Certified Professional in Patient Safety Exam Questions With Correct Answers 2023/2024

Certified Professional in Patient Safety Exam Questions With Correct Answers 2023/2024. unintended consequences of CPOE - Correct 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) - Correct 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 HRO key features - Correct Answer-1. know high-risk nature of activities and determine to have consistent safe operations 2. blame-free 3. collaboration across ranks and disciplines 4. commitment of resources to address safety concerns Patient Safety Culture Surveys and Safety Attitudes Questionnaire - Correct Answerask providers to rate the safety culture in their units and org as a whole poor perceived safety culture= increased error rates just culture - Correct Answer-id and addressing systems issues that lead individual to engage in unsafe behaviors while maintain accountability human error (slip) at risk behavior (short cuts) reckless behavior (ignoring required safety steps) Debriefing - Correct Answer-dialogue to learn from defects and improve performance through goal discussion, reflection to incorporate improvement or discover opportunities in future performance simulation real-life emergency responses teamSTEPPS Components of debriefing - Correct Answer-1. setting the stage 2. description or reactions 3. analysis 4. application plus delta debriefing - Correct Answer-1. What went well? 2. What did not go well? 3. what can we do differently or what needs to change to improve care? debriefing framework - Correct Answer-team evaluates if: had clear communication understanding of roles & responsibilities maintained sit awareness distributed workload cross-monitoring (asked and offered help prn) made, mitigated, or corrected errors detecting errors and safety hazards - Correct Answer-goal to prospectively id hazards before pt harmed and analyzing events that have occurred to id and address underlying systems flaws FMEA - Correct Answer-Failure Mode and Effects Analysis 1. id all process steps "process mapping" 2. how each step can go wrong "failure modes" 3. impact of each error 4. likelihood of process failure 5. chance of detecting failure 6. impact of error SWIFT - Correct Answer-structured what-if technique perceived safety problems can be detected through - Correct Answer-safety culture surveys executive walk rounds techniques to retrospectively id safety hazards - Correct Answer-1. screen larger datasets for evidence of preventable adverse events that merit further investigation (trigger tools, patient safety indicators) 2. analyze individual cases of adverse events (RCA, mortality reviews, in-depth investigation) Patient Safety and Quality Improvement Act - Correct Answer-Jan 2009 confidential and privilege protections for pt safety info when HCP work with Patient Safety Organizations hazard detection methods - Correct Answer-voluntary error reports malpractice claims pt complaints executive walk rounds risk mgmt. database per Harvard Medical Practice Study, what % of errors were diagnostic - Correct Answer17% 9% were undetected while pt was alive heuristics - Correct Answer-Mental shortcuts or "rules of thumb" that often lead to a solution (but not always) availability heuristic - Correct Answer-dx of current pt biased by experience with past cases (crushing chest pain=MI) anchoring heuristic - Correct Answer-relying on initial dx impression despite subsequent info to the contrary (BC with corynebacterium txed as contaminant when endocarditis) framing effects - Correct Answer-dx decision making unduly biased by subtle cues and collateral information (addicted pt with abd pain tx for withdrawal but had bowel perf) blind obedience - Correct Answer-undue reliance on test results or expert opinion (false neg rapid Strept test) prominent reason for malpractice claims - Correct Answer-missed or delayed dx predisposing factors for dx error in ES and surgery - Correct Answer-poor teamwork communication gold standard for diagnosis - Correct Answer-autopsy goals is to have 25% inpt deaths autopsied prevent dx errors - Correct Answer-1. info technology hoen triage 3. teamwork & communication training 4. increased supervision of trainees mega-cognition - Correct Answer-cognitive psychology reflect on own thinking with the hope to catch own misuse of heuristics before cause harm components of disclosure that matter most to pts - Correct Answer-1. disclosure of all harmful errors 2. explanation why occurred 3. how error's effects will be minimized 4. steps taken to proven recurrences Full Disclosure Principle - Correct Answer-disclose all circumstances and events, acknowledgement of responsibility, and apology fewer malpractice lawsuits and lower litigation cost CANDOR - Correct Answer-Communication and Optimal Resolution used with disclosure of events % who reported witnessing physicians engage in disruptive behavior vs. nurses - Correct Answer-77% 65% physician disruptive and disrespectful behavior impact on nursing - Correct Answerdissatisfaction and likelihood of leaving nursing profession adverse events in OR % of healthcare professionals at any level engage in disruptive behavior - Correct Answer-2-4% disruptive behavior - Correct Answer-disrespect for others interpersonal interaction that impedes the delivery of pt care subverts the org ability to develop a culture of safety (impacts teamwork and blame-free environment) unprofessional behavior in medical school is linked to subsequent disciplinary action by licensing board founder of patient safety movement - Correct Answer-Dr. Lucian Leape prevent disruptive behavior - Correct Answer-code of conduct defines and managing behaviors leadership in ensuring culture of safety prevent behavior Bell Commission - Correct Answer-1987 mandating residents at New Your hospitals should work no more than 80 hours per week and no more than 24 consecutive hours due to Libby Zion's death due to med prescribing error Accreditation Council for Graduate Medical Education rules for work hours in 2003 - Correct Answer-1. no more than 80 hours per week 2. no more than 24 consecutive hours on duty 3. not be on call more than every 3rd night 4. must have 1 day off per week 2003 work hours regs impact on pt safety - Correct Answer-no clear effect on pt safety or clinical outcomes may be due to the number of pt handoffs burnout and fatigue are still common Accreditation Council for Graduate Medical Education rules for work hours in 2017 - Correct Answer-based on Flexibility in Duty Hours Requirements for Surgical Trainees (FIRST) same other than no 16 hour shift limit for first-year residents problems with EHR - Correct A info display 2. complicated screen sequences and navigation 3. mismatch between user workflow safety hazards with data entry errors can be created by - Correct Answer-1. use of copy-forward or copy and paste 2. electronic signatures 3. lack of clarity in sources and date of information presented 4. alert fatigue 5. usability problems 6. altered workflow 7. altered communication Med errors not impacted by EHR - Correct Answer-1. wrong pt (bar coding decreases error) 2. wrong med at time of selection 3. wrong time SAFER guides - Correct Answer-assessment checklists and structure for team to assess and improve their systems 1. high-priority practices 2. org responsibilities 3. contingency planning 4. system configuration 5. system interfaces 6. pt identification 7 CPOE with decision support 8. test result reporting and f/u 9. clinician communication suitability safety risk for EHR - Correct Answer-1. lack support of workflow 2. lack data coding, std, and structure 3. lack duplicate record detection 4. inaccurate, incomplete, or outdated decision support rules 5. bugs in software 6. content import features usability safety risk for EHR - Correct Answer-1. default values 2. problematic alerts 3. simultaneous task performance 4. inadequate info displays 5. unclear current state of user actio9ns in order processing 6. difficult interfaces 7. error-prone intervaces Human Factors Engineering - Correct Answer-interaction between workers, the equipment, and their environment takes into account human strengths and limitations in the design of interactive systems HFE accesses - Correct Answer-1. physical demand 2. skill demands 3. mental workload 4. team dynamics 5. aspects of work environment 6. device design goal is to compete the task optimally usability testing - Correct Answer-test in real-world conditions in order to id potential problems and unintended consequences of new technology will id workarounds forcing functions - Correct Answer-prevents unintended or undesirable action from being performed or allows it performance only if another specific action is performed first (shift into reverse unless brake is pushed) does not always involve device design (removing potassium from med rooms) standardization - Correct Answer-standardizing equipment and processes whenever possible to increase reliability, improve info flow, and minimize cross-training needs (checklists) resiliency efforts - Correct Answer-attention to detection and mitigation before events occur dynamic aspects of risk mgmt. to anticipate and adapt to changing conditions and recover from system anomalies HRO characteristic way of thinking - Correct Answer-1. preoccupation with failure 2. reluctance to simplify explanations for operations, successes, and failures 3. sensitivity to operations (situational awareness) 4. deference to frontline expertise 5. commitment to resilience Health literacy - Correct Answer-individual's ability to find, process, and comprehend the basic health info necessary to act on medical instructions and make decisions about one's health Institute of Medicine definition of health literacy - Correct Answer-function of systems within and beyond health care, and it involves interaction between the individual patient and health care system, as well as other social, cultural, and ed factors 2003 health literacy results - Correct Answer-over a third had basic or below basic levels 53% had intermediate level 12% proficient why is health literacy not static - Correct Answer-vary with mental or emotional state, illness, and life stressors individual skills complexity of info and tasks universal precautions for health literacy - Correct Answer-1. create shame-free environment 2. simplifying info (3 to 5 pts, 4-6th grade level) 3. listen carefully 4. confirm comprehension (teach back or show me) 5. improving support for navigation healthcare contexts (signage, forms, apps) 6. support in health mgmt efforts