NMNC 4520 (Prof. Concepts) Exam 1
What does the use of the CUSP tool provide? correct answers CUSP = comprehensive
unit based safety program
What industries other than healthcare began focusing on quality assurance? correct answers auto and aviation
Components of high quality care correct answers Access to care, competent health care providers, separation of financial and clinical decisions, organization of health care institutions to maximize quality
Adequate scientific knowledge correct answers Estrogen example - caused cancer due
to lack of research
Overuse correct answers Not using efficiently
Underuse correct answers Not using effective and affordable interventions
Misuse correct answers Financial aspect (billing for treatments that aren't being done)
Long term care correct answers Why? Growing number of elderly/increased chronic conditions earlier in life
What? Skilled/unskilled/home HC
Improve: cost of care is high, investment of staff, PACE models of care c healthcare team (home health), address determinants of health, assure providers stay on top of care, prevent illness
What is the intent of Accountability Measures on Consumer Assessment of Healthcare Providers and Systems (HCAHPS)? correct answers To measure how well hospitals/care facilities are performing on delivery of care for very specific medical conditions
Why is the Swiss Cheese Model a good example of the intent of Quality Management Programs? correct answers Model accounts for many system processes in place to help avoid error and stop the alignment of holes - leads to patient harm
Quality nurse wants to know about number of ICU sepsis cases in the last quarter - which type of audit? correct answers Outcomes audit
At what point of QI process do you need quality audits? correct answers Collection of Data Purpose of Risk Management correct answers Prevent errors before they occur, identify and correct error, optimize pt outcomes, prevent pt care problems, mitigates adverse events
Fishbone diagram correct answers Team agrees on problem statement, team agrees on major categories of problem, brainstorm possible causes of problem, identify subbranches of problem, nonjudgmental brainstorming, identifies slice of Swiss cheese model - then the holes within it
Goal: minimize holes and potential for pt harm, occur in root cause analysis, look at systematic problem/breakdown
process audit correct answers Appropriate HC provider activities carried out to deliver care
outcomes audit correct answers Result of health care delivery
structure audit correct answers Resources/organizational arrangements in place to deliver care
Nursing special report correct answers High - value care and nursing/work environment
standards for high-value care: key performance measures, HCAHPS, pay-for-
performance, value based purchasing, press ganey employee engagement survey
High quality nursing care correct answers Dependent on: staffing ratios, nursing skill set/education, availability of supplies/equipment, staff training, facilities, reliable use and
demonstration of EBP, inter professional relationships, nurse engagement, job satisfaction
recommendations: institute of medicine the future of medicine leading change, magnet models, Kaiser permenente nursing vision/values/professional practice model
interventions: robust shared governance, support for inter professional relationships, consistent adequate staffing mix, development of highly educated workforce, appropriate/consistent leadership support
Root Cause Analysis (RCA) correct answers Analyzes errors/potential errors, goal: identify underlying problems that contribute to increased likelihood of errors/poor patient
outcomes, cause-and-effect diagram, ID root cause of problem to find solution, more effective than putting out fires
Continuous Quality Improvement (CQI) correct answers Continuous improvement looking at risk management (what are we ignoring?)
tooks: RCA, PDSA, six sigma, structure, outcome and process, TCB
