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Chapter 5: Patient Safety
MULTIPLE CHOICE
1.Safe care should be an inherent part of every nursing:
| A. | Intervention |
| B. | Treatment |
| C. | Recommendation |
| D. | All of the above |
ANS: D PTS: 1 REF: Page: 58 TOP: Safe nursing care
2.The definition of patient safety as defined by the Quality and Safety Education for Nurses (QSEN) Institute includes all of the following EXCEPT:
| A. | Individual performance |
| B. | System effectiveness |
| C. | Comprehensive data review |
| D. | Minimizing risk of harm to patients and providers |
ANS: C PTS: 1 REF: Page: 59 TOP: Defining patient safety
3.The Institute of Medicine (IOM) considers quality of care to be:
| A. | Expensive |
| B. | A luxury |
| C. | Inseparable from patient safety |
| D. | A low priority |
ANS: C PTS: 1 REF: Page: 59 TOP: Defining patient safety
4.Since the late 1900s until now, the overall changes associated with patient safety would best be described as:
| A. | Significantly improved |
| B. | Significantly worse |
| C. | Better in some areas and worse in others |
| D. | None of the above |
ANS:CPTS:1REF:Page: 60
TOP: A brief history of patient safety
5.The mission of the Agency for Healthcare Research and Quality (AHRQ) is to:
| A. | Produce evidence to make healthcare safer, while maintaining quality and cost effectiveness |
| B. | Produce evidence to make healthcare safer, higher quality, more accessible, equitable, and affordable |
| C. | Provide technological advances that support safe care |
| D. | Eliminate wasted resources and optimize research data |
ANS:BPTS:1REF:Page: 60
TOP: Primary organizations involved in patient safety
6.The Joint Commission:
| A. | Tracks voluntary reports of sentinel events |
| B. | Tracks root causes of sentinel events |
| C. | Tracks mandatory reports of adverse events |
| D. | Both A and B |
ANS: D PTS: 1 REF: Page: 63 TOP: Sentinel event statistics
7.For the purposes of Successful Nurse Communication, specific sentinel event data is being isolated with the explicit intention of:
| A. | Demonstrating links among patient safety, sentinel events, and communication and human behavior |
| B. | Teaching students how to track sentinel events |
| C. | Building the reputation of The Joint Commission |
| D. | All of the above |
ANS: A PTS: 1 REF: Page: 63 TOP: Sentinel event statistics
8.The most frequent types of sentinel events as tracked by The Joint Commission during 2011, 2012, and 2013 included all of the following EXCEPT:
| A. | Hospital-acquired infection |
| B. | Wrong site, wrong patient, or wrong procedure |
| C. | Unintended retention of a foreign body |
| D. | Delay in treatment |
ANS: A PTS: 1 REF: Pages: 63-64 TOP: Sentinel event statistics
9.Root cause analysis is a process of inquiry and review that is initiated after an error and seeks to answer the question:
| A. | How and why did this error take place? |
| B. | Who is responsible for this error? |
| C. | How much is it going to cost to prevent future errors like this? |
| D. | What information do patients need to know about what happened? |
ANS: A PTS: 1 REF: Page: 64 TOP: Root cause analysis
10.An examination of sentinel events data reported by The Joint Commission in 2011, 2012, and 2013 reveals which of the following are the leading root causes involving all types of events?
| A. | Leadership, delay in treatment, human factors |
| B. | Communication, human factors, unintended retention of a foreign body |
| C. | Leadership, human factors, post-operative infections |
| D. | Human factors, leadership, and communication |
ANS: D PTS: 1 REF: Page: 64 TOP: Root cause analysis
11.An operating nurse who does not speak up to a surgeon before a wrong site sentinel event happens:
| A. | Is incompetent and should be disciplined |
| B. | May indicate a symptom of underlying negative dynamics and poor communication within the operating room team |
| C. | Is probably responsible for many errors for which the surgeon will be blamed |
| D. | All of the above |
ANS:BPTS:1REF:Page: 68
TOP: Addressing sentinel events with communication
12.As a subcategory under leadership as a root cause of sentinel events, resource allocation may involve communication and behavior in terms of:
| A. | The skills that staff have to ask for resources they need |
| B. | The skills that managers have to listen to requests for resources |
| C. | The relationships between management and staff |
| D. | All of the above |
ANS:DPTS:1REF:Page: 67
TOP: Addressing sentinel events with communication
MULTIPLE RESPONSE
1.Subcategories of human factors involved in root causes of sentinel events tracked by The Joint Commission that may involve communication and human behavior include which of the following? Select all that apply.
| A. | Staff orientation |
| B. | Staff supervision |
| C. | Staffing levels |
| D. | Assessment |
| E. | Fatigue |
| F. | Distraction |
| G. | Complacency |
| H. | Rushing |
ANS: A, B, C, D, E, F, G, H PTS: 1 REF: Page: 64 | Page: 67
TOP: Addressing sentinel events with communication
2.Which of the following are important reasons for gaining a firm grasp on the interrelationship between sentinel events and communication? Select all that apply.
| A. | To prevent errors |
| B. | To help in discovering all contributing factors to medical errors |
| C. | To become familiar with The Joint Commission Web site |
| D. | To promote nursing students’ commitment to practicing effective communication |
| E. | To raise awareness about the many categories of root causes of sentinel events |
ANS:A, B, DPTS:1REF:Page: 70
TOP: Addressing sentinel events with communication
TRUE/FALSE
1.Making long-term meaningful improvement in patient safety requires changing the underlying human dynamics involved in individual and organizational behavior.
ANS:TPTS:1REF:Page: 58
TOP: Addressing sentinel events with communication
2.The phrase “Do no harm” was first expressed by Florence Nightingale in the mid-1800s.
ANS:FPTS:1REF:Page: 59
TOP: A brief history of patient safety
3.The Joint Commission is an independent organization that accredits and certifies healthcare organizations and programs in the United States.
ANS:TPTS:1REF:Page: 60
TOP: Primary organizations involved in patient safety
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