Module 50 Quality Improvement

Module 50   Quality Improvement

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

The Concept of Quality Improvement

1) The nurse on a medical-surgical unit is asked to participate in data collection on skin care for the unit. What purpose will it serve for the nurse to cooperate with this request?

1. A) Participate in the quality improvement process
2. B) Advance the nurse’s practice
3. C) Prevent problems from arising in the unit
4. D) Fulfill legal requirements

Answer:  A

Explanation:

1. A) Quality improvement is the name for the processes used by an agency to measure and improve aspects of client care. The nurse may advance practice, but that is usually accomplished by returning to school for a higher degree. Preventing problems from arising is only one benefit of quality management. Nurses are encouraged to participate in quality improvement programs but are not legally required to do so.
2. B) Quality improvement is the name for the processes used by an agency to measure and improve aspects of client care. The nurse may advance practice, but that is usually accomplished by returning to school for a higher degree. Preventing problems from arising is only one benefit of quality management. Nurses are encouraged to participate in quality improvement programs but are not legally required to do so.
3. C) Quality improvement is the name for the processes used by an agency to measure and improve aspects of client care. The nurse may advance practice, but that is usually accomplished by returning to school for a higher degree. Preventing problems from arising is only one benefit of quality management. Nurses are encouraged to participate in quality improvement programs but are not legally required to do so.
4. D) Quality improvement is the name for the processes used by an agency to measure and improve aspects of client care. The nurse may advance practice, but that is usually accomplished by returning to school for a higher degree. Preventing problems from arising is only one benefit of quality management. Nurses are encouraged to participate in quality improvement programs but are not legally required to do so.

Page Ref: 2683

Cognitive Level:  Analyzing

Client Need:  Safe and Effective Care Environment

Nursing Process:  Evaluation

Learning Outcome:  1. Differentiate quality improvement from quality management.

2) The quality assurance officer notes that one particular nursing unit has received a higher-than-usual number of negative client responses about aspects of the nursing care during the previous quarter. To which component of care should the quality assurance officer pay particular attention when benchmarking this issue?

1. A) Structure
2. B) Process
3. C) Outcome
4. D) Competency

Answer:  B

Explanation:

1. A) Process evaluation focuses on how the care was given in regard to relevance, appropriateness, completeness, and timeliness. Process standards focus on the manner in which the nurse uses the nursing process. Competency is not one of the components of quality assurance evaluation. Structure evaluation focuses on the setting in which the care is given. Outcome evaluation focuses on demonstrable changes in the client’s health status as a result of nursing care.
2. B) Process evaluation focuses on how the care was given in regard to relevance, appropriateness, completeness, and timeliness. Process standards focus on the manner in which the nurse uses the nursing process. Competency is not one of the components of quality assurance evaluation. Structure evaluation focuses on the setting in which the care is given. Outcome evaluation focuses on demonstrable changes in the client’s health status as a result of nursing care.
3. C) Process evaluation focuses on how the care was given in regard to relevance, appropriateness, completeness, and timeliness. Process standards focus on the manner in which the nurse uses the nursing process. Competency is not one of the components of quality assurance evaluation. Structure evaluation focuses on the setting in which the care is given. Outcome evaluation focuses on demonstrable changes in the client’s health status as a result of nursing care.
4. D) Process evaluation focuses on how the care was given in regard to relevance, appropriateness, completeness, and timeliness. Process standards focus on the manner in which the nurse uses the nursing process. Competency is not one of the components of quality assurance evaluation. Structure evaluation focuses on the setting in which the care is given. Outcome evaluation focuses on demonstrable changes in the client’s health status as a result of nursing care.

Page Ref: 2686

Cognitive Level:  Applying

Client Need:  Safe and Effective Care Environment

Nursing Process:  Evaluation

Learning Outcome:  5. Describe the process of benchmarking.

3) The nurse manager is planning to implement the Lean Six Sigma system on the care area to improve the quality of care. When following this model, what should the manager implement?

1. A) Shortening break time
2. B) Ordering more supplies than needed on the unit to ensure they never run out
3. C) Replacing a licensed staff member with unlicensed assistive personnel
4. D) Decreasing staff when the census is low

Answer:  D

Explanation:

1. A) Lean Six Sigma focuses on eliminating waste and improving process flow. When the census decreases, the nurse manager should also decrease the number of staff. Replacing licensed staff members with unlicensed assistive personnel may not be safe. The nurse manager would cut back on ordering supplies that are not needed when following this model. A shortened break time would not be considered as reducing waste.
2. B) Lean Six Sigma focuses on eliminating waste and improving process flow. When the census decreases, the nurse manager should also decrease the number of staff. Replacing licensed staff members with unlicensed assistive personnel may not be safe. The nurse manager would cut back on ordering supplies that are not needed when following this model. A shortened break time would not be considered as reducing waste.
3. C) Lean Six Sigma focuses on eliminating waste and improving process flow. When the census decreases, the nurse manager should also decrease the number of staff. Replacing licensed staff members with unlicensed assistive personnel may not be safe. The nurse manager would cut back on ordering supplies that are not needed when following this model. A shortened break time would not be considered as reducing waste.
4. D) Lean Six Sigma focuses on eliminating waste and improving process flow. When the census decreases, the nurse manager should also decrease the number of staff. Replacing licensed staff members with unlicensed assistive personnel may not be safe. The nurse manager would cut back on ordering supplies that are not needed when following this model. A shortened break time would not be considered as reducing waste.

Page Ref: 2692

Cognitive Level:  Applying

Client Need:  Safe and Effective Care Environment

Nursing Process:  Implementation

Learning Outcome:  8. Contrast four quantifiable quality management programs.

4) The nurse conducting nursing audits to help increase efficiency and reduce costs wants to suggest a better contribution to quality care. What should the nurse suggest be performed instead?

1. A) Conduct a wound care study to enhance client outcomes.
2. B) Install cameras to detect abuse of the clients.
3. C) Acquire new client care equipment.
4. D) Decrease staffing on the unit.

Answer:  A

Explanation:

1. A) The top goal of any quality improvement program is to improve client outcomes of care. Increasing the RN staff, purchasing new equipment, and installing cameras may be found to be means to reach that goal, but studies must first be conducted to identify those means.
2. B) The top goal of any quality improvement program is to improve client outcomes of care. Increasing the RN staff, purchasing new equipment, and installing cameras may be found to be means to reach that goal, but studies must first be conducted to identify those means.
3. C) The top goal of any quality improvement program is to improve client outcomes of care. Increasing the RN staff, purchasing new equipment, and installing cameras may be found to be means to reach that goal, but studies must first be conducted to identify those means.
4. D) The top goal of any quality improvement program is to improve client outcomes of care. Increasing the RN staff, purchasing new equipment, and installing cameras may be found to be means to reach that goal, but studies must first be conducted to identify those means.

Page Ref: 2685

Cognitive Level:  Applying

Client Need:  Safe and Effective Care Environment

Nursing Process:  Implementation

Learning Outcome:  2. Describe federal and state initiatives aimed at quality improvement in health care.

5) A client who has read several articles about the need to contain healthcare costs asks how a quality improvement program can contain cost of care. What should the nurse respond to this client’s question?

Select all that apply.

1. A) “Promoting safety increases the cost of care.”
2. B) “Medication errors decrease the cost of care.”
3. C) “High nurse-to-client ratios result in decreased length of stay.”
4. D) “Increased nursing staff has been linked to decreased infection rates.”
5. E) “Use of computers increases the number of lawsuits.”

Answer:  C, D

Explanation:

1. A) Studies have shown that increasing the nurse-to-client ratio can decrease overall cost because the length of stay, as well as mortality rate, is reduced with RN care. Other studies have shown that increased nursing staff has been linked to a decrease in client infection rates. Medication errors increase cost due to harm to the client and increased length of stay. Promoting safety is a cost-containment measure because it decreases injury to the client and the consequent risk of lawsuits. Computers increase efficiency and reduce cost as a result. Lawsuits do not increase because of computer use; they increase when computers are used improperly.
2. B) Studies have shown that increasing the nurse-to-client ratio can decrease overall cost because the length of stay, as well as mortality rate, is reduced with RN care. Other studies have shown that increased nursing staff has been linked to a decrease in client infection rates. Medication errors increase cost due to harm to the client and increased length of stay. Promoting safety is a cost-containment measure because it decreases injury to the client and the consequent risk of lawsuits. Computers increase efficiency and reduce cost as a result. Lawsuits do not increase because of computer use; they increase when computers are used improperly.
3. C) Studies have shown that increasing the nurse-to-client ratio can decrease overall cost because the length of stay, as well as mortality rate, is reduced with RN care. Other studies have shown that increased nursing staff has been linked to a decrease in client infection rates. Medication errors increase cost due to harm to the client and increased length of stay. Promoting safety is a cost-containment measure because it decreases injury to the client and the consequent risk of lawsuits. Computers increase efficiency and reduce cost as a result. Lawsuits do not increase because of computer use; they increase when computers are used improperly.
4. D) Studies have shown that increasing the nurse-to-client ratio can decrease overall cost because the length of stay, as well as mortality rate, is reduced with RN care. Other studies have shown that increased nursing staff has been linked to a decrease in client infection rates. Medication errors increase cost due to harm to the client and increased length of stay. Promoting safety is a cost-containment measure because it decreases injury to the client and the consequent risk of lawsuits. Computers increase efficiency and reduce cost as a result. Lawsuits do not increase because of computer use; they increase when computers are used improperly.