Exam (elaborations)
QUALITY IMPROVEMENT PRACTICE QUESTIONS AND ANSWERS
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QUALITY IMPROVEMENT PRACTICE QUESTIONS AND ANSWERS...
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The nurse is evaluating the effectiveness of changes made to improvequality of care.
Which procedure is the nurse conducting?
Quality assurance
Total quality management
Continuous quality improvement
Quality management plan - ANSWER Quality assurance
Implemented changes must be evaluated to assess their impact on
patient care, patient outcomes, patient and clinical satisfaction, and
resource utilization. Data related to the original problem must be
collected and are then analyzed on the basis of benchmark standards to
determine whether standards are being met. This is called quality
assurance. A quality management plan is used to help healthcare
facilities integrate new programs, models, and technologies with the
primary care services that are already in place. Total quality
management (TQM) is a comprehensive management philosophy used
to improve quality and productivity by using data and statistics to
improve processes. Continuous quality improvement (CQI) is a
structured organizational process for including personnel in planning and
executing a continuous flow of improvements to provide quality health
care that meets or exceeds expectations.
The hospital management is concerned about feedback regarding long
waiting times for treatment in the emergency department and forms a
committee to resolve the issue.
Which should be the first task by the leader of the committee to solve the
problem?
,Form a Continuous Quality Improvement team to define the desired
outcome.
Reevaluate emergency room waiting times.
Collect baseline data to determine if a problem exists.
Ask the director of operations for solutions. - ANSWER Form a
Continuous Quality Improvement team to define the desired outcome.
The first step in the Continuous Quality Improvement (CQI) process is to
assemble a team of individuals who are stakeholders in the problem to
form a CQI team to define the desired outcome. From there, the nurse
can measure performance against the desired outcome, analyze the
results, provide feedback, implement a solution, and evaluate its
effectiveness. If the nurse were to collect baseline information without
determining the desired outcome, they might not measure the relevant
indicators. CQI is about including the team in the problem-solving
process, rather than dictating what needs to be accomplished. By
including the team in the problem solving, it is more likely they will buy
into the solutions. Asking the operations manager for solutions is not the
best way to resolve the issue, and reevaluating the wait time will only
help after implementation of the first plan of action to reduce that issue.
The nurse recognized making a medication error and immediately
reported it to the unit supervisor.
Which response from the supervisor should the nurse expect in an
environment that promotes quality?
"Why are you reporting that to me without completing an incident
report?"
"You need to report directly to the Chief Nursing Officer."
"You have reported this to me, so you do not need to file an incident
report."
, "We have a blame-free environment so you can report errors without
fearing punishment." - ANSWER "We have a blame-free environment so
you can report errors without fearing punishment."
Most errors in health care are a result of the healthcare system and not
the fault of a single individual. If a clinic is afraid to report errors for fear
of punishment or because reporting does not result in positive change,
then problems within the system cannot be identified or addressed. A
key component in quality improvement is establishing a blame-free
environment in which healthcare providers can report errors or near
misses without the fear of punishment. This helps identify problems, so
that corrections can be made, and future events can be prevented. An
incident report will be completed as a part of the investigation.
Which statement should the nurse use to describe the purpose of the
root cause analysis?
Brainstorming preferred outcomes
Identifying risks causing financial loss
Providing a report to the leader of the committee
Identifying the root cause of the problem through problem solving -
ANSWER Identifying the root cause of the problem through problem
solving
The purpose of a root cause analysis is to determine the root cause of a
problem. Brainstorming outcomes and reporting to the leader would be
part of the task force to implement quality improvements. Identifying
risks of financial loss is part of an audit.
Which governmental agency should the nurse recognize as being
instrumental in developing indicators of high-quality care and measures?
U.S. Red Cross
Centers for Disease Control and Prevention (CDC)
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