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Chapter 22: Quality Improvement and Patient Safety Cherry: Contemporary Nursing:
Issues, Trends, and Management, 9th Edition
MULTIPLE CHOICE
1. A nurse is preparing to administer a medication by using the vastus lateralis site and is
unfamiliar with the process. A step-by-step reference that shows how to complete the process
is referred to by what term? a. Deployment flowchart
b. Top-down flowchart
c. Pareto chart
d. Control chart
ANS: B
A top-down flowchart shows the sequence of steps in a job or process such as medication
administration. A deployment flowchart maps out the steps of a process under headings that
designate the people or departments who carry out each step. A Pareto chart is a type of bar
graph, with the height of bars reflecting the frequency with which events occur or the effect
events have on a process problem. A control chart is basically a run chart with statistical
control limits added.
DIF:Comprehension
2. What nonprofit organization distributes knowledge related to health care for the purpose of
improving health to governmental agencies, the public, business, and health care
professionals?
a. Institute for Safe Medication Practices
b. Institute of Medicine (IOM)
c. National Committee for Quality Assurance
d. The Joint Commission (TJC)
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ANS: B
The Institute of Medicine is a nonprofit organization whose mission is to advance and
disseminate to the government, the corporate sector, the professions, and the public
scientific information that will improve human health.
DIF:Comprehension
3. A nurse is removing a saturated dressing from an abdominal incision and must cut the tape to
remove the dressing. The nurse accidentally cuts the sutures holding the incision, and
evisceration occurs. In quality improvement, this incident is best identified using what term?
a. Root cause
b. Sentinel event
c. Variation in performance
d. Causal factor
ANS: B
A sentinel event is an unexpected occurrence that could result in serious physical or
psychological injury to the patient, including the possibility of returning to surgery and a
prolonged length of stay. A root cause or causal factor is the factor that resulted in a sentinel
event. A variation in performance is the action that includes the occurrence or possible
occurrence of a sentinel event.
DIF:Comprehension
4. A nurse is assisting with the delivery of twins. The first infant is placed on the scale to be
weighed. The physician requests an instrument stat. The nurse turns to hand the instrument to
the physician, and the infant falls off the scale. When evaluating the incident, the nurse and
her manager list contributory factors such as the need for two nurses when multiple births are
known, and the location of the scale so far from the delivery field. These nurses are engaged
in what process?
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a. Standardization of care
b. Root cause analysis
c. Process variation
d. Analysis of a deployment flowchart
ANS: B
A root cause analysis is a process by which factors that underlie variation in performance,
including the occurrence or possible occurrence of a sentinel event, are identified. The
purpose of root cause analysis is to identify improvements that can be implemented to
prevent future occurrences. Standardization of care is process improvement that involves
developing and adhering to best-known methods and repeating key tasks in the same way,
time and time again, until a better way is found, thereby creating exceptional service with
maximal efficiency. Process variation is a difference in how the steps in a work process
might be accomplished and/or the variables that may affect each step in the process.
Variation results from the lack of perfect uniformity in the performance of any process. A
deployment flowchart maps out the steps of a process under headings that designate the
people or departments who carry out each step. This type is especially helpful when dealing
with processes that cross multiple areas or caregivers and when there is a need for common
under-standing of what the process is doing as a whole.
DIF:Comprehension
5. Each month data on admission assessments that are based on the following standard are
entered: ―All patients will be assessed by an RN within 2 hours of admission.‖ The target
goal for this standard is 97% compliance. Data are displayed on a graph that shows number
and time of admission assessments and compliance variation limits. This pictorial
representation is documented using what tool? a. Pareto chart
b. Control chart
c. Deployment chart
d. Top-down flowchart
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Chapter 22: Quality Improvement and Patient Safety Cherry: Contemporary Nursing:
Issues, Trends, and Management, 9th Edition
MULTIPLE CHOICE
1. A nurse is preparing to administer a medication by using the vastus lateralis site and is
unfamiliar with the process. A step-by-step reference that shows how to complete the process
is referred to by what term? a. Deployment flowchart
b. Top-down flowchart
c. Pareto chart
d. Control chart
ANS: B
A top-down flowchart shows the sequence of steps in a job or process such as medication
administration. A deployment flowchart maps out the steps of a process under headings that
designate the people or departments who carry out each step. A Pareto chart is a type of bar
graph, with the height of bars reflecting the frequency with which events occur or the effect
events have on a process problem. A control chart is basically a run chart with statistical
control limits added.
DIF:Comprehension
2. What nonprofit organization distributes knowledge related to health care for the purpose of
improving health to governmental agencies, the public, business, and health care
professionals?
a. Institute for Safe Medication Practices
b. Institute of Medicine (IOM)
c. National Committee for Quality Assurance
d. The Joint Commission (TJC)
Downloaded by: puacaldwell | Want to earn $1.236 Distribution of
this document is illegal extra per year?
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
ANS: B
The Institute of Medicine is a nonprofit organization whose mission is to advance and
disseminate to the government, the corporate sector, the professions, and the public
scientific information that will improve human health.
DIF:Comprehension
3. A nurse is removing a saturated dressing from an abdominal incision and must cut the tape to
remove the dressing. The nurse accidentally cuts the sutures holding the incision, and
evisceration occurs. In quality improvement, this incident is best identified using what term?
a. Root cause
b. Sentinel event
c. Variation in performance
d. Causal factor
ANS: B
A sentinel event is an unexpected occurrence that could result in serious physical or
psychological injury to the patient, including the possibility of returning to surgery and a
prolonged length of stay. A root cause or causal factor is the factor that resulted in a sentinel
event. A variation in performance is the action that includes the occurrence or possible
occurrence of a sentinel event.
DIF:Comprehension
4. A nurse is assisting with the delivery of twins. The first infant is placed on the scale to be
weighed. The physician requests an instrument stat. The nurse turns to hand the instrument to
the physician, and the infant falls off the scale. When evaluating the incident, the nurse and
her manager list contributory factors such as the need for two nurses when multiple births are
known, and the location of the scale so far from the delivery field. These nurses are engaged
in what process?
Downloaded by: puacaldwell | Want to earn $1.236 Distribution of
this document is illegal extra per year?
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a. Standardization of care
b. Root cause analysis
c. Process variation
d. Analysis of a deployment flowchart
ANS: B
A root cause analysis is a process by which factors that underlie variation in performance,
including the occurrence or possible occurrence of a sentinel event, are identified. The
purpose of root cause analysis is to identify improvements that can be implemented to
prevent future occurrences. Standardization of care is process improvement that involves
developing and adhering to best-known methods and repeating key tasks in the same way,
time and time again, until a better way is found, thereby creating exceptional service with
maximal efficiency. Process variation is a difference in how the steps in a work process
might be accomplished and/or the variables that may affect each step in the process.
Variation results from the lack of perfect uniformity in the performance of any process. A
deployment flowchart maps out the steps of a process under headings that designate the
people or departments who carry out each step. This type is especially helpful when dealing
with processes that cross multiple areas or caregivers and when there is a need for common
under-standing of what the process is doing as a whole.
DIF:Comprehension
5. Each month data on admission assessments that are based on the following standard are
entered: ―All patients will be assessed by an RN within 2 hours of admission.‖ The target
goal for this standard is 97% compliance. Data are displayed on a graph that shows number
and time of admission assessments and compliance variation limits. This pictorial
representation is documented using what tool? a. Pareto chart
b. Control chart
c. Deployment chart
d. Top-down flowchart
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this document is illegal extra per year?
