Deck 2: Patient Safety

Question 1

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

A) A nursing program that emphasizes the development of a strong disciplinary identity.
B) Programming that stresses discipline-based research.
C) Partnerships with health care to develop software for reporting of adverse events.
D) An interdisciplinary program for nurses, pharmacists, and medical practitioners that emphasizes collaborative learning teams.

Answer 1

An interdisciplinary program for nurses, pharmacists, and medical practitioners that emphasizes collaborative learning teams.

Question 2

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

A) We believe that sustainable funding is a key factor in service.
B) Our staff members are valuable.
C) We believe in people.
D) We believe that change is essential to good service and quality patient care.

Answer 2

We believe that change is essential to good service and quality patient care.

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:

A) Consist of administrative and patient representatives.
B) Are interdisciplinary and intersectoral.
C) Are composed of senior executives and managers.
D) Are composed of patients and patients' families.

Answer 3

Are interdisciplinary and intersectoral.

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?

A) Questions on the pre-admission history that specifically explore details of substance use
B) Careful monitoring of all patients who are ambulating postoperatively
C) Rigorous patient teaching related to deep breathing and coughing
D) Systematic follow-up with patients to ensure that they understand details of surgery

Question 5

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

A) Commit staff resources over a six-month period to updating procedure manuals.
B) Educate staff through meetings and training sessions regarding appropriate answers to questions.
C) Prepare a manual that outlines orientation procedures, and ensure that all safety issues are addressed.
D) Ensure that review of patient outcomes and of responses to outcome data is ongoing.

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:

A) Similar to staff evaluations of safety.
B) More positive about safety than staff.
C) Less positive about safety than staff.
D) Less positive than senior executives about safety.

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:

A) Meets individually with nurses who are observed to be using the lifts incorrectly to review the correct procedure.
B) After consultation with the staff about the review, orders new lifts to replace older ones that are malfunctioning.
C) Blames the system for inadequate funding for resources.
D) Reviews the system of reporting incidents to ensure that appropriate reporting is occurring.

Question 8

Traditional approaches to ensuring patient safety have focused on:

A) Assigning blame.
B) Finding solutions to systems issues.
C) Instituting best practices in response to errors.
D) Hiding errors from potential litigation.

Question 9

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

A) The need to understand and record all medications being taken.
B) Bringing their own linens and other personal items to the hospital.
C) Washing hands frequently while in a healthcare environment and using a hand sanitizer.
D) Following closely the directions and orders of healthcare providers.

Question 10

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

A) Loss of funding
B) Organizational shift to profit status
C) Practices continue as usual
D) Staff morale and care standards remain high

Question 11

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

A) Patients are actively encouraged to make decisions related to care.
B) Rules and decisions are made through centralized processes.
C) You monitor the performance of each staff member closely.
D) Preference is given to increasing staff numbers rather than staff credentials.

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:

A) The overload of staff nurses.
B) Inability of staff at the bedside to make good choices.
C) A change in reporting systems.
D) Fewer clinical leaders and advocates for necessary resources.

Question 13

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

A) Evidence-based practice.
B) Informatics.
C) Staffing.
D) The patient.

Question 14

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

A) A normal risk.
B) Rare.
C) A reflection of some organizations.
D) Related to systems errors.

Question 15

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

A) Seek further learning.
B) Finish the care that was started.
C) Think about what needs to be done.
D) Concentrate on the task at hand.

Question 16

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

A) Asking the community what the safety issues are.
B) Consulting with a management expert about staffing schedules.
C) Ensuring that the senior nursing officer attends the board meetings.
D) Instituting improved practices to reduce needle-stick injuries.

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:

A) Encourage her to ask the patient if he has questions or concerns about the procedure.
B) Advise her to consider providing the patient with more information.
C) Suggest that she leave some brochures on the procedure with the patient.
D) Suggest that she also provide teaching to the adolescent's parents.

Question 18

The STAR approach to patient safety encourages:

A) Focus and reflection.
B) Continuing education.
C) Multidisciplinary approaches.
D) Patient feedback.

Question 19

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

A) Programming that builds individual nurse competency into smoking cessation
B) Implementation of informatics at the bedside
C) Staff-manager conferences to reviewed reporting of adverse events
D) Patient councils to review food, recreation, and nurse-patient relations

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:

A) Review daytime and evening staffing mixes.
B) Schedule continuing education for all staff members.
C) Review the safety of ambulation devices.
D) Continue your current practices and procedures.

Question 21

As the case manager in a home health service,you are interested in trying the Institute for Healthcare Improvement TCAB project in your service.In considering this application,you need to particularly consider:

A) Reliability of data gathered by the project.
B) Applicability of the project to your setting.
C) Lack of patient-centeredness in the project.
D) The focus of the project on resource issues.

Question 22

Mary,an 85-year-old patient with cognitive impairment and gross instability,wanders continuously.Lately,she has fallen twice,and the family demands that she be restrained.As the unit manager,you have initiated a least restraint practice.An appropriate action in this situation would be:

A) Setting up a nursing team meeting to review practices.
B) Calling the family to inform them of the practice.
C) Initiating a multidisciplinary and family meeting to focus on Mary's needs.
D) Restraining Mary to satisfy the family's wishes.

Question 23

The culture of blame and punishment of errors tends to encourage a culture of:

A) Perfectionism.
B) Learning.
C) Safety.
D) Trust.

Question 24

A client requires an appendectomy.The surgeon explains the procedure and asks the client to sign the consent.The patient speaks very little English and looks worried.As a nurse,you would:

A) Suggest that an interpreter explain the procedure to the client and answer any questions.
B) Ask the client if he has any questions.
C) Draw a picture to show the incision.
D) Not intervene.

Question 25

Which of the following patients would be at greatest risk in a healthcare visit ?

A) Clyde requires an anticoagulant. He tells the nurse about his medications. He does not include an herbal supplement.
B) George is very shy and withdrawn. He asks the nurse to leave him alone.
C) Sarah is a new parent who finds that nurses on the children's unit are very helpful. She is eager to accept all suggestions, including those that she does not yet understand.
D) Claude is booked for bowel surgery. His doctor explains about the colostomy. Later, Claude tells his wife that he really doesn't know what the doctor meant by colostomy.