RNSG 1137 Safety/Quality Improvement Quiz 2020 – San Antonio College 4. Safety/Quality Improvement Question 1 According to the American Nurses’ Association statement on the impact of fatigue on th e nurse and the quality
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RNSG 1137 Safety/Quality Improvement Quiz 2020 – San Antonio College 4. Safety/Quality Improvement Question 1 According to the American Nurses’ Association statement on the impact of fatigue on th e nurse and the quality of patient care, which statement is correct? Nurses form the infrastructure of safety Solutions to balance work load and promote safe staffing are the responsibility of the leadership Poor work environments have little effect on fatigue and emotional exhaustion Fatigue and early detection of adverse events are unrelated. Question 2 The Joint Commission (JC) issued a sentinel alert regarding health care worker fatigue injuries. A nurse recognizes JC recommended fatigue prevention techniques as ( Select All That Apply). Limiting extended work hours This JC alert was in direct response to evidence that shows fatigue from lack of sleep slows reaction time, alters mental judgment, and predisposes the person to physiologic changes in the form of disease and disability. JC recommends: assess work schedules and staffing to address extended work shifts and hours, review hand-off processes and procedures to ensure safe transfer of information, request staff input in designing work schedules to minimize staff fatigue, develop and implement a fatigue management plan,educate staff about sleep hygiene and the effects of fatigue on patient safety, address staff concerns about fatigue, encourage teamwork to support staff who work extended shifts, and keep the effects of fatigue in mind when reviewing adverse events. Sleep-promotion medications and coffee are not in the recommendations
Explanation: This JC alert was in direct response to evidence that shows fatigue from lack of sleep slows reaction time, alters mental judgment, and predisposes the person to physiologic changes in the form of disease and disability. JC recommends: assess work schedules and staffing to address extended work shifts and hours, review hand-off processes and procedures to ensure safe transfer of information, request staff input in designing work schedules to minimize staff fatigue, develop and implement a fatigue management plan,educate staff about sleep hygiene and the effects of fatigue on patient safety, address staff concerns about fatigue, encourage teamwork to support staff who work extended shifts, and keep the effects of fatigue in mind when reviewing adverse events. Sleep-promotion medications and coffee are not in the recommendations. Taylor, C.R. Fundamentals of Nursing, 8th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2015, Chapter 33: Rest and Sleep, pp. 1124-1125 Education on sleep hygiene Considering sleep medications Include staff in schedule redesign Providing free coffee in the lobby Question 3 A nurse is preparing handoff communication for a patient who is being discharged from the hospital to home health care. Which example is an action performed during this process? The nurse uses the SBAR technique during the handoff. The nurse prepares the new room for a patient prior to admission, not during the discharge process. The patient handoff refers to transferring responsibility for a patient from one caregiver to another with the goal of providing timely, accurate information about a patient’s plan of care, treatment, current condition and anticipated changes. The nurse determines who he or she needs to communicate with during the discharge and asks those health care professionals if they have any questions in order to provide continuity of care. SBAR (Situation-Background-Assessment-Recommendation) is an outline that many facilities follow to ensure that proper communication occurs during the handoff procedure. Taylor, C.R. Fundamentals of Nursing, 8th ed., Philadelphia: Wolters Kluwer Health, 2015, Chapter 9, Care Coordination, and Continuity in Health Care Settings and the Community, page 169-170 Only the charge nurse is involved in the handoff. The charge nurse restricts the information to the unit nurses and excludes the other health care professionals. The nurse completes the handoff only to anticipate changes at the new location. Question 4 0 / 10 pts Sendelbach and Funk (2013) in their article, “Alarm Fatigue-A Patient Safety Concern”, identified “monitor watchers” as one of the areas needing additional research in efforts to improve patient safety related to alarms. Which statement is true based on the article? Wireless technology is more effective for patient safety than “monitor watchers” A former study concluded that use of “monitor watchers” did not lower rates of most adverse outcomes The cost of “monitor watchers” is justified by better patient outcomes. “Monitor watchers” don’t affect nurses’ knowledge about EKG and EKG monitoring Question 5 Which of the following are ways to prevent nurse fatigue? Work no more than 60 hours in a 7 day period Powerpoint on Nurse fatigue. Work no more than 10 hours per day Initiate safe habour if you work more than three 12 hour shifts in a week Only accept an assigment with no more than 3 patients Question 6 What role has The Joint Commission (TJC) assumed in ensuring quality at the organizational level? Establishing clinical practice guideline Reducing diagnosis-related group reimbursement levels Standardizing clinical outcome data collection Assessing monetary fines for hospitals that fail to meet standards Question 7 Upon doing a record audit of patients admitted for angina on a medical unit, it was noted that not 100% of patients received a 12-lead EKG with complaints of chest pain. What is the most appropriate QSEN competency focus in this case? Safety Quality Improvement Patient-Centered Care Evidence Based Practice Question 8 The Joint Commission is conducting an accreditation visit at the hospital. What is the focus of the evaluation being conducted? Quality assurance Accreditation by the Joint Commission evaluates quality assurance. Quality assurance is an externally driven process, demonstrating nursing excellence by meeting professional standards of care. Quality improvement is an internally driven continuous process, focusing on the processes of client care. Peer review is a process whereby individual nurses improve their professional performance through the evaluation of one staff member by another staff member on the same level of the hierarchy of the organization. Magnet status is awarded by the American Nurses Credentialing Center, recognizing healthcare organizations for their excellence in nursing. Taylor, C., et al. Fundamentals of Nursing, 8th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015, Chapter 15: Evaluating, p. 333. Magnet status Peer Review Quality Improvement Question 9 A nursing student asks the clinical instructor to explain the difference between quality improvement and quality assurance. Which response by the clinical instructor is appropriate? ”Quality improvement focuses on organization structure and individuals". "Quality assurance promotes empowerment and collaboration." "Quality improvement focuses on processes, data, and statistical thinking." "Quality assurance is concerned with patient satisfaction." Question 10 Which of the following does a nurse recognize is among the rules suggested by the Institute of Medicine's (IOM) Committee on Quality of Health Care in America to improve health care? (Select All That Apply) The patient as the source of control Safety as a system priority Providing client care based on a standardized plan of care. Anticipation of client's needs Cooperation among clinicians
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