Chapter 02 Patient Safety

Chapter 02  Patient Safety

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. In an effort to control costs and maximize revenues, the Rehabilitation Unit at Cross Hospital reduces the number of its managers and flattens its organizational structure. Within a year, the number of adverse events on the units has doubled. This may be attributable to:
a.
The overload of staff nurses.
b.
Inability of staff at the bedside to make good choices.
c.
A change in reporting systems.
d.
Fewer clinical leaders and advocates for necessary resources.

ANS: D
Flattening of the organizational structure has been shown to increase mistrust in organizations while removing clinical leaders who provide support, consultation, and leadership in securing resources and in inspiring standards of excellence.

REF: Page 28
TOP: AONE competency: Knowledge of the Healthcare Environment

2. Traditional approaches to ensuring patient safety have focused on:
a.
Assigning blame.
b.
Finding solutions to systems issues.
c.
Instituting best practices in response to errors.
d.
Hiding errors from potential litigation.

ANS: A
The IOM report (2004) identified that traditional practice focused on punishment of the person for errors as compared with a system view of responsibility for errors and solutions.

REF: Pages 26-28 TOP: AONE competency: Leadership

3. To increase safety in patient care areas of the Valley Hospital, the executive begins by:
a.
Asking the community what the safety issues are.
b.
Consulting with a management expert about staffing schedules.
c.
Ensuring that the senior nursing officer attends the board meetings.
d.
Instituting improved practices to reduce needle-stick injuries.

ANS: B
The IOM report (2004) highlighted the importance of the attendance of the senior nurse executive at board meetings to enhance understanding of issues and opportunities in the system that contribute to safe (or unsafe) nursing practice and patient care.

REF: Page 28
TOP: AONE competency: Communication and Relationship-Building

4. During review of back injuries, it is determined that mechanical lifts and transfer belts are not being properly used. In addressing this concern, the unit manager:
a.
Meets individually with nurses who are observed to be using the lifts incorrectly to review the correct procedure.
b.
After consultation with the staff about the review, orders new lifts to replace older ones that are malfunctioning.
c.
Blames the system for inadequate funding for resources.
d.
Reviews the system of reporting incidents to ensure that appropriate reporting is occurring.

ANS: B
The IOM report (2004) points to the need to involve nurses in decisions that affect them and the provision of care.

REF: Page 28
TOP: AONE competency: Communication and Relationship-Building

5. Before the IOM report was issued, “To err is human” adverse events were considered:
a.
A normal risk.
b.
Rare.
c.
A reflection of some organizations.
d.
Related to systems errors.

ANS: B
The IOM report (2004) highlighted deaths attributable to medical error as more common than was once thought.

REF: Pages 26, 27 TOP: AONE competency: Knowledge of Healthcare Environment