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IHI a questions and answers already passed 2024
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IHI a questions and answers already passed 2024
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IHI: PS 104: Teamwork andCommunication
Lesson 1
Referring to the video on the previous page, in your opinion, what was the
underlying cause of the adverse event?
-The culture of the hospital did not promote safety as the highest priority.
- The surgeon failed to listen to the scrub technician student and the nurses.
The charge nurse failed to insist on an X-ray.
The scrub technician student and the circulating nurse failed to insist on an X-
ray. - correct answer ✔The charge nurse failed to insist on an X-ray.
A healthy 45-year-old athlete is scheduled for a knee arthroscopy to clean up
her knee so that she can ski better in the coming winter. This is a low-risk,
straightforward procedure.The chief of orthopedics will perform the procedure.
After two complex and time-consuming procedures, this is his final surgery of
the day.Because of a staffing issue, two nurses are pulled from another
operating room (OR) to help. They are experienced nurses but have never
worked in orthopedics before, and they don't know any of their colleagues.The
surgery begins with limited introductions or discussion about the case, and the
surgeon has loud music playing. He asks one of the two "new" nurses for 20
mL of local anesthetic with dilute epinephrine to put in the knee. The nurse
hears only, "Give me the epi." Not knowing what it is for, she hands him a
syringe with 20 mL of concentrated epinephrine, which is 1,000 times too
much.As a resul - correct answer ✔All of these answers could be correct.
There are many factors that increased the risk for error in this example: The
surgeon is fatigued, the nurses are unfamiliar with their environment, and the
environment is distracting. (See PS 103: Human Factors and Safety for a
review of the internal and external factors that contribute to error.)
, Yet, if the members of the surgical team had taken time before the start of the
procedure to acquaint themselves with one another and the procedure and
express any concerns, and if the team had communicated effectively during
the procedure — reconfirming critical points and functioning as a more
cohesive unit — it is likely the same error would not have occurred.
A one-minute conversation could have:
- Acquainted the team members.
- Verified the experience and comfort level of the team members to provide
the care.
- Identified what drugs were going to be used.
- Outlined the plan.
It's perhaps all they needed to mitigate the factors that contributed to this
nearly lethal event.
Post-Lesson Assessment: PS 104 Lesson 1
Effective health care teams have several important characteristics, including:
- Stable membership; that is, they have the same people on the team from
day to day
- Effective communication techniques
- The ability to rehearse procedures together, like a choir or a sports team
- The ability to achieve good results without strong communication - correct
answer ✔- Effective communication techniques
Post-Lesson Assessment: PS 104 Lesson 1
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