Nursing Quality and Safety Exam 1 With Complete Solution

Nursing Quality and Safety Exam 1 With Complete Solution 1. what are the 3 reason why health care is so dangerous: o Diagnosing and treating patients is incredibly complex. o Practitioners are often inadequately trained to deliver care as a well- integrated team. o The hierarchical nature of health care can breed disrespectful and abusive behav- ior. 2. Making dramatic improvements in patient safety will require commitment from who?: both individuals and the organizations working in health care 3. Acknowledge the scope of the problem of medical errors and make a clear commitment to redesign systems to achieve: unprecedented levels of safety 4. most patient harm is caused by?: bad systems and not bad people 5. adverse events cause psychological harm to who?: health care providers as well as their patients 6. individuals alone cannot improve safety it requires what?: Everyone on the care team to work in partnership with one another and with patients and families 7. what is safety culture?: the product of individual and group values, attitudes, competencies, and behaviors that form the foundation on which to build a learning system 8. what is Psychological safety: creating an environment where people feel com- fortable raising concerns and asking questions and have opportunities to do so 9. what is accountability?: holding individuals responsible for acting in a safe and respectful manner when they are given the training and support to do so 10. what is negotiation?: gaining genuine agreement on matters of importance to team members, patients, and families 11. what is Teamwork and communication: promoting teams that develop shared understanding, anticipate needs and problems, and apply standard tools for man- aging communication and conflict 12. what are the factors that contribute to an organizations safety culture: - -psychological safety -accountability -negotiation -teamwork and communication 13. Although blaming and punishing individuals for errors are not appropriate responses what should occur?: individuals should still be accountable for their actions 14. a just culture recognizes that: · competent professionals make mistakes. However, it has zero tolerance for reckless behavior. 15. who defined just culture for healthcare: by the lawyer and engineer David Marx 16. whys is the swiss cheese model useful?: it helps to think about errors in complex organizations 17. Who created the Swiss cheese model?: James Reason 18. in the swiss cheese model what does the stack of cheese represent: the organization's safety system 19. what do the slices of cheese in the swiss cheese model represent?: the prevention of hazards from resulting in harm, but every now and then, the "holes" line up and cause harm. 20. what are latent conditions: so-called accidents waiting to happen 21. what are active failures: errors and violations by front-line providers 22. what are the categories for unsafe acts: -Errors -Violations 23. what are the 3 types of errors: -lapse -slip -mistake 24. an example of a slip is: accidentally pushing the wrong button on a piece of equipment: You and others can see that you pushed the wrong button 25. an example of a lapse is: some form of memory failure, such as failing to administer a medication: No one can see your memory fail, so the error is not observable 26. When an action goes as intended but is the wrong one, it is called a: mistake 27. what is a violation: a deliberate deviation from an operating procedure, stan- dard, or rules 28. what is the definition of harm: unintended physical injury resulting from or contributed to by medical care that requires additional monitoring, treatment, or hospitalization or that results in death 29. true/false Human cognition, both conscious and unconscious processing, is prone to error in known ways: true 30. what is human factors engineering: is an established science that uses many disciplines (such as anatomy, physiology, physics, and biomechanics) to understand how people perform under different circumstances 31. what looks at the capabilities and limitations of human performance and uses those scientific data to design the things that we use, systems we work in, and processes we follow.: human factors engineering 32. what are issues that impact human performance and increase risk for er- ror?: -Mental and physiological states such as fatigue, stress, dehydration, hunger, and boredom -Environmental conditions such as noise, light, interruptions, and poorly designed procedures