Deck 8: Performance

Question 1

Select the quality term that is coupled with its correct definition.

A)Quality Improvement: A healthcare philosophy and culture that emphasizes innovation, customer satisfaction and employee involvement
B)Quality Improvement: The ongoing, continuous processes that are used by organizations to minimize risks and losses associated with adverse events
C)Quality Management: A healthcare philosophy and culture that emphasizes innovation, customer satisfaction and employee involvement
D)Quality Management: The ongoing, continuous processes that are used by organizations to support its quality management philosophy and culture

Answer 1

Quality Management: A healthcare philosophy and culture that emphasizes innovation, customer satisfaction and employee involvement

Question 2

A process improvement methodology that is currently being adopted and adapted for use in health care is:

A)Six Sigma
B)Six Outcomes
C)APIE (Assessment, Problem, Intervention and Evaluation)
D)PRIME (Problem, Resolution, Intervention, Modifications and Evaluation)

Answer 2

Six Sigma

Question 3

Six Sigma is a data driven methodology that has several phases. These phases are:

A)Define opportunities, measure performance, analyze opportunity, improve performance, and evaluate performance
B)Define opportunities, measure performance, analyze opportunity, improve performance and control performance
C)Measure performance, analyze opportunity, improve performance, evaluate performance and control performance
D)Measure performance, analyze opportunity, improve performance, evaluate performance, control performance and reevaluate performance.

Answer 3

Define opportunities, measure performance, analyze opportunity, improve performance and control performance

Question 4

Quality improvement and performance improvement activities can focus on one of three aspects of care and service. What are these three aspects of care and service?

A)Policies, procedures and process
B)Systems, structure and procedures
C)Structure, process and outcome
D)Measurement, analysis and synthesis

Question 5

Select the performance improvement focus with a possible area of investigation for a quality improvement and performance improvement activity.

A)Structure: Patient satisfaction
B)Outcome: The severity of falls
C)Process: Patient compliance
D)Structure: Number of MRSA infections
E)Structure: Timeliness of documentation
F)Outcome: The adequacy of staffing
G)Process: A documentation procedure
H)Structure: A patient assessment policy

Question 6

Performance improvement expected outcomes, or goals, should be based on:

A)The consensus of the work group.
B)Established policies and procedures.
C)Independent decision making.
D)Evidence based practices

Question 7

What kind of performance improvement data is obtained by using "benchmarking"?

A)Only qualitative data
B)Only quantitative data
C)Inferential data
D)Comparative data

Question 8

Which statement regarding performance improvement is the most accurate?

A)Performance improvement activities are most successful when all are strongly committed to it.
B)Performance improvement activities focus on an individual's or group's human errors.
C)Performance improvement activities are based on the organization's definition of quality.
D)Performance improvement activities are based on the premise that some processes can be improved.

Question 9

Which performance improvement tool is effective for determining the forces that are impacting on a process or outcome?

A)Flow chart
B)Pareto chart
C)Fishbone diagram
D)Histogram

Question 10

A type of bar graph that reflects the major causes of a problem is a:

A)Flow chart.
B)Pareto chart.
C)Histogram.
D)Line graph.

Question 11

Which is the highest level goal of a performance improvement program?

A)To continuously improve processes and systems
B)To compete in the current health care market
C)To continuously improve the outcomes of patient care
D)To adhere to, and exceed, JCAHO expectations

Question 12

According to the Institute of Medicine's Committee on Quality of Healthcare in America, the number of people who die annually from medical errors in our nation is:

A)20,000
B)50,000
C)68,000
D)98,000

Question 13

Which theory is useful for understanding the interrelationships among departments in a health care setting?

A)Lewin's Field theory
B)Maslow's Hierarchy of Needs
C)Piaget's Cognitive theory
D)Open Systems theory

Question 14

The Picker Institute has researched and developed the:

A)Seven Dimensions of Collaboration.
B)Seven Dimensions of Patient Centered Care.
C)Six Dimensions of Collaboration.
D)Six Dimensions of Patient Centered Care.

Question 15

Which of Picker's Dimensions of Patient Centered Care addresses the rights of consumers to maintain dignity and autonomy?

A)Information and communication
B)Coordination and integration
C)Consumers' values and preferences
D)Continuity of care along the continuum

Question 16

Which of the following is a most basic and essential trait of successful health care teams?

A)Time limits
B)Homogeneity
C)Trust
D)Heterogeneity

Question 17

Which of the following is a barrier to interdepartmental communication?

A)Close ended questions
B)Open ended questions
C)Message simplicity
D)Message overload

Question 18

You are speaking to the Director of Laboratory Services regarding the lack of timeliness in getting stat lab reports. You are not at all familiar with the policies and procedures of the Laboratory Services Department. You also do not know the Laboratory Services Department's definition of stat. You immediately request that all stat lab results must be on your unit within 5 minutes. The Director of Laboratory Services disagrees and conflict emerges. What barrier to communication led to this conflict?

A)A divergent thinking barrier
B)A systems design barrier
C)A systemic philosophical barrier
D)An attitudinal barrier

Question 19

Which is an example of an attitudinal barrier to communication?

A)Lack of motivation
B)Ambiguity
C)Environmental noise
D)A systems design barrier

Question 20

Match the theorist(s) with their model of power and influence.

A)Toffler: Power as Based on Obedience
B)Burke: Circuits of Power
C)Clegg: Referent Power
D)French and Raven: Six Bases of Power

Question 21

Which is the least effective form of power and the one that leads to resistance and resentments?

A)Manipulative power
B)Coercive power
C)Referent power
D)Informational power

Question 22

The most formal type of power and influence is:

A)Legitimate power.
B)Expert power.
C)Referent power.
D)Informational power.

Question 23

Which term is best defined as a specialized communication skill that is used to resolve conflicts, especially when all must agree on an important issue or intervention?

A)Collaboration
B)Arbitration
C)Negotiation
D)Consensus

Question 24

What types of power and influence were developed by Sullivan in 2004?

A)Collaboration, arbitration, negotiation and consensus
B)Personal, expert, position, perceived, information and connection power
C)Alpha, beta and zeta power
D)Internal, external, environmental, departmental and organizational power

Question 25

Which type of mentor power is identified when a nurse seeks out and selects a mentor for professional development?

A)Collaborative power
B)Connection power
C)Perceived power
D)Collective power

Question 26

Your VP for Nursing Services appears to have developed optimal relationships with the CEO, the CFO and other department heads. What kind of power is your VP seeking?

A)Collaborative power
B)Connection power
C)Perceived power
D)Collective power

Question 27

An Occupational Safety and Health Administration (OSHA) mandated Exposure Control plan relating to bloodborne pathogens must be:

A)Readily accessible to all staff.
B)Kept in a secure, locked area.
C)Composed by upper management.
D)Composed by upper and middle management.

Question 28

Which is an example of a piece of personal protective equipment?

A)Hand washing
B)Sterile pens for documentation
C)Goggles
D)Computers

Question 29

Some health care providers do not use personal protective equipment, despite its importance. Which of the following is a common barrier to the use of personal protective equipment?

A)Lack of comfort
B)Weight
C)Timing
D)Cost

Question 30

When is the risk for sharps injuries the greatest?

A)During lengthy procedures
B)When a health care provider is alone
C)When replacing sharps containers
D)During minimally invasive procedures

Question 31

Which is the first thing that you should do if you see a fire in the workplace?

A)RACE
B)Rescue those in imminent danger
C)Pull the fire alarm
D)Extinguish the fire

Question 32

What should do if a patient's clothing catches fire?

A)Have the patient run or walk briskly
B)Pull the fire alarm
C)Smother the fire with blankets
D)Protect the patient's face

Question 33

Which is an example of lateral evacuation?

A)Moving patients to a lower floor
B)Moving patients to a higher floor
C)Moving patients down and out of the exits
D)Moving patients from the west to east wing

Question 34

When you pick up the OR's telephone, a caller states that there is a bomb in the recovery room. What should you do?

A)Keep the caller on the phone
B)Pull the fire alarm
C)Move patients to the lowest floor possible
D)Move patients to the highest floor possible

Question 35

Which of the following is an example of an internal disaster?

A)A utility outage
B)Plane crash
C)Factory explosion
D)School bus accident

Question 36

Which of the following is an example of an external disaster?

A)A utility outage
B)A radioactive spill in the lab
C)The loss of water supply
D)A plane crash

Question 37

What should you do if there is a tornado or cyclone in your area?

A)Go to the highest possible floor
B)Move east because these things come from the east
C)Assume the fetal position and cover your head
D)Evacuate the building and go outdoors

Question 38

Many patient falls can be prevented with:

A)Padded briefs to lessen injury.
B)The proper use of restraints.
C)A bedside gym mat.
D)A thorough falls risk assessment.

Question 39

Medication errors occur when one of the Five Rights of Medication Administration is violated. What are the Five Rights?

A)The right patient, the right documentation, the right time, the right drug and the right route
B)The right patient, the right dosage, the right time, the right drug and the right route
C)The right patient, the right dosage, the right time, the right assessment and the right route
D)The right patient, the right dosage, the right time, the right drug and the right documentation

Question 40

Which medical error is an error of omission?

A)Giving the incorrect medication to a patient
B)Giving a patient an incorrect medication dosage
C)Failing to give a patient their ordered drug
D)Giving a medication to the wrong patient

Question 41

What patient safety process is a systematic goal directed process that uncovers the underlying factors that have contributed to a sentinel event?

A)Root Cause Analysis
B)Critical thinking
C)Valence Analysis
D)Contributory cause

Question 42

Root Cause Analysis must be thorough and credible. What must be done in order for this process to be thorough?

A)It must identify all risk points.
B)It must ask a series of "Who" questions.
C)It must be at least 6 hours in duration.
D)It must be internally consistent.

Question 43

Medical errors are defined as:

A)All health care errors including the suicide of a patient.
B)Only those errors that result in death or disability.
C)Medication errors that result from the wrong dosage.
D)Medication errors that result from the wrong drug.

Question 44

Re-engineering systems and processes is a good way to decrease and eliminate medical errors. The BEST systems and processes are those that:

A)Have the fewest steps.
B)Make it easy for people to follow.
C)Make it impossible for a person to err.
D)Rapid, complete and not redundant.

Question 45

Your medical center has recently had two episodes of wrong site surgery. As you serve on the performance improvement work group that is chartered to address this issue, it is important to ask which question over and over again to get down to the root cause of this medical error?

A)Who did it?
B)What departments contributed to it?
C)What should the staff have done?
D)Why did it happen?

Question 46

What is the definition of a sentinel event in terms of patient safety?

A)A sentinel event is an unexpected patient safety medical error that involves physical injury, or death, as well as near misses.
B)A sentinel event is an unexpected patient safety medical error that involves physical and psychological injury, or death, as well as near misses.
C)A sentinel event is an unexpected patient safety medical error that involves physical and psychological injury, or death, not including near misses.
D)A sentinel event is an unexpected patient safety medical error that involves physical injury, or death, not including near misses.

Question 47

Who publishes annual National Patient Safety Goals?

A)The Agency for Healthcare Research and Quality (AHRQ)
B)The American Nurses Association (ANA)
C)The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO)
D)All of our 50 states

Question 48

Which is a 2012 National Patient Safety Goal for hospitals?

A)To identify patient safety risks
B)To improve the timeliness of care
C)To improve the efficiency of care
D)To identify medication errors

Question 49

Which is considered a sentinel event because it is risky?

A)The discovery of an uncharged defibrillator before it was needed
B)A transfusion reaction because the incorrect blood was given
C)A patient fall without any injury to the patient
D)A medication error that results in an allergic response