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Certified Professional in Patient Safety exam questions and answers
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Certified Professional in Patient Safetyexam questions and answers
iatrogenesis - answer Greek for originating from a physician
preventable adverse events - answer those that occurred due to error or failure to apply an
accepted strategy for prevention
Ameliorable adverse event - answer events that, while not preventable, could have been less
harmful if care had been different
adverse events due to negligence - answer those that occurred due to care that falls below the
standards expected of clinicians in the community
near miss - answer an unsafe situation that is indistinguishable from a preventable adverse
event except for the outcome - exposed but does not experience harm either through luck or
early detection
error - answer broader term referring to any act of commission or omission that exposes
patients to a potentially hazardous situation
adverse event - answer An injury caused by medical management (rather than the underlying
disease) and that prolonged the hospitalization, produced at disability at the time of discharge,
or both
commision - answer doing something wrong
omission - answer failing to do the right thing
,CPOE - answer Computerized Provider Order Entry
2009 HITECH Act and meaningful use program
computer alerts three main findings - answer 1. modestly effective at best
2. alert fatigue is common
3. fatigue increases with exposure and heavier use of CPOE systems
minimize alert fatigue - answer 1. increase alert specificity to reduce inconsequential alerts
2. tier alerts according to severity
3. make only high level/severe alerts interruptive
4. use human factors principles
three concepts that influence safety in ambulatory care - answer 1. role of pt and caregiver
behaviors
2. role of provider-pt interactions
3. role of community and health system
Medical Office Survey on Pt Safety Culture - answer designed to assess safety culture in amb
care and data is available from AHRQ
Pt Engagement - answer 1. ed pt about their illness and medications with pt demonstrating
understanding "teach back"
2. empowering to act as a safety double check
checklist - answer Algorithmic listing of actions to be performed for a given clinical procedure
designed to ensure that no matter how often performed by a given clinician, no step will be
forgotten
reduce risk of slips
consensus of required behaviors
,slips - answer failure of schematic (autopilot) behaviors
lapses in concentration, distractions, or fatigue
mistake - answer failures in attentional behavior
lack of experience or insufficient training
Situational Awareness - answer the ability to access and track relevant to the task,
comprehend the data,
forecast what may happened based on the data, and
formulate an appropriate plan in response
situational awareness cannot be achieved without - answer clear and high-quality
communication between all providers
most common root cause of sentinel events - answer communication
elements the affect communication - answer 1. rigid hierarchies
2. overtly disruptive and unprofessional behavior
3. nonverbal cues
4. interpersonal relations
5. group dynamics
communication tools - answer read-back protocols
SBAR
teamwork training
, process for prescribing and adm meds - answer 1. order
2. Transcribing
3. dispensing
4. administration
90% errors occur at ordering (48%) or transcribing thus CPOE prevent
CDSS - answer Clinical Decision Support System
assist healthcare providers in the actual diagnosis and treatment of patients, analyze data from
clinical information systems
avoids commission and omission errors
unintended consequences of CPOE - answer 1. more or new work for clinicians
2. unfavorable workflow
3. never-ending system demands
4. persistence of paper orders
5. changes in communication patterns and practices
6. neg towards new technology
7. new types of errors
8. change in power structure, org culture , or professional roles
High Reliability Organizations (HROs) - answer persistent mindfulness with in an organization
cultivate resilience by relentlessly prioritizing safety over other performance pressures
consistently minimize adverse events despite carrying out intrinsically complex and hazardous
work
safety is emergent vs. static
commitment to safety at all levels
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