Question 1

What benchmarks might be expected to be measured for hospital performance? (Select all that apply.)

Accepted Answer

A) Average length of hospital stay for cardiac surgery 
B) Total admissions for cardiac surgery 
C) Infection rates for cardiac surgery 
D) Length of surgery 
E) Deaths by surgeon 
A) Average length of hospital stay for cardiac surgery 
B) Total admissions for cardiac surgery 
C) Infection rates for cardiac surgery 
D) Length of surgery 
E) Deaths by surgeon A, B, C

Question 2

Hospital performance improvement standards are primarily focused on the ability of the hospital to

Accepted Answer

A) meet the goals established by the regulating bodies. 
B) develop an atmosphere that meets and exceeds the expectations of the customers and staff. 
C) be known in the community for good care. 
D) provide a shelter for people in a disaster. 
A) meet the goals established by the regulating bodies. 
B) develop an atmosphere that meets and exceeds the expectations of the customers and staff. 
C) be known in the community for good care. 
D) provide a shelter for people in a disaster. B

Question 3

What is the best method for hospitals to track patient satisfaction?

Accepted Answer

A) Family buys chocolates for each shift. 
B) Family speaks to the charge nurse about how unhappy they are with a particular employee. 
C) Family writes a letter to the unit and to the chief nurse officer to thank the staff for providing care and compassion even though their family member died. 
D) Patient completes a patient survey after returning home from the hospital. 
A) Family buys chocolates for each shift. 
B) Family speaks to the charge nurse about how unhappy they are with a particular employee. 
C) Family writes a letter to the unit and to the chief nurse officer to thank the staff for providing care and compassion even though their family member died. 
D) Patient completes a patient survey after returning home from the hospital. D

Question 4

A unit secretary mistakenly enters the wrong medication into the MAR when transcribing orders.After a root cause analysis, it is determined that the cause is the illegibility of the physician's order.Which measure should be taken to prevent future incidences?

Accepted Answer

A) The physician is required to carry a typewriter with him to type the orders onto the order sheet. 
B) The physician must either write legibly or orders will not be transcribed. 
C) The unit secretary must receive more training on transcribing orders. 
D) Introduction of a computer entry system for all physician orders will be instituted. 
A) The physician is required to carry a typewriter with him to type the orders onto the order sheet. 
B) The physician must either write legibly or orders will not be transcribed. 
C) The unit secretary must receive more training on transcribing orders. 
D) Introduction of a computer entry system for all physician orders will be instituted.

Question 5

"Lean culture" is a term used for the principle of eliminating waste.Which illustrates the principle that nurses must do more with less?

Accepted Answer

A) Assigning the night shift RN to restock the rooms. 
B) Employing a staff member to stock all patient rooms for frequently used supplies. 
C) Assigning all nurses to restock their rooms every day. 
D) Placing all frequently used supplies in a central location. 
A) Assigning the night shift RN to restock the rooms. 
B) Employing a staff member to stock all patient rooms for frequently used supplies. 
C) Assigning all nurses to restock their rooms every day. 
D) Placing all frequently used supplies in a central location.

Question 6

When using the DMAIC acronym of the Six Sigma quality process improvement model, the nurse understands that the M (measure) refers to

Accepted Answer

A) the development of a data collection plan. 
B) determination of the average LOS. 
C) determination of the average wages. 
D) determination of the ethnicity of admissions. 
A) the development of a data collection plan. 
B) determination of the average LOS. 
C) determination of the average wages. 
D) determination of the ethnicity of admissions.

Question 7

A nurse is learning about quality improvement measures taken by the hospital.Root cause analysis is a process for identifying the cause of an error.What is the greatest benefit to establishing the root cause?

Accepted Answer

A) Prevention of future similar incidents 
B) Identification of the responsible person 
C) Allows corrective action to be taken 
D) Identification of cause 
A) Prevention of future similar incidents 
B) Identification of the responsible person 
C) Allows corrective action to be taken 
D) Identification of cause

Question 8

When using the DMAIC acronym of the Six Sigma quality process improvement model, the nurse understands that the D (define) refers to

Accepted Answer

A) the cost of getting a new MRI machine. 
B) the patients and their families. 
C) the number of dollars in donations. 
D) the number of dollars spent on charity. 
A) the cost of getting a new MRI machine. 
B) the patients and their families. 
C) the number of dollars in donations. 
D) the number of dollars spent on charity.

Question 9

A sentinel event is usually one that results in an unexpected outcome for the patient and "signals" the need for investigation and response.Which of the following would be considered a sentinel event?

Accepted Answer

A) A patient with a brain tumor who falls and breaks his wrist after trying to get up by himself 
B) A 32-year-old woman with no significant health history who dies in the operating room during an elective surgical procedure 
C) A patient who self-extubates after cardiac surgery 
D) A patient who is given the wrong bolus of heparin that is corrected with the first prothrombin time 
A) A patient with a brain tumor who falls and breaks his wrist after trying to get up by himself 
B) A 32-year-old woman with no significant health history who dies in the operating room during an elective surgical procedure 
C) A patient who self-extubates after cardiac surgery 
D) A patient who is given the wrong bolus of heparin that is corrected with the first prothrombin time

Question 10

A nurse has administered the wrong medication to a patient.In investigating the root cause of the error, it is discovered that the nurse was unfamiliar with the medication and that the Pyxis was incorrectly loaded with the wrong medication.What should be the outcome of this process?

Accepted Answer

A) The nurse should be educated on this medication. 
B) Pharmacy should develop a second check of medications prior to loading in the Pyxis. 
C) The nurse will not be allowed to pass medications without supervision until deemed safe. 
D) An incident report will be completed. 
A) The nurse should be educated on this medication. 
B) Pharmacy should develop a second check of medications prior to loading in the Pyxis. 
C) The nurse will not be allowed to pass medications without supervision until deemed safe. 
D) An incident report will be completed.

Question 11

Which of these is a measured outcome from a performance improvement process perspective?

Accepted Answer

A) Overtime hours worked by the RNs 
B) Identifying the responsible person for a patient's fall 
C) Sternal infection rates in cardiac surgery patients 
D) Method of shift report 
A) Overtime hours worked by the RNs 
B) Identifying the responsible person for a patient's fall 
C) Sternal infection rates in cardiac surgery patients 
D) Method of shift report

Question 12

Patient satisfaction surveys include questions about quality of care.What has the greatest impact on patient satisfaction?

Accepted Answer

A) Responsiveness of staff 
B) Getting pain medication on time 
C) Being allowed to go outside to smoke a cigarette 
D) The race and gender of the nurses 
A) Responsiveness of staff 
B) Getting pain medication on time 
C) Being allowed to go outside to smoke a cigarette 
D) The race and gender of the nurses

Question 13

A sentinel event is usually one that results in an unexpected outcome for the patient and "signals" the need for investigation and response.Which of the following would be considered a sentinel event?

Accepted Answer

A) A patient who requires a left leg amputation after developing an arterial occlusion at the access site 
B) An older adult patient who falls after trying to get up by herself 
C) A patient who receives two doses of amiodarone because the nurse did not chart the first one 
D) A patient whose peripheral pulses have not been checked for 2 hours after he returns from a cardiac catheterization 
A) A patient who requires a left leg amputation after developing an arterial occlusion at the access site 
B) An older adult patient who falls after trying to get up by herself 
C) A patient who receives two doses of amiodarone because the nurse did not chart the first one 
D) A patient whose peripheral pulses have not been checked for 2 hours after he returns from a cardiac catheterization

Question 14

Risk management is a hospital program organized to prevent the incidences of preventable accidents, injuries, and errors.Which of the following situations would a hospital risk manager need to investigate?

Accepted Answer

A) A patient breaks his wrist from a fall caused by a wet floor. 
B) A patient receives a dose of subcutaneous heparin 1 hour later than scheduled. 
C) A patient who is NPO is not given her morning medications. 
D) A patient who is allergic to shellfish is given preprocedure medications to reduce his risk for allergic reaction to the dye being used in the procedure. 
A) A patient breaks his wrist from a fall caused by a wet floor. 
B) A patient receives a dose of subcutaneous heparin 1 hour later than scheduled. 
C) A patient who is NPO is not given her morning medications. 
D) A patient who is allergic to shellfish is given preprocedure medications to reduce his risk for allergic reaction to the dye being used in the procedure.

Question 15

A sentinel event is usually one that results in an unexpected outcome for the patient and "signals" the need for investigation and response.Which of these situations would be considered a sentinel event?

Accepted Answer

A) Patient dies because there is no bed available in the ICU. 
B) Patient receives an incorrect dose of medication. 
C) Patient consents to be terminally weaned. 
D) A patient's family is upset with a physician's approach. 
A) Patient dies because there is no bed available in the ICU. 
B) Patient receives an incorrect dose of medication. 
C) Patient consents to be terminally weaned. 
D) A patient's family is upset with a physician's approach.

Question 16

The Joint Commission ( TJC ) tracks core measures for performance.Which core measures are tracked by TJC? (Select all that apply.)

Accepted Answer

A) Heart failure 
B) Ventilator days 
C) Scheduled sedation vacation 
D) Acute myocardial infarction 
E) Childhood asthma 
A) Heart failure 
B) Ventilator days 
C) Scheduled sedation vacation 
D) Acute myocardial infarction 
E) Childhood asthma

Question 17

When using the DMAIC acronym of the Six Sigma quality process improvement model, the nurse understands that the I (improve) refers to

Accepted Answer

A) identification of the start and stop dates. 
B) comparison of data to customer surveys. 
C) use of technology to design improvements. 
D) staff training. 
A) identification of the start and stop dates. 
B) comparison of data to customer surveys. 
C) use of technology to design improvements. 
D) staff training.

Question 18

The National Database of Nursing Quality Indicators (NDNQI) has established which of the following goals to assist nurses to make practice changes in order to benefit patients?

Accepted Answer

A) Patient satisfaction 
B) Employee satisfaction 
C) Unit-specific measures 
D) Medication errors 
A) Patient satisfaction 
B) Employee satisfaction 
C) Unit-specific measures 
D) Medication errors

Question 19

What area is included when risk management explores the prevention of accidents, injuries, and errors?

Accepted Answer

A) Financial risk 
B) Quality of care 
C) Employee management 
D) Employee promotion 
A) Financial risk 
B) Quality of care 
C) Employee management 
D) Employee promotion

Question 20

The National Patient Safety Goals of The Joint Commission ( TJC ) are established goals to reduce the risks for injuries to patients and provide a safe environment.Which practice has been instituted as a result of these goals established by TJC?

Accepted Answer

A) Use of the automatic medication dispenser equipment 
B) Handwashing to prevent infections 
C) Provision of patient information to the nurse covering for breaks 
D) Use of two patient identifiers when providing care or treatments 
A) Use of the automatic medication dispenser equipment 
B) Handwashing to prevent infections 
C) Provision of patient information to the nurse covering for breaks 
D) Use of two patient identifiers when providing care or treatments

Exam 18: Improving Organizational Performance

What benchmarks might be expected to be measured for hospital performance? (Select all that apply.)

Hospital performance improvement standards are primarily focused on the ability of the hospital to

What is the best method for hospitals to track patient satisfaction?

A unit secretary mistakenly enters the wrong medication into the MAR when transcribing orders.After a root cause analysis, it is determined that the cause is the illegibility of the physician's order.Which measure should be taken to prevent future incidences?

"Lean culture" is a term used for the principle of eliminating waste.Which illustrates the principle that nurses must do more with less?

When using the DMAIC acronym of the Six Sigma quality process improvement model, the nurse understands that the M (measure) refers to

A nurse is learning about quality improvement measures taken by the hospital.Root cause analysis is a process for identifying the cause of an error.What is the greatest benefit to establishing the root cause?

When using the DMAIC acronym of the Six Sigma quality process improvement model, the nurse understands that the D (define) refers to

A sentinel event is usually one that results in an unexpected outcome for the patient and "signals" the need for investigation and response.Which of the following would be considered a sentinel event?

A nurse has administered the wrong medication to a patient.In investigating the root cause of the error, it is discovered that the nurse was unfamiliar with the medication and that the Pyxis was incorrectly loaded with the wrong medication.What should be the outcome of this process?

Which of these is a measured outcome from a performance improvement process perspective?

Patient satisfaction surveys include questions about quality of care.What has the greatest impact on patient satisfaction?

A sentinel event is usually one that results in an unexpected outcome for the patient and "signals" the need for investigation and response.Which of the following would be considered a sentinel event?

Risk management is a hospital program organized to prevent the incidences of preventable accidents, injuries, and errors.Which of the following situations would a hospital risk manager need to investigate?

A sentinel event is usually one that results in an unexpected outcome for the patient and "signals" the need for investigation and response.Which of these situations would be considered a sentinel event?

The Joint Commission ( TJC ) tracks core measures for performance.Which core measures are tracked by TJC? (Select all that apply.)

When using the DMAIC acronym of the Six Sigma quality process improvement model, the nurse understands that the I (improve) refers to

The National Database of Nursing Quality Indicators (NDNQI) has established which of the following goals to assist nurses to make practice changes in order to benefit patients?

What area is included when risk management explores the prevention of accidents, injuries, and errors?

The National Patient Safety Goals of The Joint Commission ( TJC ) are established goals to reduce the risks for injuries to patients and provide a safe environment.Which practice has been instituted as a result of these goals established by TJC?

Leadership and Management

Organizational Structure of Health Care

Strategic Management and Planning

Financial Management in Health Care

Healthcare Regulatory and Certifying Agencies

Organizational Decision Making and Shared Governance

Professional Decision Making and Advocacy

Communication in the Work Environment

Personnel Policies and Programs in the Workplace

Professional Development

Professional Practice and Care Delivery Models and Emerging Practice Models

Staffing and Scheduling

Delegation of Nursing Tasks

Providing Competent Staff

Group Management for Effective Outcomes

Hospital Information Systems

Ethical and Legal Issues in Patient Care

Evidence-Based Practice

Monitoring Outcomes and the Use of Data for Improvement

New Graduates: the Immediate Future: Job Interviewing, Nclex, and Continuing Education

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