c157 Complete Questions & Answers(Latest Update 2024)

Quality Improvement assumes that... - ANSWER Problems with service delivery results from process difficulties, not individuals. Quality in QI refers to - ANSWER Characteristics of a product or service that bear on its ability to satisfy stated or implied needs The major difference between traditional "quality assurance" activities (e.g., keeping track of the total number of different procedures conducted in your practice, rates of adverse outcomes) and "quality improvement" activities is that quality improvement also focuses on: - ANSWER Systems and processes Effective quality improvement does not require - ANSWER An increased emphasis on inspection of individuals work. A leadership style that is said to motivate employees, and that optimizes the introduction of change is: - ANSWER Participatory - An approach where leaders interact with other participants as peers, engaging them in the decision-making process and playing an equal role in the process as others and jointly carrying out the problem solving activities. Which representatives of a CV practice should be included on a quality improvement team to implement a new practice - ANSWER All staff directly affected by the quality improvement practice to be implemented. When is it appropriate to collect and use data - ANSWER 1. Before the QI project, to prove a problem exists. 2. During the QI project, to answer questions about the cause and help prioritize the implementation of improvements. 3. After the implementation of the improvement to maintain the gain Which of the following concerns would be best solved by a QI team? a. A computer systems issue with linking the clinical database to the hospital ADT system. b. A discipline issue with a problem employee. c. An individual customer complaint regarding lengthy wait time. d. A financial variance in cost per left heart cath procedure over the past 6 months. - ANSWER d. A financial variance in cost per left heart cath procedure over the past 6 months. The first step in problem solving is to - ANSWER Define the problem issue After assessing current work flow and processes, a clinical team presumes that a delay can occur anywhere along the process of their tasks. Data is inadequate at this point to identify a particular time of day, day of week, type of patient, and/or step in the process that is largely responsible for the delays. Further data collection is necessary. What should the team "product" be for the next meeting? a. A prioritization matrix. b. A finalized data collection tool and instruction sheet for implementation. c. A list of questions to be answered and a draft data collection tool. d. A listing of possible solutions. - ANSWER C. A list of questions to be answered and a draft data collection tool. As a building block for determining whether or not quality has been improved, the use of basic descriptive statistics in applying QI is critical. Which of the following is not a strictly quantitative description of the basic features of a study? a. Mean data values. b. Frequency counts. c. Hospital ratings. d. Standard deviations. - ANSWER C. Hospital ratings Of the following, two statistics are essential for identifying opportunities for performance improvement. These are: a. Frequency counts and modes. b. Variance and distributions. c. Mean and median values. d. Data ranges and standard deviations - ANSWER B. Variance and distributions Comparisons of your data against the top performers in your region/industry describe the process(es) of: - ANSWER External benchmarking Benchmarking creates objective measures of performance that are based on - ANSWER a. Past performance targets within an organization. b. Performance of a competing external organization. c. Some external universal performance target established by the industry Most helpful in identifying a problem in a process that could benefit from a quality improvement strategy. - ANSWER Flow Charts A patient has a terminal illness. Against the family's wishes, the patient requests a "do not resuscitate" order. Which ethical principle supports the patient's decision - ANSWER Autonomy Which ethical conflict places the equitable access to health care against actions that produce the greatest good - ANSWER Justice vs. Utilitarianism Four strategies that promote staff empowerment - ANSWER 1. adopting a shared vision 2. team building 3. relinquishing administrative control 4. rewarding performance that adheres to high standards. The nurse executive is the chair of a new performance improvement team whose purpose is to address patient flow through the emergency department. A laboratory team member openly blames emergency department nurses for a long turnaround time in obtaining patient test results. To which phase of group development does the nurse executive attribute the blaming behavior? a. Forming b. Norming c. Performing d. Storming - ANSWER Storming Storming - ANSWER —refers to the conflict-ridden stage of team development Performing - ANSWER —team members begin to obtain results Norming - ANSWER —team members begin to resolve differences Forming - ANSWER —the team is brought together The nurse executive develops a balanced scorecard for nursing practice by emphasizing - ANSWER internal and external benchmarks A nurse executive sponsors a multidisciplinary team that is charged with educating patients scheduled for total joint replacement surgery, about topics including what to expect after discharge. What is the nurse executive's response when encountering resistance from team members? a. Direct the mid-level managers to reemphasize the vision to their direct reports b. Encourage the first-level managers to reinforce the vision to the team members c. Gather together the various disciplines and listen to their concerns about the project d. Reeducate the team members about how their role affects the outcome of the team - ANSWER c. Gather together the various disciplines and listen to their concerns about the project The nurse executive receives notice that critical supplies have not arrived before a three-day holiday weekend. Due to a computer system error, "just-in-time" supplies were not queued for delivery. The nurse executive's next action is to: a. conduct an internal audit of supplies, compared to patient usage and census, before requesting assistance from materials management. b. contact the materials manager to expedite the delivery of supplies before the end of the work day. c. direct the department managers to negotiate for needed supplies, and allocate resources according to department census. d. mobilize personnel to facilitate the purchase of needed supplies from the available vendors - ANSWER b. contact the materials manager to expedite the delivery of supplies before the end of the work day. What is the primary purpose of a policy, as opposed to a procedure? a. A policy is binding in all circumstances to which the policy relates. b. A policy is broad and durable, designating actions for matters that frequently recur. c. A policy is designed to guide actions when managing exceptional situations. d. A policy is specific and detailed so as to avoid individual interpretation. - ANSWER b. A policy is broad and durable, designating actions for matters that frequently recur. A 14-year-old female patient, who is a practicing Jehovah's Witness, is admitted for anemia. The physician determines that blood transfusions are necessary, but the patient's parents refuse to consent. The patient states that she wishes to be treated. The advanced practice nurse action is to: a. contact local clergy for assistance in crisis intervention. b. inform the patient that her parents must consent before treatment can be administered. c. inform the patient that she is a minor and incapable of such decisions under state law. d. request that the administration contact the hospital attorney for legal counsel - ANSWER a. contact local clergy for assistance in crisis intervention. Which statement is an outcome indicator for an educational strategy? a. The nurse working in a coronary care unit has successfully completed an advanced coronary care course. b. The nursing care plan outlines a strategy for each patient problem c. The patient names all medications to be taken after discharge. d. The patient who is newly diagnosed with diabetes receives 10 hours of instruction - ANSWER c. The patient names all medications to be taken after discharge. The data obtained for quantitative research would best be used for what purpose? a. To gain insight into cultural practices b. To investigate the "why and how" of decision-making c. To predict future clinical outcomes d. To understand the meaning of events - ANSWER c. To predict future clinical outcomes Research suggests that a nurse executive most effectively improves employee job satisfaction by: a. increasing employee salaries. b. increasing staff autonomy. c. offering more educational assistance. d. providing a clinical advancement program. - ANSWER b. increasing staff autonomy. The first step in a remedial action program for an employee whose clinical performance does not meet standards is to: a. determine whether the employee will be more receptive to self-learning modalities or referral to a staff development educator. b. determine whether the problem is related to a lack of competency or a lack of productivity. c. refer the employee to a staff development educator for further education and training. d. determine whether the problem is related to a lack of knowledge or a lack of skill - ANSWER b. determine whether the problem is related to a lack of competency or a lack of productivity. A committee in a large urban hospital is appointed to plan improvements in patient care. The committee members include the: a. chief nursing officer and the chief medical officer. b. institution's strategic planning committee members. c. medical, nursing, and ancillary staff personnel. d. senior management and the budget adviser - ANSWER c. medical, nursing, and ancillary staff personnel. Which of the following describe examples of patient safety barriers? a. Persistent fear and hierarchical authority b. Complexity and deficient measures c. Reporting systems and safety culture—this is the only item that would support patient safety! d. Diffuse accountability and lack of leadership - ANSWER a. Persistent fear and hierarchical authority b. Complexity and deficient measures d. Diffuse accountability and lack of leadership 31. If data are plotted over time, the resulting chart will be a (A) Run chart (B) Histogram (C) Pareto chart (D) Poisson distribution - ANSWER a. Run chart illustration of the steps in a process - ANSW