Question 1

The vice president of nursing is curious about the quality performance of the cardiovascular intensive care program as compared with other major city hospitals.Which resource should the vice president use to determine this performance?

Accepted Answer

The National Database of Nursing Quality Indicators (NDNQI) is an appropriate resource to use for determining the quality performance of a cardiovascular intensive care program as compared to other major city hospitals. It is a national database that collects and reports on nursing care quality indicators and benchmarks for hospitals. Comparing the performance of the cardiovascular intensive care program with other hospitals using NDNQI data will provide an accurate comparison.

Question 2

At the completion of orientation the new graduate is completing a written test that focuses on the QSEN competencies.Which statements should the nurse identify as describing these competencies? (Select all that apply. )

Accepted Answer

The QSEN (Quality and Safety Education for Nurses) competencies are a set of six competencies that were developed to improve the quality and safety of healthcare. The competencies include:
A) Minimizing the risk of harm
B) Functioning within interprofessional teams
C) Following time-out protocols as appropriate (this statement refers specifically to surgical time-out protocols, which is just one aspect of the QSEN competencies)
D) Using data to monitor the outcomes of care processes
E) Integrating the best current evidence with clinical expertise. 
Therefore, choices A, B, D, and E all accurately describe the QSEN competencies.

Question 3

The Quality Improvement committee is identifying indicators as measures of health care.What should the committee identify as characteristics of quality indicators? (Select all that apply. )

Accepted Answer

Quality indicators should have readily available data, focus on priority areas, be scientifically acceptable, and useful for decision making. While identifying nurses' roles may be important in some contexts, it is not a necessary characteristic of quality indicators.

Question 4

A client with a nasogastric tube to suction has been prescribed tracheostomy suctioning as needed to maintain airway integrity.While rounding after report the nurse notes that the tubing for the nasogastric suction has been switched with that to be used for the tracheostomy suctioning.How should the charge nurse categorize this error?

Accepted Answer

This error would be categorized as an active error, which is a mistake that occurs at the point where patient care is being delivered. The incorrect connection of the tubing occurred during the delivery of care, making it an active error. Latent errors are those that are present within the system but usually don't result in harm until combined with other factors. Technical errors are mistakes that occur when using equipment or technology. Organizational system errors are issues with policies, procedures, and systems that can lead to mistakes.

Question 5

The quality improvement committee is creating materials to use when implementing Six Sigma into the organization.In which order should the steps of this process be presented to the staff?

Accepted Answer

The first step should be to identify the desired outcomes, followed by collecting data on the defined process to know where to focus improvements. Then, analyze the data of the new processes to determine areas for improvement and identify the process revisions required. Once changes are made, the committee should monitor ongoing improvements to ensure their success.

Question 6

The nurse is completing an occurrence report for a client in the intensive care area.The client's medications were accidentally switched with another client necessitating extending mechanical ventilation.Prior to the occurrence the client's hemodynamic parameters were stable,however they have been tenuous for the last 16 hours.What collected data should the nurse identify as nursing work environment variables that contributed to this occurrence? (Select all that apply. )

Accepted Answer

The answer of The nurse is completing an occurrence report...

Question 7

A major urban hospital is adopting the practices of high reliability organizations.Which behaviors indicate that nursing staff are incorporating these practices? (Select all that apply. )

Accepted Answer

A) Staff development training on algorithms to address system errors demonstrates a focus on high reliability practices and the use of evidence-based guidelines.
C) Nurse manager interceding before an error with intravenous medication occurs is an example of proactive risk mitigation, a key principle in high reliability organizations.
D) The vice president of nursing meeting with staff to learn ways to reduce the incidence of sharps occurrences demonstrates a commitment to continuous improvement and staff involvement in improving safety.
E) Staff nurses analyzing the steps to determine why a client had an adverse reaction in the operating room demonstrates a focus on identifying and addressing underlying system issues rather than just blaming individuals.

Question 8

The director of nursing is searching for information about the Consumer Assessment of Health Plans.Which organization website should the director access for this information?

Accepted Answer

The Agency for Healthcare Research and Quality (AHRQ) provides information about the Consumer Assessment of Healthcare Providers and Systems (CAHPS), which includes health plans.

Question 9

The hospital administrator is considering the implementation of the Lean model as the framework for quality improvement in an organization.In which order should the administrator explain the elements of this model?

Accepted Answer

The Lean model for quality improvement follows a specific sequence: First, identify value from the customer's perspective (A). Next, determine the value stream, mapping out all the steps in the process and eliminating those that do not create value (E). Then, improve the flow of the remaining value-creating steps (B). After that, perfect the process by seeking to eliminate waste and ensure that value flows smoothly (C). Finally, test the new process (D) to ensure that the improvements are effective and sustainable.

Question 10

The Quality Improvement director is reviewing the number of medication errors that occurred in a skilled nursing facility over the last month. The total number of medication doses provided equals 625,500. The total number of medication errors was 7. If using the Six Sigma statistical measure to limit defects to 3.4 per million opportunities, what should be the goal for the number of medication errors for this care area? (Round the answer to the nearest whole number.)

Accepted Answer

The answer of The Quality Improvement director is reviewing the...

Question 11

The staff on a care area expresses dissatisfaction with participating in data collection of quality indicators.What should the manager explain as reasons to measure quality? (Select all that apply. )

Accepted Answer

Measuring quality is essential for several reasons: Pay for performance (A) is increasingly common, where reimbursement rates are tied to the quality of care provided. Public accountability (B) ensures that healthcare providers are responsible for maintaining high standards of care. Driving quality improvement (D) is a core reason for measuring quality, as it identifies areas for enhancement and tracks progress over time. Informing consumer decisions (E) allows patients to make informed choices about their healthcare providers based on quality indicators. While determining staffing needs (C) is important for operational efficiency, it is not a primary reason for measuring quality in the context of the given options.

Question 12

The nurse manager is reviewing an occurrence report written after a client fall.For which personal factors should the manager consider as contributing to this occurrence? (Select all that apply. )

Accepted Answer

The answer of The nurse manager is reviewing an occurrence...

Question 13

A staff nurse accidentally provided a client with an incorrect stock medication,however did not report the occurrence to anyone.What behavior is this staff nurse demonstrating?

Accepted Answer

The answer of A staff nurse accidentally provided a client...

Question 14

The nurse manager is curious as to how the client care staff is meeting process outcomes.On what should the manager focus when making this determination? (Select all that apply. )

Accepted Answer

Process outcomes are related to the methods and procedures used in delivering care, so the manager should focus on work flow, patient education, and tasks and activities.

Question 15

The Shared Governance committee is tasked with creating an approach to introduce Just Culture to the nursing staff.When creating the materials,which duties should be emphasized? (Select all that apply. )

Accepted Answer

The answer of The Shared Governance committee is tasked with...

Question 16

A series of medication errors occurred on a care area and are believed to be caused by the redesign of the unit dose delivery system.Who should the nurse manager expect to participate when conducting a root cause analysis of these occurrences? (Select all that apply. )

Accepted Answer

The answer of A series of medication errors occurred on...

Question 17

The nurse receives the report for a client recovering from a repair of a fractured hip,who is being transferred to the orthopedic care area.The following information was obtained in the telephone report:
Report received 14:00 hours: 76-year-old female;ORIF of right hip caused by falling in the home;receiving Morphine sulfate 2 mg IV every 4 to 6 hours for pain;difficult to keep turned on non-operative site;indwelling urinary catheter in place;Hgb 10 after 2 units PRBCs post-operatively.
Which National Patient Safety goals should the nurse make a priority for this client? (Select all that apply. )

Accepted Answer

The correct answers are focused on preventing health-care associated pressure ulcers (B), reducing the risk of patient harm resulting from falls (D), and reducing the risk of health care-associated infections (E). The patient's difficulty being turned on the non-operative site increases the risk of pressure ulcers. The history of falling that led to the hip fracture indicates a need to reduce the risk of further falls. The presence of an indwelling urinary catheter increases the risk of healthcare-associated infections.

Question 18

During an emergency room visit a client refuses to be admitted because of information learned over the internet about the care of clients with the same health problem.To what should the nurse realize that the client is referring?

Accepted Answer

The client is likely referring to a "report card," which provides information about the quality of care and outcomes for specific health conditions, often available online.

Question 19

The charge nurse is beginning rounds after attending morning report.Which clients should the nurse be concerned for developing a never event? (Select all that apply. )

Accepted Answer

A never event refers to particularly shocking medical errors (such as wrong-site surgery) that should never occur. B) Foul-smelling urine may indicate a catheter-associated urinary tract infection. C) Calf pain after surgery could indicate a deep vein thrombosis. E) A stage III pressure ulcer is a preventable condition that should not occur in a healthcare setting.

Question 20

The staff development trainer is preparing information for a seminar on the Quality and Safety Education for Nurses (QSEN)initiative as part of the National Safety Week celebration.Which attributes should the trainer emphasize as being an integral part of this initiative? (Select all that apply. )

Accepted Answer

The answer of The staff development trainer is preparing information...

Quiz 11: The Nurses Role in Quality and Safety