Question 1

The Institute of Medicine (IOM) uses two dimensions in the quality matrix to describe quality. Which factors are included in the first dimension? Select all that apply.

Accepted Answer

1. The first dimension focuses on the delivery of healthcare and includes factors such as patient-centeredness, safety effectiveness, and timeliness.
2. The first dimension focuses on the delivery of healthcare and includes factors such as patient-centeredness, safety effectiveness, and timeliness.
3. The first dimension focuses on the delivery of healthcare and includes factors such as patient-centeredness, safety effectiveness, and timeliness.
4. The second dimension of quality focuses on the consumer perspective of healthcare needs and includes staying healthy, getting better, living with illness or disability, and coping with palliative or end-of-life issues.
5. The second dimension of quality focuses on the consumer perspective of healthcare needs and includes staying healthy, getting better, living with illness or disability, and coping with palliative or end-of-life issues.

Question 2

Which statements regarding the Consumer Bill of Rights, Protections, and Responsibilities are accurate? Select all that apply.

Accepted Answer

1. This was the commission's first subcommittee's purpose.
2. Patient privacy and confidentiality was considered by this committee.
3. This is a true statement. This is really the only element of this commission's work that has not been successful.
4. The work included consideration of coverage, choice of practitioners, privacy and confidentiality, disclosure of practitioner qualifications, and external appeals processes.
5. This element of the commission's work has not been successful.

Question 3

The nurse commits an error while caring for a patient who receives Medicare benefits. The error results in a complication that is on the Centers for Medicare and Medicaid Services' "never list." What is the implication of this error?

Accepted Answer

1. The occurrence of a "never event" does not necessitate investigation by the Board of Nursing. These events are usually related to failure of a system, rather than individual failure.
2. There is no requirement to terminate the nurse's employment.
3. This is the Medicare rule. The cost of caring for the complication will not be covered.
4. The patient cannot be billed for this cost and Medicare will not cover the cost of this care. The cost must be absorbed by the healthcare organization.

Question 4

What has been the historical importance of the Institute of Medicine (IOM) reports since 1999?

Accepted Answer

1. The IOM reports stimulated the development of strategies that will improve quality of care.
2. Accrediting of healthcare organizations and establishing minimum standards are the responsibilities of The Joint Commission.
3. Accrediting of healthcare organizations and establishing minimum standards are the responsibilities of The Joint Commission.
4. Supporting research designed to improve healthcare outcomes and quality is the focus of the Agency for Healthcare Research and Quality.

Question 5

The nurse works with breast cancer survivors in a "Reach for Recovery" program. Which portion of the Institute of Medicine's (IOM) focus on quality care does this work represent?

Accepted Answer

1. Staying healthy means that the individual needs to get healthcare to stay well and avoid illness.
2. Getting better requires that the patient reach for recovery.
3. Living with illness or disability acknowledges that some health problems cannot be cured, and then the individual needs assistance in learning how to manage and cope long-term.
4. Coping with palliative care or end-of-life issues requires that individuals need support and care during terminal stages of illness. Families and caregivers are also involved in each of these consumer components of healthcare.

Question 6

Which information would be used to monitor the process element of a hospital's quality?

Accepted Answer

1. This is a structure or input monitor.
2. This is an output monitor.
3. This is a structure or input monitor.
4. This is a process monitor.

Question 7

The patient develops postoperative pneumonia when the physician fails to order respiratory therapy treatments after surgery. Which type of quality problem does this situation most clearly represent?

Accepted Answer

1. Misuse is an unavoidable complication that prevents patients from receiving full potential benefit of a service.
2. This could possibly be an error in planning, but there is no indication that the physician did not plan to order the treatments. It most clearly represents underuse.
3. This is most clearly an underuse problem or failure to provide a service that would have produced a favorable outcome for the patient.
4. This is not one of the types of error discussed in the text.

Question 8

Which phrase best explains the Institute of Medicine's (IOM) 21^st century rule, "Care based on continuous healing relationships?"

Accepted Answer

1. Sharing of information is related to the critical nature of "Shared knowledge and the free flow of information."
2. Patient-centered care is related to the need for customization based on patient needs and values.
3. This IOM rule means that patients should receive care whenever they need it-access is critical.
4. Patient care that is based on the best possible evidence available relates to evidence-based decision making.

Question 9

Which statement, made by a staff nurse, indicates that the nurse understands the meaning of Medicare HACs?

Accepted Answer

1. Despite good nursing care, patients may suffer a HAC. They often indicate a safety system problem, not a specific provider problem.
2. In order to be placed on the HACs, the event must be adverse. There is no requirement for the event to be lethal.
3. These events are not that uncommon, but most nurses will experience HACs with patients such as falls and decubiti.
4. These events are indicative of a problem in the healthcare facility's safety system.

Question 10

The medical center quality improvement director issues a report on the "opportunity" costs of errors occurring in the organization. Which situation would be included in this report? Select all that apply.

Accepted Answer

1. This is an instance of costs being increased because of a complication (fracture) due to error.
2. Opportunity costs occur when repeat diagnostic tests are required or interventions are needed to counteract adverse drug events.
3. Opportunity costs occur when repeat diagnostic tests are required or interventions are needed to counteract adverse drug events.
4. This statement reveals a patient's loss of trust in the healthcare system and its providers. This is a different critical concern.
5. This is an instance of costs being increased because of lack of communication or communication error.

Question 11

Which factors are evidence of an increased interest in quality care? Select all that apply.

Accepted Answer

1. Increased legislation is one indication of increased interest in quality care, which shows public concern for care. An example of this legislation is the Patient Safety and quality improvement Act that was signed into law in 2005.
2. Businesses want value for the money they spend on healthcare, and employers are the major purchasers of care because they provide healthcare coverage for their employees.
3. Healthcare professional organizations are also involved in the increased interest in healthcare quality.
4. There has not been an increase associated with healthcare quality.
5. This has not occurred.

Question 12

Which statement, made by a staff nurse, reflects correct identification of the primary goal of quality improvement (QI)?

Accepted Answer

1. Quality improvement may save the hospital money, especially in the long term, but this is not the primary goal of the process.
2. Quality improvement may result in more efficient work, but this is not the primary goal of the process.
3. While quality improvement may result in everyone being happier and more satisfied with care, this is not the primary goal of the process.
4. The primary goal of the QI process is to improve patient outcomes.

Question 13

Select the option that reflects the focus of the "U" portion of the Joint Commission's "Speak Up" program.

Accepted Answer

1. This is not reflected by the "U" portion of "Speak Up."
2. This is not reflected by the "U" portion of "Speak Up."
3. The "U" portion of this program is to use a hospital, clinic, surgery center, or other type of healthcare organization that has undergone a rigorous on-site evaluation against established state-of-the-art quality and safety standards, such as those provided by the Joint Commission.
4. This is not reflected by the "U" portion of "Speak Up."

Question 14

The quality improvement nurse is working to increase the efficiency of resource utilization in the medical center. This nurse is focusing on which element of healthcare quality?

Accepted Answer

1. The three accepted elements of quality are process, structure, and outcome. Process is the manner in which services are provided.
2. The three accepted elements of quality are process, structure, and outcome. Structure is the environment in which services are provided. Resource utilization has to do with creating the environment.
3. The three accepted elements of quality are process, structure, and outcome. Outcome is the result of services.
4. Function is not one of the accepted elements of quality.

Question 15

The nurse is interested in educating patients to become active participants in their own healthcare. Which information should the nurse review to develop a program for the hospital?

Accepted Answer

1. The Joint Commission initiated a program that the American Nurses Association supports. "Speak Up: Help Prevent Errors in Your Care" urges patients to ask questions, pay attention to the care that is being received, become knowledgeable about their diagnosis, ask a trusted person to be their advocate, know their medications, and use organizations that are accredited.
2. Crossing the Quality Chasm is a report focused on the quality of care.
3. To Err is Human: Building a Safer Health System is a report that focuses on quality of care.
4. Envisioning the National Healthcare Quality is a report focused on quality of care.

Question 16

The faculty of a school of nursing has decided to follow the guidelines listed by the Institute of Medicine (IOM) Health Professions Education report. Which competencies should the faculty include in the school curriculum? Select all that apply.

Accepted Answer

1. Using informatics is one of the five core competencies listed in the report.
2. Working in interprofessional teams is a competency listed in this report.
3. The provision of patient-centered care is a competency listed in the report.
4. Applying quality improvement is a competency listed in the report.
5. Employing evidence-based practice is a competency listed in the report.

Question 17

Information from To Err is Human: Building a Safer Health System (Institute of Medicine, 1999) indicates that at least 44,000 Americans die each year as a result of a medication error. Nurses from which setting could closely apply this information to their personal practice?

Accepted Answer

1. To date, the focus has only been on hospital errors.
2. This study focused on hospital errors; however, this does not negate the presence of medical errors in other settings.
3. This study focused on hospital errors; however, this does not negate the presence of medical errors in other settings.
4. This study focused on hospital errors; however, this does not negate the presence of medical errors in other settings.
5. This study focused on hospital errors; however, this does not negate the presence of medical errors in other settings.

Question 18

A serious medication administration error occurred on the unit last night. What statement, made by the nurse manager, reflects the current focus of quality improvement (QI) related to this situation?

Accepted Answer

1. In this statement, the nurse manager is trying to discover who to blame for the error. Today's emphasis is on system failure, rather than on an individual.
2. This statement reflects concern about how the system allowed the error to occur. This is the current view of errors.
3. The nurse manager is trying to discover the individual to blame in this statement. Today's emphasis is on fixing the system, not on blaming an individual.
4. This statement is one of determining blame for the error. Today's focus is on the system, not on the individual.

Question 19

The nursing student is writing a paper on the Institute of Medicine's (IOM) 2001 report, Crossing the Quality Chasm. Which options reflect aims of this report that the student should include? Select all that apply.

Accepted Answer

1. Reducing waits and harmful delays for both those who receive and those who give care is an improvement aim.
2. Providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit constitutes the effectiveness aim of the paper.
3. Reimbursement is not an aim of this study.
4. Providing care that does not vary in quality because of personal characteristics is an aim proposed by this study.
5. Avoiding injuries to patients from the care that is intended to help them is a quality aim proposed by this study.

Question 20

High reliability organizations are best described by which statement?

Accepted Answer

The answer of High reliability organizations are best described by...

Quiz 17: Healthcare Quality: a Critical Health Policy Issue

The Institute of Medicine (IOM) uses two dimensions in the quality matrix to describe quality. Which factors are included in the first dimension? Select all that apply.

Which statements regarding the Consumer Bill of Rights, Protections, and Responsibilities are accurate? Select all that apply.

The nurse commits an error while caring for a patient who receives Medicare benefits. The error results in a complication that is on the Centers for Medicare and Medicaid Services' "never list." What is the implication of this error?

What has been the historical importance of the Institute of Medicine (IOM) reports since 1999?

The nurse works with breast cancer survivors in a "Reach for Recovery" program. Which portion of the Institute of Medicine's (IOM) focus on quality care does this work represent?

Which information would be used to monitor the process element of a hospital's quality?

The patient develops postoperative pneumonia when the physician fails to order respiratory therapy treatments after surgery. Which type of quality problem does this situation most clearly represent?

Which phrase best explains the Institute of Medicine's (IOM) 21^st century rule, "Care based on continuous healing relationships?"

Which statement, made by a staff nurse, indicates that the nurse understands the meaning of Medicare HACs?

The medical center quality improvement director issues a report on the "opportunity" costs of errors occurring in the organization. Which situation would be included in this report? Select all that apply.

Which factors are evidence of an increased interest in quality care? Select all that apply.

Which statement, made by a staff nurse, reflects correct identification of the primary goal of quality improvement (QI) ?

Select the option that reflects the focus of the "U" portion of the Joint Commission's "Speak Up" program.

The quality improvement nurse is working to increase the efficiency of resource utilization in the medical center. This nurse is focusing on which element of healthcare quality?

The nurse is interested in educating patients to become active participants in their own healthcare. Which information should the nurse review to develop a program for the hospital?

The faculty of a school of nursing has decided to follow the guidelines listed by the Institute of Medicine (IOM) Health Professions Education report. Which competencies should the faculty include in the school curriculum? Select all that apply.

Information from To Err is Human: Building a Safer Health System (Institute of Medicine, 1999) indicates that at least 44,000 Americans die each year as a result of a medication error. Nurses from which setting could closely apply this information to their personal practice?

A serious medication administration error occurred on the unit last night. What statement, made by the nurse manager, reflects the current focus of quality improvement (QI) related to this situation?

The nursing student is writing a paper on the Institute of Medicine's (IOM) 2001 report, Crossing the Quality Chasm. Which options reflect aims of this report that the student should include? Select all that apply.

High reliability organizations are best described by which statement?

Quiz 17: Healthcare Quality: a Critical Health Policy Issue

The Institute of Medicine (IOM) uses two dimensions in the quality matrix to describe quality. Which factors are included in the first dimension? Select all that apply.

Which statements regarding the Consumer Bill of Rights, Protections, and Responsibilities are accurate? Select all that apply.

The nurse commits an error while caring for a patient who receives Medicare benefits. The error results in a complication that is on the Centers for Medicare and Medicaid Services' "never list." What is the implication of this error?

What has been the historical importance of the Institute of Medicine (IOM) reports since 1999?

The nurse works with breast cancer survivors in a "Reach for Recovery" program. Which portion of the Institute of Medicine's (IOM) focus on quality care does this work represent?

Which information would be used to monitor the process element of a hospital's quality?

The patient develops postoperative pneumonia when the physician fails to order respiratory therapy treatments after surgery. Which type of quality problem does this situation most clearly represent?

Which phrase best explains the Institute of Medicine's (IOM) 21st century rule, "Care based on continuous healing relationships?"

Which statement, made by a staff nurse, indicates that the nurse understands the meaning of Medicare HACs?

The medical center quality improvement director issues a report on the "opportunity" costs of errors occurring in the organization. Which situation would be included in this report? Select all that apply.

Which factors are evidence of an increased interest in quality care? Select all that apply.

Which statement, made by a staff nurse, reflects correct identification of the primary goal of quality improvement (QI) ?

Select the option that reflects the focus of the "U" portion of the Joint Commission's "Speak Up" program.

The quality improvement nurse is working to increase the efficiency of resource utilization in the medical center. This nurse is focusing on which element of healthcare quality?

The nurse is interested in educating patients to become active participants in their own healthcare. Which information should the nurse review to develop a program for the hospital?

The faculty of a school of nursing has decided to follow the guidelines listed by the Institute of Medicine (IOM) Health Professions Education report. Which competencies should the faculty include in the school curriculum? Select all that apply.

Information from To Err is Human: Building a Safer Health System (Institute of Medicine, 1999) indicates that at least 44,000 Americans die each year as a result of a medication error. Nurses from which setting could closely apply this information to their personal practice?

A serious medication administration error occurred on the unit last night. What statement, made by the nurse manager, reflects the current focus of quality improvement (QI) related to this situation?

The nursing student is writing a paper on the Institute of Medicine's (IOM) 2001 report, Crossing the Quality Chasm. Which options reflect aims of this report that the student should include? Select all that apply.

High reliability organizations are best described by which statement?

Which phrase best explains the Institute of Medicine's (IOM) 21^st century rule, "Care based on continuous healing relationships?"