Deck 23: Quality Control

Question 1

What is the first step in quality control?

A) To take corrective action when standards have not been met
B) To collect data to determine whether standards have been met
C) To determine criteria and standards
D) To determine who will measure the standard

Answer 1

To determine criteria and standards

Question 2

An RN is a supervisor in an organization that has total quality management (TQM) as the backbone of its organizational goals and objectives for quality control. How does the RN practice TQM on the unit?

A) Encouraging employees to think of a unit slogan
B) Developing a quota system for number of patients cared for
C) Explaining to the staff that "if it's not broke, don't fix it"
D) Promoting teamwork rather than individual accomplishments

Answer 2

Promoting teamwork rather than individual accomplishments

Question 3

Which task is a management function associated with quality control?

A) Periodic evaluation of unit mission and philosophy
B) Making out the daily patient care assignments
C) Creating a yearly budget
D) Distributing holiday staffing policies

Answer 3

Periodic evaluation of unit mission and philosophy

Question 4

What results from effective benchmarking?

A) Two organizations become financially integrated under a capitated model
B) Organizations compete for a "best practices" label from the National Committee for Quality Assurance (NCQA)
C) An organization compares its performance with that of "best-performing institutions"
D) Minimum practice guidelines are established for each health-care organization

Question 5

Thirty-eight percent of the people who attended a smoking cessation clinic were not smoking 1 year after the clinic closed. What type of audit provided this type of data?

A) Structure
B) Process
C) Outcome
D) Concurrent

Question 6

Nursing students who scored in the top 5% on the examination studied in small groups, attended class 100% of the time, took frequent rest breaks during study sessions, and ate a balanced diet for 1 week before the examination. What type of audit provided this type of data?

A) Structure
B) Process
C) Outcome
D) Concurrent

Question 7

What is the function of a nursing minimum data set?

A) Compares the quality of nursing care and medical care
B) Identifies minimal levels of quality necessary for nurses to maintain licensure
C) Standardizes the collection of nursing data for use by multiple data users
D) Identifies only "nursing-sensitive" patient outcome measures

Question 8

What role has the Joint Commission assumed in ensuring quality at the organizational level?

A) Establishing clinical practice guidelines
B) Reducing diagnosis-related group reimbursement levels
C) Standardizing clinical outcome data collection
D) Assessing monetary fines for hospitals that fail to meet standards

Question 9

Who is involved in quality control measurement functions? Select all that apply.

A) Facility staff
B) Consumers
C) All levels management
D) Health-care professionals

Question 10

Which is a true statement regarding TQM?

A) It is based on the premise that the organization knows what is best for the consumer
B) Its guiding purpose is to save the organization money
C) It is based on the premise that the customer is the focal element on which production and service depend
D) It assumes that inspection and removal of errors lead to the delivery of quality services

Question 11

Which statement is true regarding criteria for assuring that a quality control program will be effective?

A) The primary purpose of the program is to satisfy various federal and state standards
B) Developed standards should reflect minimally acceptable levels so the organization will score well on self-assessment audits
C) A belief in the importance of quality control must be integrated through all levels of the organizational hierarchy
D) The process should be reactive; in other words, quality improvement efforts should be initiated after problems are identified

Question 12

What is the greatest limitation of the Health Plan Employer Data Information Set (HEDIS)?

A) Findings are not released to the public
B) Only about half of managed care organizations have chosen to participate
C) Performance indicators are process focused rather than outcome focused
D) There are only 15 performance measures

Question 13

What is the best qualitative measurement in determining quality control for marketing?

A) Morbidity and mortality rates
B) Nursing care hours per patient day
C) Average length of stay
D) Patient surveys of general satisfaction

Question 14

What is the best course of action to stimulate staff nurses' involvement in quality control research on a nursing unit?

A) Hire a well-qualified researcher to help staff design studies
B) Create a joint medical/nursing staff research committee
C) Provide staff with paid release time for research activities
D) Ensure that research designs are well grounded and scientific

Question 15

Which statement is true regarding adverse drug events (ADEs)?

A) They occur infrequently in accredited hospitals
B) They are responsible for about 20% of hospitalized disabilities
C) They usually involve either prescribing or pharmacy errors
D) They occur because of individual recklessness

Question 16

What is the definition of a standard?

A) A predetermined baseline condition or level of excellence that constitutes a model to be followed and practiced
B) Diagnosis-based, step-by-step interventions for nurses to follow in an effort to promote evidence-based, high-quality care
C) Process of measuring products, practices, and services against those of best-performing organizations
D) Identify not only what and how an event happens but why it happens, with the end goal being to ensure that a preventable negative outcome does not recur

Question 17

What do clinical practice guidelines provide?

A) A predetermined baseline condition or level of excellence that constitutes a model to be followed and practiced
B) Diagnosis-based, step-by-step interventions for nurses to follow in an effort to promote evidence-based, high-quality care
C) Process of measuring products, practices, and services against those of best-performing organizations
D) Identify not only what a nd how an event happens but why it happens, with the end goal being to ensure that a preventable negative outcome does not recur

Question 18

What do the critics of prospective payment system argue?

A) Diagnosis-related groups have not helped to contain rising health care costs
B) The system has increased the length of hospital stay
C) Services provided under this system have only slightly increased
D) On the whole quality of care has declines since its implementation

Question 19

What are the four evidence-based standards identified by the Leapfrog Group to reduce medical errors?

A) Computerized physician-provider order entry, evidence-based hospital referral, ICU physician staffing, and the use of Leapfrog Safe Practices scores
B) Computerized physician-provider order entry, evidence-based visiting nurse referral, ED physician staffing, and the use of Leapfrog Safe Practices scores
C) Computerized primary care provider order entry, evidence-based hospital referral, ICU physician staffing, and the use of Leapfrog Safe Medication scores
D) Computerized nurse practitioner-provider order entry, evidence-based outpatient referral, ED physician staffing, and the use of Leapfrog Safe Medication scores

Question 20

Which practice has the U.S. Food and Drug Administration suggested in order to decrease the risk of medication errors?

A) Computerized order entry with a drug bar code system
B) Medications automatically dispensed to patients at predetermined times
C) Use of medication nurses to administer all ordered medications
D) Have patients' medicati kept at the bedside for self-administration

Question 21

When working on clinical practice guidelines for a mental health unit, the nursing committee will implement which intervention initially?

A) Assessing the medical psychiatric staff for practice suggestions
B) Implementing a search of the literature for current related research results
C) Reviewing patient satisfaction data to identify the unit's strengths and weaknesses
D) In-servicing all unit nursing staff on the need to adhere to established guidelines

Question 22

Which statement is true regarding the factors that impact patient satisfaction with a hospitalization?

A) The quality of care delivered is the primary factor related to
B) The patient's understanding of his/her condition influences satisfaction
C) The length of the hospital stay is the deciding influence on satisfaction
D) The patient's satisfaction has little to do with actual health improvement

Question 23

What is the guiding principle when attempting to address errors made in the delivery of health care?

A) Reporting of errors must be both mandatory and voluntary
B) Errors are a result of faulty organizational processes
C) People are the root cause of health delivery errors
D) Errors are either unavoidable or result from reckless behavior

Question 24

What results from the development of plan of correction associated with health-care delivery errors?

A) Sentinel event
B) Root cause analysis
C) Quality assessment (QA) program
D) Failure mode and effects analysis (FMEA)

Question 25

Which intervention is associated with the nursing leadership role?

A) Inspiring staff to establish and maintain high standards regarding patient care
B) Being aware of the changes in quality control regulations
C) Reviewing research results upon which to base changes
D) Identifying outcomes that support quality nursing care