Chapter 22: Quality Patient Care
MULTIPLE CHOICE
1. The continuous quality improvement (CQI) committee has performed a
retrospective chart audit to investigate whether outcomes recorded in each
nursing care plan are patient centered and written in behavioral terms. The
expected standard is 98% compliance. The sample size was 200. Results showed
that 180 charts met the standard. What assessment can be made? .
a. The standard was met. No action plan is necessary.
b. The standard was not met, but no action plan is necessary because the rate
of compliance was close to the standard.
c. The standard was not met. An action plan should be developed.
d. The standard was not met. An immediate re-audit is necessary.
ANS: C
A threshold, or cutoff point, is determined for each indicator. This example represents
a 90% compliance rate (180 divided by 200 = 0.9, or 90%), but the threshold or
expected standard was set at 98%. Therefore, the standard was not met, and an action
plan needs to be developed.
PTS: 1 DIF: Cognitive Level: Application/Applying REF: p. 508
OBJ: Incorporate successful process improvement strategies.
TOP: Continuous quality improvement (CQI)
MSC: NCLEX®: Safe and effective care environment—management of care
2. The nurse manager has an adequate understanding of root cause analysis when
stating which of the following?
a. “Root cause analysis determines who was most responsible for the error.”
, b. “Root cause analysis can identify some factors leading up to an error.”
c. “Root cause analysis is rarely conducted effectively.”.
d. “Root cause analysis investigates the root causes of events that occur.”
ANS: D
The nurse manager has an adequate understanding of root cause analysis when he or
she states it involves investigation of the root causes of events that occur. Root cause
analysis does not determine who is to blame, identifies all factors leading up to an
error, and is conducted effectively by trained professionals.
PTS: 1 DIF: Cognitive Level: Comprehension/Understanding REF: p. 501
OBJ: Define quality standards in health care management.
TOP: Standards of quality health care management
MSC: NCLEX®: Safe and effective care environment—management of care
3. A nurse is educating students on the history of quality improvement. The
teaching has been effective when one of the students states that, historically,
quality improvement focused on
a. “controlling process by inspection so that errors were prevented.”
b. “quality improvement did not begin until recently.”
c. “proactive approaches to lessen errors.”
d. “error prevention strategies.”
ANS: A.
Teaching is effective when the student states that, historically, quality improvement
focused on controlling process by inspection so that errors were prevented. Later, the
emphasis changed from inspection to proactive approaches to error prevention.
PTS: 1 DIF: Cognitive Level: Evaluation/Evaluating REF: p. 502
OBJ: Describe the history and evolution of quality in health care.
, TOP: History and evolution of quality in health care
MSC: NCLEX®: Safe and effective care environment—management of care
4. A nurse is explaining to another nurse about the contributions of Edward
Deming. The nurse judges that the explanation is effective when the nurse states:
.
a. “Quality is the responsibility of everyone within an organization.”
b. “Quality is the responsibility of the quality control inspector.”
c. “Quality is the responsibility of the CEO of the organization.” .
d. “Quality is the responsibility of the manager of the organization.”
ANS: A
Edward Deming embraced the philosophy that quality is the responsibility of
everyone within an organization.
PTS: 1 DIF: Cognitive Level: Evaluation/Evaluating REF: p. 502
OBJ: Describe the history and evolution of quality in health care.
TOP: History and evolution of quality in health care
MSC: NCLEX®: Safe and effective care environment—management of care
5. Which action takes place during the design phase of the DMAIC process?
a. A charter is developed.
b. Key performance indicators are agreed upon.
c. Analyze baseline data.
d. Determine whether measures reflect the true problems.
ANS: A
During the design phase of the DMAIC process, a charter is developed. Key
performance indicators are agreed upon during the measure phase, baseline data are
MULTIPLE CHOICE
1. The continuous quality improvement (CQI) committee has performed a
retrospective chart audit to investigate whether outcomes recorded in each
nursing care plan are patient centered and written in behavioral terms. The
expected standard is 98% compliance. The sample size was 200. Results showed
that 180 charts met the standard. What assessment can be made? .
a. The standard was met. No action plan is necessary.
b. The standard was not met, but no action plan is necessary because the rate
of compliance was close to the standard.
c. The standard was not met. An action plan should be developed.
d. The standard was not met. An immediate re-audit is necessary.
ANS: C
A threshold, or cutoff point, is determined for each indicator. This example represents
a 90% compliance rate (180 divided by 200 = 0.9, or 90%), but the threshold or
expected standard was set at 98%. Therefore, the standard was not met, and an action
plan needs to be developed.
PTS: 1 DIF: Cognitive Level: Application/Applying REF: p. 508
OBJ: Incorporate successful process improvement strategies.
TOP: Continuous quality improvement (CQI)
MSC: NCLEX®: Safe and effective care environment—management of care
2. The nurse manager has an adequate understanding of root cause analysis when
stating which of the following?
a. “Root cause analysis determines who was most responsible for the error.”
, b. “Root cause analysis can identify some factors leading up to an error.”
c. “Root cause analysis is rarely conducted effectively.”.
d. “Root cause analysis investigates the root causes of events that occur.”
ANS: D
The nurse manager has an adequate understanding of root cause analysis when he or
she states it involves investigation of the root causes of events that occur. Root cause
analysis does not determine who is to blame, identifies all factors leading up to an
error, and is conducted effectively by trained professionals.
PTS: 1 DIF: Cognitive Level: Comprehension/Understanding REF: p. 501
OBJ: Define quality standards in health care management.
TOP: Standards of quality health care management
MSC: NCLEX®: Safe and effective care environment—management of care
3. A nurse is educating students on the history of quality improvement. The
teaching has been effective when one of the students states that, historically,
quality improvement focused on
a. “controlling process by inspection so that errors were prevented.”
b. “quality improvement did not begin until recently.”
c. “proactive approaches to lessen errors.”
d. “error prevention strategies.”
ANS: A.
Teaching is effective when the student states that, historically, quality improvement
focused on controlling process by inspection so that errors were prevented. Later, the
emphasis changed from inspection to proactive approaches to error prevention.
PTS: 1 DIF: Cognitive Level: Evaluation/Evaluating REF: p. 502
OBJ: Describe the history and evolution of quality in health care.
, TOP: History and evolution of quality in health care
MSC: NCLEX®: Safe and effective care environment—management of care
4. A nurse is explaining to another nurse about the contributions of Edward
Deming. The nurse judges that the explanation is effective when the nurse states:
.
a. “Quality is the responsibility of everyone within an organization.”
b. “Quality is the responsibility of the quality control inspector.”
c. “Quality is the responsibility of the CEO of the organization.” .
d. “Quality is the responsibility of the manager of the organization.”
ANS: A
Edward Deming embraced the philosophy that quality is the responsibility of
everyone within an organization.
PTS: 1 DIF: Cognitive Level: Evaluation/Evaluating REF: p. 502
OBJ: Describe the history and evolution of quality in health care.
TOP: History and evolution of quality in health care
MSC: NCLEX®: Safe and effective care environment—management of care
5. Which action takes place during the design phase of the DMAIC process?
a. A charter is developed.
b. Key performance indicators are agreed upon.
c. Analyze baseline data.
d. Determine whether measures reflect the true problems.
ANS: A
During the design phase of the DMAIC process, a charter is developed. Key
performance indicators are agreed upon during the measure phase, baseline data are
