answer

The answer of Ethical contradictions that nurses have regarding what...

Question 6

The purpose behind the creation of the Quality and Safety Education for Nurses (QSEN) Institute was to:
A) Prepare future nurses to continuously improve quality and safety of healthcare systems
B) Promote relationships between nursing faculty and educators within other healthcare disciplines
C) Ensure nurses gain knowledge, skills, and attitudes that will support their role as positive change agents in their places of employment
D) Both A and C

Accepted Answer

The Quality and Safety Education for Nurses (QSEN) Institute was established to prepare future nurses with the competencies necessary to continuously improve the quality and safety of the healthcare systems within which they work. This includes ensuring nurses gain the requisite knowledge, skills, and attitudes to act as positive change agents in their workplaces, which are covered in both options A and C.

Question 7

Quality improvement refers to any changes in the delivery of care that focus on doing a better job of:
A) Making sure care is safe, equitable, and patient-centered
B) Ensuring care is timely, efficient, and effective
C) Meeting the six aims promoted by the Institute of Medicine
D) All of the above

Accepted Answer

Quality improvement in healthcare focuses on enhancing various aspects of patient care, including safety, equity, patient-centeredness, timeliness, efficiency, and effectiveness. These aspects align with the six aims for improvement outlined by the Institute of Medicine (IOM), making all the options correct in the context of quality improvement efforts.

Question 8

All of the following about the plan-do-study-act (PDSA) model as a method of quality improvement are true EXCEPT:
A) Changes can be made on a small scale.
B) PDSA should be used primarily by nurse managers.
C) PDSA was made popular by W. Edward Demings.
D) Impact of change can be determined quickly.

Accepted Answer

The PDSA (Plan-Do-Study-Act) model is a widely used method for quality improvement in various settings, not just by nurse managers. It encourages all team members to contribute to the improvement process, making it a collaborative effort rather than being limited to a specific role or position.

Question 9

Questions that should precede the plan-do-study-act (PDSA) process include:
A) What is wrong with our current system?
B) What are we trying to accomplish?
C) How will we know if a change is an improvement?
D) Both B and

Accepted Answer

Questions that should precede the PDSA process include understanding what the team is trying to accomplish and how they will know if a change is an improvement. These questions help set clear goals and measurable outcomes for the process.

Question 10

Implementing the action plan on a pilot basis and installing an ongoing measuring/monitoring system to ensure success represents which step in the focus-analyze-develop-execute (FADE) model for quality improvement?
A) Focus
B) Analyze
C) Develop
D) Execute

Accepted Answer

The Execute step in the FADE model involves putting the developed plan into action on a pilot basis and setting up systems for ongoing measurement and monitoring to ensure the plan's success.

Question 11

Ideas for quality improvement in healthcare that will address core problems that everyone faces include:
A) Ask for and give help.
B) Remember that patients don't want to be patients.
C) Treat patients and families as you would want to be treated.
D) Do not forget your power.
E) All of the above

Accepted Answer

The answer of Ideas for quality improvement in healthcare that...

Question 12

A learning organization can be described as all of the following EXCEPT:
A) An organizational culture that embraces ongoing change and improvement
B) A place where staff are engaged with the purpose of what truly works best for the safest delivery of care
C) A facility in which change and quality improvement are unrelated
D) An environment in which a deliberate commitment to learning is made

Accepted Answer

A learning organization is characterized by its commitment to ongoing improvement, engagement with staff towards effective and safe care delivery, and a deliberate commitment to learning. The statement that change and quality improvement are unrelated contradicts the fundamental principles of a learning organization, which sees change as integral to quality improvement.

Question 13

Senge's concepts about learning organizations, continuing education, sharing ideas, and listening respectfully to others are most strongly associated with:
A) Personal mastery
B) Mental model
C) Shared vision
D) Team learning

Accepted Answer

The answer of Senge's concepts about learning organizations, continuing education,...

Question 14

Changing an organizational culture from toxic to healthy:
A) May take years to accomplish
B) Involves leaving old perceptions, behaviors, and attitudes behind
C) Requires creating a safe environment for change
D) All of the above

Accepted Answer

Changing an organizational culture from toxic to healthy is a complex process that may take years, involves leaving old perceptions, behaviors, and attitudes behind, and requires creating a safe environment for change.

Question 15

Leaders who are learning to share power and staff members who are learning to take on more power during a culture change must learn to deal with:
A) Dependency
B) Vulnerability
C) Technology
D) All of the above

Accepted Answer

During a culture change, both leaders and staff members must learn to deal with vulnerability. This is because sharing and taking on more power involves trust and openness to new ways of working, which can make individuals feel exposed or uncertain. Dependency and technology might be relevant in some contexts, but vulnerability is the key issue when it comes to adjusting power dynamics.

Question 16

New nurses should expect to be treated respectfully by all seasoned nurses while also keeping in mind that many seasoned nurses may:
A) Have been treated disrespectfully
B) Have witnessed much heartache and grief
C) Try to seek validation of their own bad experiences by exposing new nurses to similar ones
D) All of the above

Accepted Answer

Seasoned nurses have likely experienced disrespect, witnessed heartache and grief, and some may inadvertently seek validation for their experiences by exposing new nurses to similar challenges. This encompasses the complexity of the nursing environment and the importance of understanding and empathy in these professional relationships.

Question 17

Which of the following characteristics, adapted from the IOM publication Best Care and Lower Cost: The Path to Continuously Learning Healthcare in America, are necessary in order to achieve a continuously learning healthcare organization? Select all that apply.
A) Elimination of urgent care wait times
B) Patient and clinician partnerships
C) Longer clinical rotations for nursing students
D) Shorter clinical internships for medical students
E) Science and informatics
F) Incentives that are aligned with improvement goals
G) Leadership committed to a continuously learning culture

Accepted Answer

Patient and clinician partnerships, science and informatics, aligned incentives, and committed leadership are key characteristics for a continuously learning healthcare organization.

Question 18

Which of the following are necessary for creating a safe environment for effective communication and collaboration? Select all that apply.
A) Creation of a list of implicit rules desired
B) A clear and compelling vision of what the environment will look like
C) Acknowledgement of inappropriate behaviors
D) A list of explicit and consistent expectations for behavior
E) Termination of staff at the first signs of poor conduct
F) Opportunities for training and practicing communication skils
G) Ongoing enforcement of good conduct

Accepted Answer

Creating a safe environment for effective communication and collaboration involves having a clear and compelling vision (B) to guide behavior, acknowledging inappropriate behaviors (C) to address and correct them, setting explicit and consistent expectations for behavior (D) to ensure everyone understands the rules, providing opportunities for training and practicing communication skills (F) to improve team interactions, and ongoing enforcement of good conduct (G) to maintain a positive environment. Implicit rules (A) can be too vague to be effective, and terminating staff at the first signs of poor conduct (E) can be too extreme and does not allow for growth or improvement.

Question 19

Nurses who practice effective communication and understand their roles as potential change agents will be better prepared for initiating, supporting, and evaluating ongoing quality improvement efforts.

Accepted Answer

Effective communication and understanding of their roles as potential change agents equip nurses with the necessary skills to initiate, support, and evaluate quality improvement efforts, leading to enhanced patient care and outcomes.

Question 20

The language used in the IOM publication Best Care and Lower Cost: The Path to Continuously Learning Healthcare in America differs from Senge's five disciplines, but the implications involving effective communication, empowered change agents, and collaborative care are similar.

Accepted Answer

Both the IOM publication and Senge's five disciplines, despite their different language and contexts, emphasize the importance of effective communication, empowering individuals to drive change, and fostering collaboration in order to improve outcomes, which in the context of healthcare translates to better care and lower costs.

Quiz 12: Change Agents, Quality Improvement, and the Learning Organization

Areas in which nurses can make quality improvement efforts that have a positive impact include:

Calling upon nurses to be positive agents of change arises from the recognition of all of the following things about nurses EXCEPT:

The IOM report The Future of Nursing: Leading Change, Advancing Health contained all of the following messages about the roles nurses should play EXCEPT:

The Transforming Care at the Bedside (TCAB) program resulted in nurses doing all of the following EXCEPT:

Ethical contradictions that nurses have regarding what they can share with patients regard all of the following EXCEPT:

The purpose behind the creation of the Quality and Safety Education for Nurses (QSEN) Institute was to:

Quality improvement refers to any changes in the delivery of care that focus on doing a better job of:

All of the following about the plan-do-study-act (PDSA) model as a method of quality improvement are true EXCEPT:

Questions that should precede the plan-do-study-act (PDSA) process include:

Implementing the action plan on a pilot basis and installing an ongoing measuring/monitoring system to ensure success represents which step in the focus-analyze-develop-execute (FADE) model for quality improvement?

Ideas for quality improvement in healthcare that will address core problems that everyone faces include:

A learning organization can be described as all of the following EXCEPT:

Senge's concepts about learning organizations, continuing education, sharing ideas, and listening respectfully to others are most strongly associated with:

Changing an organizational culture from toxic to healthy:

Leaders who are learning to share power and staff members who are learning to take on more power during a culture change must learn to deal with:

New nurses should expect to be treated respectfully by all seasoned nurses while also keeping in mind that many seasoned nurses may:

Which of the following characteristics, adapted from the IOM publication Best Care and Lower Cost: The Path to Continuously Learning Healthcare in America, are necessary in order to achieve a continuously learning healthcare organization? Select all that apply.

Which of the following are necessary for creating a safe environment for effective communication and collaboration? Select all that apply.

Nurses who practice effective communication and understand their roles as potential change agents will be better prepared for initiating, supporting, and evaluating ongoing quality improvement efforts.

The language used in the IOM publication Best Care and Lower Cost: The Path to Continuously Learning Healthcare in America differs from Senge's five disciplines, but the implications involving effective communication, empowered change agents, and collaborative care are similar.