Question 1

After consulting with practice environments about quality and safety concerns in health care,the Dean of Health Programs at US University develops:

Accepted Answer

Health Professions Education identified that education related to health disciplines in silos leads to compromised communication and inability to function as an integrated whole for patient-centered care.

Question 2

Which philosophical statement would be MOST consistent with that of a learning organization?

Accepted Answer

Learning organizations are committed to the probability of change,to the need to learn,and to maintaining competence to address change.

Question 3

The NQF provides a model for advancement of healthcare quality that could be used in healthcare organizations.Using this model might involve councils or committees that dialogue openly regarding quality and:

Accepted Answer

The NQF included various sectors (government,professional,consumer,business)and disciplines in discussions about quality in health care.

Question 4

As a nurse manager on the West Surgery Unit,you are interested in increasing patient safety on your unit.Your initial focus is on the two encounters that the Chasm series identified as most likely to generate concerns about patient safety.As a result,you initiate which of the following?

Accepted Answer

The Chasm series identified two common occurrences that can compromise patient safety: (1)underlying mental health or substance-use conditions that complicate the basic intervention strategy and (2)medication errors.Awareness of substance use enables caregivers to anticipate potential complications and the need to modify interventions.Falls and respiratory complications arise out of the Nurse-Sensitive Care Standards; ensuring that patients have an understanding of what will happen when surgery is needed reflects the fifth step in Five Steps to Safe Health Care.

Question 5

How would you prepare your unit for a Joint Commission visit?

Accepted Answer

The Joint Commission conducts reviews on an ongoing basis that are directed toward outcomes (such as number of patient falls)and not processes (such as procedure manuals).

Question 6

A survey of safety practices and attitudes at hospital XYZ finds that staff members have concerns about their safety and that of patients.Results from the manager subgroup are likely to be:

Accepted Answer

A study of long-term care facilities found that managers rated the safety culture more positively than staff.

Question 7

During review of back injuries,it is determined that mechanical lifts and transfer belts are not being properly used.In addressing this concern,the unit manager:

Accepted Answer

The IOM report (2004)points to the need to involve nurses in decisions that affect them and the provision of care.

Question 8

Traditional approaches to ensuring patient safety have focused on:

Accepted Answer

The IOM report (2004)identified that traditional practice focused on punishment of the person for errors as compared with a system view of responsibility for errors and solutions.

Question 9

As a patient care advocate,you regularly coach patients as to how to stay safe in health care by educating them about:

Accepted Answer

The five steps to safer health care for patients include keeping a list of medications that patients are taking.

Question 10

As a result of the Joint Commission assessment,a healthcare facility loses it accreditation.What is the primary consequence for this institution?

Accepted Answer

The Joint Commission is a not-for-profit organization that has attained status from the Centers for Medicare and Medicaid.Failure to meet Joint Commission standards is deemed failure to meet CMS sets,which has funding implications.

Question 11

In complying with Crossing the Quality Chasm,you ensure that:

Accepted Answer

Quality care is related to safer patient care,and autonomy in decision making is associated with the factors identified in the report.

Question 12

In an effort to control costs and maximize revenues,the Rehabilitation Unit at Cross Hospital reduces the number of its managers and flattens its organizational structure.Within a year,the number of adverse events on the units has doubled.This may be attributable to:

Accepted Answer

Flattening of the organizational structure has been shown to increase mistrust in organizations while removing clinical leaders who provide support,consultation,and leadership in securing resources and in inspiring standards of excellence.

Question 13

In designing a quality,safe healthcare environment,the primary emphasis needs to be on:

Accepted Answer

Focusing on the patient moves care from concern about who controls care to a focus on what care is provided to and with patients,which was an aim identified in the IOM report,Crossing the Quality Chasm.

Question 14

Before the IOM report was issued,"To err is human" adverse events were considered:

Accepted Answer

The IOM report (2004)highlighted deaths attributable to medical error as more common than was once thought.

Question 15

A logical response to the final step of the STAR Approach to Patient Safety might be to:

Accepted Answer

The final step of the STAR approach is to review how well the task was accomplished.If the task did not meet established standards or did not meet patient needs satisfactorily,a next step might be to refine knowledge and skills.

Question 16

To increase safety in patient care areas of the Valley Hospital,the executive begins by:

Accepted Answer

The IOM report (2004)highlighted the importance of the attendance of the senior nurse executive at board meetings to enhance understanding of issues and opportunities in the system that contribute to safe (or unsafe)nursing practice and patient care.

Question 17

You notice that Sally,a student on your unit,is giving information to an anxious young teen,who seems very uncertain about preparation for an upper GI series.After Sally leaves the room,you ask her how she thought her conversation went and:

Accepted Answer

The Five Steps to Safe Health Care for Patients includes the step of asking questions if there are doubts or concerns.The nurse can encourage patients to take a larger role in care by taking these steps and by providing patients with coaching in the steps.

Question 18

The STAR approach to patient safety encourages:

Accepted Answer

The STAR approach to patient safety emphasizes the following: Stop to concentrate on the task,think about the task,act to accomplish the task (focus activities),and review how well the task has been accomplished (reflection).

Question 19

To achieve nurse-sensitive care standards developed by the NQF,you advocate for which of the following in your health facility?

Accepted Answer

The NQF outlines nursing-centered intervention measures related to smoking cessation,which may require training and education for nurses.

Question 20

On the basis of a review of increased falls with injury and increased restraint use during evening hours,as the unit manager,you most likely would:

Accepted Answer

As a nurse manager,it is your responsibility to challenge any act that is unsafe and to stop actions that are not performed in the patient's best interest.This includes,according to the Nurse-Sensitive Care Standards,ensuring that staffing mixes are appropriate for care provided on each shift.

Quiz 2: Patient Safety