Chapter 20: Managing Quality and Risk

Leading and Managing in Nursing 5th Edition by Patricia S. Yoder-Wise

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Chapter 20: Managing Quality and Risk

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

  1. A new graduate is asked to serve on the hospital’s quality improvement (QI) committee. The nurse understands that the first step in quality improvement is to:
a. Collect data to determine whether standards are being met.
b. Implement a plan to correct the problem.
c. Identify the standard.
d. Determine whether the findings warrant correction.

 

ANS:   C

Before further action (data collection, decision making related to correction, and implementation of a plan) can occur, it is necessary to identify the standards against which data collection and decision making will occur. Institutions may or may not adopt standards that are already established by organizations such as the ANA.

 

REF:    Pages 395, 396

TOP:    AONE competency: Knowledge of the Healthcare Environment

 

  1. The chief executive officer asks the nurse manager of the telemetry unit to justify the disproportionately high number of registered nurses on the telemetry unit. The nurse manager explains that nursing research has validated which statement about a low nurse-to-patient ratio? It:
a. Promotes teamwork among healthcare providers.
b. Increases adverse events.
c. Improves outcomes.
d. Contributes to duplication of services.

 

ANS:   C

Studies related to staffing and patient outcomes suggest that patient outcomes are improved with a low nurse-to-patient ratio and especially with a low registered nurse-to-patient ratio.

 

REF:    Pages 403, 404

TOP:    AONE competency: Knowledge of the Healthcare Environment

 

 

  1. A nurse manager wants to decrease the number of medication errors that occur in her department. The manager arranges a meeting with the staff to discuss the issue. The manager conveys a total quality management philosophy by:
a. Explaining to the staff that disciplinary action will be taken in cases of additional errors.
b. Recommending that a multidisciplinary team should assess the root cause of errors in medication.
c. Suggesting that the pharmacy department should explore its role in the problem.
d. Changing the unit policy to allow a certain number of medication errors per year without penalty.

 

ANS:   B

Quality management stresses improving the system, and the detection of staff errors is not stressed. If errors occur, reeducation of staff is emphasized rather than imposition of punitive measures such as disciplinary action or blaming.

 

REF:    Pages 390, 391

TOP:    AONE competency: Knowledge of the Healthcare Environment

 

  1. The nurse educator of the pediatric unit determines that vital signs are frequently not being documented when children return from surgery. According to quality improvement (QI), to correct the problem, the educator, in consultation with the patient care manager, would initially do which of the following?
a. Talk to the staff individually to determine why this is occurring.
b. Call a meeting of all staff to discuss this issue.
c. Have a group of staff nurses review the established standards of care for postoperative patients.
d. Document which staff members are not recording vital signs, and write them up.

 

ANS:   B

Leadership must identify safety shortcomings and must locate resources at patient care levels to identify and reduce risks. One method of doing this is to invite all staff into a discussion related to solutions to an identified concern. This approach encourages teamwork.

 

REF:    Page 390

TOP:    AONE competency: Knowledge of the Healthcare Environment

 

  1. A nurse is explaining the pediatric unit’s quality improvement (QI) program to a newly employed nurse. Which of the following would the nurse include as the primary purpose of QI programs?
a. Evaluation of staff members’ performances
b. Determination of the appropriateness of standards
c. Improvement in patient outcomes
d. Preparation for accreditation of the organization by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO)

 

ANS:   C

The primary purpose of QI is improvement of patient outcomes, which relates to prevention of error, quality patient care, and patient satisfaction.

 

REF:    Page 390

TOP:    AONE competency: Knowledge of the Healthcare Environment

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