NURS 344 SAFETY SCIENCE & QUALITY IMPROVEMENT EXAM Q & A WITH RATIONALES 2024, Exams of Nursing

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NURS 3 44

Safety Science &

Quality Improvement

Q & A w/ Rationales

1. A nurse is conducting a root cause analysis (RCA) of a medication error that occurred in her unit. She interviews the staff involved, reviews the incident report, and examines the medication administration process. What is the next step in the RCA? a) Identify the contributing factors and root causes of the error b) Develop an action plan to prevent recurrence of the error c) Implement the action plan and monitor its effectiveness d) Communicate the findings and recommendations to stakeholders Answer: A. The next step in the RCA is to identify the contributing factors and root causes of the error, which are the underlying reasons why the error happened. This helps to understand how to prevent similar errors in the future. B, C, and D are subsequent steps in the RCA after identifying the root causes.
2. A nurse is leading a quality improvement (QI) project to reduce hospital-acquired infections (HAIs) in her unit. She uses the Plan-Do-Study-Act (PDSA) cycle as a framework for implementing changes. She has developed a plan to introduce a new hand hygiene protocol and has tested it on a small scale. What should she do next in the PDSA cycle? a) Study the results of the test and compare them to the baseline data b) Act on the results of the test and decide whether to adopt, adapt, or abandon the change c) Do another test with a larger sample size and longer

missing from her communication. The situation is a brief statement of what is happening at the present time, such as "We have an emergency" or "We have a critical patient". This helps to alert other team members to pay attention and prioritize their actions. B, C, and D are present in her communication. B: Which of the following best defines the concept of patient safety? A) The absence of adverse events in healthcare settings B) A system of procedures to prevent medical errors C) The reduction and mitigation of harm to patients D) The promotion of patient well-being through effective communication Answer: C) The reduction and mitigation of harm to patients Rationale: Patient safety involves not only the prevention of adverse events but also the active reduction and mitigation of harm to patients through systematic measures and protocols. What is the primary goal of quality improvement initiatives in healthcare? A) Minimizing healthcare costs B) Enhancing patient satisfaction C) Improving clinical outcomes

D) Streamlining administrative processes Answer: C) Improving clinical outcomes Rationale: Quality improvement initiatives aim to enhance the effectiveness and efficiency of healthcare delivery, ultimately leading to improved clinical outcomes for patients. In the context of patient safety, what does the acronym "SBAR" stand for? A) Safety, Behavior, Assessment, Response B) Situation, Background, Assessment, Recommendation C) Standardized, Best practices, Adherence, Reporting D) Systematic, Balanced, Analysis, Response Answer: B) Situation, Background, Assessment, Recommendation Rationale: SBAR is a communication tool used in healthcare settings to provide a standardized framework for conveying essential information about a patient's condition. Which of the following is a key component of a culture of safety in healthcare organizations? A) Blaming individuals for medical errors B) Open communication and transparency C) Rigid adherence to hierarchical structures D) Minimizing staff involvement in decision-making processes Answer: B) Open communication and transparency

Rationale: A just culture encourages open reporting of errors without fear of retribution, fostering a learning environment focused on system improvements. What is the primary purpose of conducting Failure Mode and Effects Analysis (FMEA) in healthcare? A) Assigning blame for system failures B) Identifying potential failure points in processes C) Minimizing staff involvement in safety initiatives D) Streamlining administrative processes Answer: B) Identifying potential failure points in processes Rationale: FMEA is a proactive risk assessment method used to identify potential failure points in processes, allowing for preemptive measures to enhance patient safety. Which of the following is a core element of the Plan-Do- Study-Act (PDSA) cycle in quality improvement? A) Implementing changes without evaluation B) Continuously repeating the same processes C) Standardizing all aspects of care delivery D) Iteratively testing and refining changes Answer: D) Iteratively testing and refining changes Rationale: The PDSA cycle involves iterative testing of changes, studying the results, and acting on the findings to continuously improve processes.

In the context of medication safety, what is the "five rights" principle? A) The right to refuse medication B) The right dosage, route, time, patient, and medication C) The right to self-administer medication D) The right to access medication records Answer: B) The right dosage, route, time, patient, and medication Rationale: The "five rights" principle emphasizes the correct administration of medication, including the right dosage, route, time, patient, and medication. Which of the following best describes the concept of "never events" in healthcare? A) Medical events that are unlikely to occur B) Adverse events that should never happen in healthcare settings C) Routine occurrences in clinical practice D) Unpredictable medical emergencies Answer: B) Adverse events that should never happen in healthcare settings Rationale: "Never events" refer to serious adverse events that are largely preventable and should never occur in healthcare settings. What role does the World Health Organization (WHO) play in promoting patient safety globally? A) Setting international standards for healthcare quality

Commission? A) Minimizing patient involvement in care decisions B) Enhancing patient satisfaction scores C) Promoting specific improvements in patient safety D) Reducing healthcare costs for patients Answer: C) Promoting specific improvements in patient safety Rationale: The NPSGs are designed to promote specific improvements in patient safety by addressing key areas of concern and risk within healthcare settings. What role does the Agency for Healthcare Research and Quality (AHRQ) play in advancing patient safety and quality improvement? A) Providing malpractice insurance for healthcare providers B) Conducting clinical trials for new medical treatments C) Developing evidence-based tools and resources for healthcare professionals D) Minimizing staff involvement in safety initiatives Answer: C) Developing evidence-based tools and resources for healthcare professionals Rationale: The AHRQ plays a vital role in advancing patient safety and quality improvement by developing evidence-based tools and resources to support healthcare professionals in delivering safe and effective care. How does the implementation of standardized patient

safety protocols contribute to improved care outcomes? A) By increasing variability in care processes B) By minimizing the need for continuous quality monitoring C) By promoting consistency and reliability in care delivery D) By reducing the involvement of frontline staff in safety initiatives Answer: C) By promoting consistency and reliability in care delivery Rationale: Standardized patient safety protocols contribute to improved care outcomes by promoting consistency and reliability in care delivery, ultimately enhancing patient safety and well-being. C:

1. Which of the following is an essential component of a culture of safety in healthcare organizations? a) High patient satisfaction scores b) Continuous improvement mindset and transparency c) Use of advanced technology in patient care d) Reduction of healthcare costs Answer: b) Continuous improvement mindset and transparency Rationale: A culture of safety in healthcare organizations emphasizes a continuous improvement mindset and

Answer: c) Effective teamwork and communication Rationale: High-reliability organizations (HROs) prioritize effective teamwork and communication as key components of their safety culture. This enables quick and accurate information exchange, promotes shared situational awareness, and helps prevent errors and adverse events.

4. What is the purpose of failure mode and effects analysis (FMEA) in healthcare? a) To identify the root causes and contributing factors of adverse events b) To prioritize potential failures based on severity, occurrence, and detectability c) To assign blame to specific individuals involved in adverse events d) To develop standard operating procedures for healthcare providers Answer: b) To prioritize potential failures based on severity, occurrence, and detectability Rationale: Failure mode and effects analysis (FMEA) is a proactive approach used to identify potential failures in a process or system, prioritize them based on their impact and likelihood of occurrence, and implement preventive measures to reduce risks and enhance patient safety.
5. What does the acronym "SBAR" stand for in the context of healthcare communication? a) Standardized Barriers for Adverse Reactions b) Situation, Background, Assessment, and

Recommendation c) Standardized Breakdown of Adverse Reporting d) Safety and Barriers Assessment in Rehabilitation Answer: b) Situation, Background, Assessment, and Recommendation Rationale: SBAR is an acronym for Situation, Background, Assessment, and Recommendation, a structured communication framework used in healthcare to improve the clarity, accuracy, and efficiency of information exchange between healthcare professionals.

6. What is the purpose of a workflow analysis in healthcare quality improvement? a) To increase patient wait times and reduce efficiency b) To optimize the flow of patients and information within healthcare processes c) To limit access to necessary resources for healthcare professionals d) To decrease the involvement of healthcare professionals in decision-making processes Answer: b) To optimize the flow of patients and information within healthcare processes Rationale: A workflow analysis in healthcare quality improvement aims to identify inefficiencies in the flow of patients, information, and resources within healthcare processes and make necessary changes to optimize the workflow, thereby enhancing patient safety and efficiency.

focuses on continuous learning from mistakes without resorting to blame or punitive actions against healthcare professionals. It encourages open reporting of errors, analyzes system failures, and seeks opportunities for improvement to enhance patient safety.

9. Which of the following is an example of a high- reliability practice to reduce medication errors? a) Overloading healthcare providers with excessive workload b) Encouraging the use of handwritten prescriptions c) Implementing barcode scanning systems for medication administration d) Relying on verbal communication for medication orders Answer: c) Implementing barcode scanning systems for medication administration Rationale: Implementing barcode scanning systems for medication administration is a high-reliability practice that reduces medication errors by ensuring the right medication is given to the right patient at the right dose and time. It minimizes the reliance on manual transcription and decreases the potential for errors.
10. What is the purpose of a failure to rescue (FTR) program in healthcare? a) To increase the number of adverse events and patient injuries b) To assign blame to healthcare professionals for system failures

c) To identify scenarios where healthcare professionals effectively rescue patients from harm d) To identify and improve areas where patients are not effectively rescued from harm Answer: d) To identify and improve areas where patients are not effectively rescued from harm Rationale: A failure to rescue (FTR) program in healthcare aims to identify areas where patients are not effectively rescued from harm or adverse events. By analyzing these areas, necessary improvements can be made to enhance patient safety and reduce preventable harm.

11. Which of the following best describes the concept of "never events" in healthcare? a) Inevitable and unavoidable adverse events that occur in healthcare settings b) Adverse events that are never reported or addressed within healthcare organizations c) Serious and preventable medical errors or events that should never happen d) Adverse events that only occur in outpatient settings Answer: c) Serious and preventable medical errors or events that should never happen Rationale: "Never events" in healthcare refer to serious and preventable medical errors or events that should never happen. These events are identifiable, largely preventable, and indicate significant underlying safety problems in a healthcare organization.

among healthcare professionals is a potential barrier to effective interprofessional collaboration in healthcare. It can hinder effective communication, teamwork, and coordination, leading to compromised patient safety and quality of care.

14. What is the significance of human factors engineering in safety science? a) To eliminate the role of human professionals in healthcare delivery b) To prioritize cost-saving measures over patient care c) To design systems and tools that take into account human capabilities and limitations d) To ensure punitive actions are taken against healthcare professionals for errors Answer: c) To design systems and tools that take into account human capabilities and limitations Rationale: Human factors engineering plays a vital role in safety science by designing systems, tools, and processes that consider human capabilities and limitations. It aims to optimize the interaction between humans and the healthcare system, reducing the potential for errors and enhancing patient safety.
15. Which of the following is an example of a quality improvement metric related to patient safety? a) Patient satisfaction scores b) Annual revenue of a healthcare organization c) Number of healthcare providers in a facility

d) Rate of healthcare-associated infections (HAIs) Answer: d) Rate of healthcare-associated infections (HAIs) Rationale: The rate of healthcare-associated infections (HAIs) is an example of a quality improvement metric related to patient safety. It provides insight into the effectiveness of infection control practices and helps identify areas for improvement to reduce the occurrence of HAIs.