Assessment 3 L&M

A new graduate nurse plans to administer early morning medications after receiving change-of-shift report. Which medication should the nurse administer first? -A narcotic to a client who has a pain level of 6 on a 1 to 10 scale -A scheduled IV antibiotic for a client who has resolving pneumonia -An antidiarrheal for a client who had one watery stool in the last hour -An antipyretic to a client who has a temperature of 37.9° C (100.7° F)

-A scheduled IV antibiotic for a client who has resolving pneumonia

A nurse manager is attempting to ensure adequate resources are available in order to meet changing patient needs. What would be the best type of audit for the manager to perform? -A structure audit -An outcome audit -A process audit -A quality audit

-A structure audit

There are hallmarks that are associated with effective quality control programs. Select those hallmarks from the following list: -Administration support, organizational support, process is ongoing -Annual process, community support, organizational support -Organizational support, community support, fiscal support -Fiscal support, administrative support, annual process

-Administration support, organizational support, process is ongoing

A nurse manager is implementing a quality control tool that is systematic and will allow the official examination of a record for patients with postoperative infections. What type of tool is the nurse manager using to collect and evaluate this data? -An examination -An evaluation -A review -An audit

-An audit

Before developing a procedure on prevention of falls in elderly patients, a nurse reviews all current research-based literature on this topic. What type of nursing will be practiced based on this review? -Standards of care practice -Expert practice -Data-driven practice -Evidence-based practice

-Evidence-based practice

what are the steps for QI? 1. Define the actions of my team that impact the facility's goals for increased patient satisfaction 2. take corrective action 3. capture when we are and are not using best practices and the outcomes 4. make a judgement about the quality of the team's work 5. determine which actions we need to do and avoid to meet our goals and best practices 6. re-evaluate -1,3,2,4,5,6 -5,3,1,2,4,6 -1,5,3,4,2,6

-1,5,3,4,2,6

When a new nurse executive identifies the goal of creating a "just culture" environment in their healthcare organization, the staff understands that such an environment is characterized by a culture where: -The focus is on system processes that caused an error, not on individual blame. -Each department reviews the work processes of another department. -Constant questioning of the status quo is encouraged to prevent errors. -All team members share culpability for an error committed by one member of the team.

-The focus is on system processes that caused an error, not on individual blame.

The nurse should plan to see which patient first when planning morning care? -A 12-year-old who is 24 hours postoperative from an appendectomy awaiting orders for a full diet and discharge. -A 15-year-old who is scheduled for discharge this morning pending teaching regarding prednisone therapy for an allergic reaction. -An 11-month-old who is receiving oral rehydration therapy for an admission of dehydration with orders to progress to a regular diet. -A 12-year-old who was admitted for chemotherapy via a central venous catheter.

-A 12-year-old who was admitted for chemotherapy via a central venous catheter.

A nurse manager discusses with the health care team the importance of performing core measures for the designated areas of implementation. What should the manager be sure to inform the team may be the consequence of noncompliance? -The hospital will lose accreditation by The Joint Commission -Discontinuation of participation in Medicaid and Medicare. -A 5% reduction in the Medicaid annual payment. -A 2% reduction in the Medicare annual payment.

-A 2% reduction in the Medicare annual payment.

The charge nurse is making assignments for the next shift. Which patient should be assigned to the new graduate nurse who has just successfully completed her unit orientation? -A 58-year-old with Guillain-Barre syndrome who is ventilator dependent -A 38-year-old just admitted on airborne precautions for tuberculosis (TB) -A 60-year-old who needs teaching about the use of incentive spirometry -A 38-year-old just returned from bronchoscopy with biopsy

-A 60-year-old who needs teaching about the use of incentive spirometry

A nurse manager who grew up in a home with an alcoholic father suspects an unlicensed assistive person (UAP) of alcohol abuse and possibly coming to work impaired. In order to fairly deal with the UAP, what should the nurse manager consider as an immediate priority? -Review hospital policies and procedures on chemical impairment. -Call the state board of nursing to inquire about nursing treatment programs. -Examine personal biases related to chemical and alcohol dependence. -Confront the UAP about suspicions of alcohol impairment.

-Examine personal biases related to chemical and alcohol dependence.

After a patient had a negative outcome related to a medical error, the nurse follows the policy for sentinel events. What organization does the nurse recognize monitors the adherence to this type of policy for accreditation? -American Nurses Association (ANA) -Leapfrog -The Joint Commission (JC) -Institute of Medicine (IOM)

-The Joint Commission (JC)

The nurse working on a medical-surgical nursing floor should plan to assess which client first? -A patient admitted with renal failure with a previous day's urinary output of 900 cc. -A patient who is three days' postoperative for a below-knee amputation (BKA) who is tearful and refusing to get out of bed. -A patient with diabetes and a MRSA-infected leg wound who is requesting to leave the hospital against medical advice. -A patient with a chest tube treating a spontaneous pneumothorax with continuous bubbling in the suction control chamber.

-A patient admitted with renal failure with a previous day's urinary output of 900 cc.

The nurse in the emergency department should see which of these four patients first? -A patient requesting ice chips for a sore throat and an earache. -A patient with an elevated temperature, sore throat, and upper respiratory symptoms. -A patient reporting a headache, photosensitivity, and a stiff neck. -A patient who cannot bear weight without pain who has a bruised, edematous ankle after playing basketball.

-A patient reporting a headache, photosensitivity, and a stiff neck.

After receiving report, which client should the nurse see first? -A patient who was admitted with kidney stones and is crying with back pain. -A patient who is scheduled for surgery this afternoon and is requesting a shower. -A patient admitted with chest pain who has been pain-free since admission and is now requesting breakfast. -A patient who is to receive one unit of packed RBCs today and needs an IV restarted.

-A patient who was admitted with kidney stones and is crying with back pain.

What would the new nurse identify as an example of evidence-based practice (EBP) in action on a medical-surgical nursing unit? -A group of staff from the dietary department and the med-surg unit, organized by the Director of Nursing, meeting monthly to address the issue of cold food. -The evening charge nurse posting an "article of the month" in the staff breakroom. -Implementation of a new telemetry monitoring system with all staff attending in-services. -The nurse manager working with the dietary manager to share patient concerns about cold food.

-A group of staff from the dietary department and the med-surg unit, organized by the Director of Nursing, meeting monthly to address the issue of cold food.

The nursing student recalls that evidence-based practice (EBP) is defined as: -Nursing care based on historical nursing tradition and history -A problem-solving approach to clinical practice based on best practices -Scholarly inquiry into the nursing and medical research literature -Quality nursing care provided in an efficient and economically sound manner

-A problem-solving approach to clinical practice based on best practices

A nurse leader at a long-term care facility wants to determine if vital signs are being checked according to policy. What can the leader do to measure this process of care? -A critical event analysis -A process audit -Patient outcome evaluation -Benchmarking

-A process audit

A new graduate nurse has successfully completed orientation and has also been successfully oriented to the role of charge nurse. Over the course of several weeks, she has noticed that tasks she has delegated to a long-term, experienced certified nursing assistant (CNA) have not been completed by the end of the shift, leaving her to complete them. Which action by the new charge nurse is best? -Continue to complete the tasks that were assigned to the CNA while attempting to build a relationship of trust with the CNA. -Write up a counseling form to give to the nurse manager, citing specific tasks that were not completed. -Inform the nurse manager that the CNA has not completed the tasks assigned to her. -Approach the CNA in private to discuss the tasks that were not completed.

-Approach the CNA in private to discuss the tasks that were not completed.

A health care team has been challenged to determine what other facilities are doing to decrease the number of hospital-acquired infections so that an action plan can be created to decrease the rate in their facility. What will the health care team do to achieve this challenge? -Benchmarking -Best practices -Root cause analysis -Patient outcome evaluation

-Benchmarking

A nurse manager would like to determine how well the team is doing in terms of meeting the hospital's goal of increased patient satisfaction. What action should the manager take after determining best practices? -Reevaluate. -Capture when the team is and is not using best practices and the outcomes. -Take corrective action. -Make a judgment about the quality of the team's work.

-Capture when the team is and is not using best practices and the outcomes.

A nurse manager is implementing the National Patient Safety Goals (NPSG) for the acute care unit. What will the manager have the staff implement to meet these goals? (Select all that apply.) -Check identification bracelet and ask the patient name and date of birth prior to medication administration. -Ask the patient about their financial status to determine ability to pay for hospitalization. -When handing off report to other staff, use SBAR format. -Have patient identify surgical site prior to going to the perioperative suite. -Ensure that urinary catheters are properly secured to promote unobstructed urine drainage.

-Check identification bracelet and ask the patient name and date of birth prior to medication administration. -When handing off report to other staff, use SBAR format. -Have patient identify surgical site prior to going to the perioperative suite. -Ensure that urinary catheters are properly secured to promote unobstructed urine drainage.

A nurse leader is performing a process audit. Which would be a consideration on a process audit? (Select all that apply.) -Assessing the availability of fire extinguishers in patient care areas -Checking the completeness of a patient's medical record -Comparing a patient's medication order to the medications the patient has been taking -Ensuring that machines are recalibrated according to department policy -Ensuring that a patient has access to television in their room

-Checking the completeness of a patient's medical record -Comparing a patient's medication order to the medications the patient has been taking -Ensuring that machines are recalibrated according to department policy

Which response by the nurse manager is expected when an employee continuously reports late for work? -Please apologize to your team standing here waiting for you to get to work so they can start on time. -I've been hearing complaints about you coming into work late. You promised me you were going to fix it. I'm going to have to dock you half a shift's pay, since it happened before. -Coming in late to work has got to stop. Please schedule an appointment with me so we can sit down and discuss why it's happening and what you can do to correct it. -You're outta here if you come in late even one more time - no exceptions!

-Coming in late to work has got to stop. Please schedule an appointment with me so we can sit down and discuss why it's happening and what you can do to correct it.

A nurse manager suspects a staff nurse of being chemically impaired. Which changes may have prompted the nurse manager to suspect impairment? (Select all that apply.) -Defensiveness related to high frequency of medication errors -Poor handwriting for nursing notes -Increasing absences without adequate explanation -Frequently volunteering to pull narcotics for other nurses -Reports that a patient's pain medication regimen is ineffective -Frequent breaks and leaving the unit without explanation

-Defensiveness related to high frequency of medication errors -Increasing absences without adequate explanation -Frequently volunteering to pull narcotics for other nurses -Frequent breaks and leaving the unit without explanation

A nurse is tasked with performing an audit on patients in the long-term care facility who are developing pressure ulcers. After identifying the information relevant to the criteria, what is the nurse's next action? -Determine ways to collect data -Analyze the data -Make a judgment about quality -Reevaluate

-Determine ways to collect data

Which of the following is considered a nursing leadership role with regard to quality control? -Embraces, supports, and champions the quality improvement process -Uses findings to determine educational staff needs -Selects and uses quality control tools -Establishes measurable patient outcomes

-Embraces, supports, and champions the quality improvement process

The six aims for improving quality health care as directed by the Institute of Medicine include safe, effective, patient-centered, timely, efficient, and _____. -Equitable -Holistic -Naturalistic -Alternative

-Equitable

The new graduate nurse recalls that when looking at a model for evidence-based practice, what is the final step of the process? -Evaluation of the new practice change -Implementation of the new practice -Submitting a description of the new practice change for publication -Including the practice change in all the unit policies

-Evaluation of the new practice change

A health care team is implementing the Toyota Production System (TPS) because the facility is having financial difficulty and may have to consider minimizing its workforce. Prior to implementing TPS, what should the team consider? (Select all that apply.) -How it will allow for problem solving -How it will change the organization's culture, values, and roles -The commitment of time and resources from the facility's leadership -The level of staff preparation and involvement that will be required -The ease with which the transition will take place

-How it will change the organization's culture, values, and roles -The commitment of time and resources from the facility's leadership -The level of staff preparation and involvement that will be required

Which statement is the most appropriate for a nurse manager to use when counseling an employee about repeated absences for the first time? -I have to address your frequent absences because our unit policy is that two absences in one month requires a verbal warning. -If there something going on in your life that is making it difficult for you to work on Mondays, I can work with you to give you that day off. -I am concerned about your attendance because you have called in sick every Monday for the last few weeks. -If you can you promise me that you will not call in sick on Mondays anymore, I will not have to give you a written warning.

-I am concerned about your attendance because you have called in sick every Monday for the last few weeks.

What are recent examples of National Patient Safety Goals as identified by the Joint Commission for Accreditation of Healthcare Organizations (JCAHO)? (Select all that apply.) -Prevent falls in our elderly population -Reduce blood transfusion reactions -Identify patients correctly -Identify patient safety risks -Improve staff communication -Use medications safely

-Identify patients correctly -Identify patient safety risks -Improve staff communication -Use medications safely

A root cause analysis (RCA) is a process during which participants: -Identify the individuals who are at fault in the incident. -Identify risk points before, during, and after the event and the impact on the incident -Identify one primary factor that may have contributed to the event -Include consideration of all relevant literature related to the incident

-Identify risk points before, during, and after the event and the impact on the incident

A nurse leader is trying to bring about change on the unit. Which intervention is associated with the nurse leader role? -Inspiring staff to maintain high standards regarding patient care -Being aware of the changes in quality control regulations -Reviewing research results upon which to base changes -Identifying outcomes that support quality nursing care

-Inspiring staff to maintain high standards regarding patient care

The nurse is planning care with the family of an older adult who is recuperating on a rehab unit for injuries sustained in a fall due to postural hypotension. As part of a quality improvement (QI) project to reduce the number of the falls on this rehab unit, what will be most effective in preventing falls in this client? -Instruct the client to sit, obtain balance, dangle legs, and rise slowly. -Attach a sensor to the client's bed, so that the bed alarm will sound when the client attempts to get out of bed. -Complete a fall diary with the family to determine if there were any falls before the CVA. -Encourage a family member to stay with the client.

-Instruct the client to sit, obtain balance, dangle legs, and rise slowly.

The new nurse recalls that which strategies promote evidence-based practice? (Select all that apply.) -Continue to use older and outdated practices if requested by the patient and family. -Interact with other disciplines to bring nursing evidence to the table. -Collaborate with other nurses locally and globally. -Use sources that are only authored by nurses to stay true to nursing practice. -Use and encourage use of multiple sources of evidence.

-Interact with other disciplines to bring nursing evidence to the table. -Collaborate with other nurses locally and globally. -Use and encourage use of multiple sources of evidence.

Which statement about total quality management is correct? -It is a process with a definitive endpoint. -It involves only a select few employees in an organization. -It considers the individual as the focal element on which production and service depend. -It emphasizes that profit should be considered before quality.

-It considers the individual as the focal element on which production and service depend.

A patient is planning to have a surgical procedure but is concerned about poor patient care quality at the local hospital, and performed a quality check and comparison of several hospitals. What conglomeration of non-healthcare Fortune 500 companies defined quality measurements to allow consumers to compare hospitals? -Leapfrog -Patient Safety Center -National Quality Forum -Prevention of Medical Errors, Inc.

-Leapfrog

A new graduate nurse believes that a work schedule developed by the nurse manager is unfair, with more weekend shifts assigned to the new nurse than any of the other nurses. The nurse has mentioned these concerns to the manager several times, but the schedule has not changed. Which is the most appropriate action for the RN to take? -Make an appointment to formally discuss this with the nurse manager, bringing previous and current examples of concerning work schedules. -Wait to address this issue until upcoming schedules are posted, to see if they also have the excessive weekend shifts still assigned. -Ask another senior nurse to review the work schedule and advise if the work schedule is unfair. -Ask the Director of Nursing to meet with the nurse manager and the new graduate nurse to resolve this issue.

-Make an appointment to formally discuss this with the nurse manager, bringing previous and current examples of concerning work schedules.

Nurse leaders make use of quality control tools to identify various types of errors as outlined by the IOM report. What are some of the most common types of errors reported in today's health care system? Select all that apply. -Medication errors -Diagnostic errors -Communication errors -Equipment errors - Spelling errors

-Medication errors -Diagnostic errors -Communication errors -Equipment errors

Nurse leaders need to understand that in order to be effective, the quality control process must be _______. -Ongoing -Reflective -Formative -Cyclical

-Ongoing

The nurse manager of an acute care unit determines the increase in the incidence of medication errors over the last six months and identifies this as a focus area for improvement. What is the next action by the nurse manager? -Organize a total quality management (TQM) meeting -Identify variations -Implement action plan -Assess results

-Organize a total quality management (TQM) meeting

A nurse manager was reviewing patient care data to determine opportunities to improve the quality of patient care. The nurse manager identified that many clients were being admitted to the unit without a required allergy arm band. The nurse manager, working with a unit-based committee of nurses and nursing assistants, developed a plan including goals, objectives, and a timeline to address this problem. This is an example of which approach? -Patient and family-centered care initiative -Six-Sigma approach -Risk management project -Performance improvement project

-Performance improvement project

The nurse overhears two nursing assistants in the breakroom discussing their plans to call in sick to work on an upcoming Friday in order to attend a family party. Which action by the nurse is best? -Privately ask to speak to them and let them know you overheard their plans and are concerned about the impact on staffing since you will be working that shift. -Offer to assist the nursing assistants in finding coverage for their scheduled shift so they will not have to call in sick. -Do nothing unless they do call in sick to work that day, and then notify the nurse manager of what was overheard. -Notify the nurse manager of what you have overheard.

-Privately ask to speak to them and let them know you overheard their plans and are concerned about the impact on staffing since you will be working that shift.

Quality control tools used by the nurse leader include which of the following? -Process audits and structure audits -Outcome audits and structure audits -Program audits and process audits -Outcome audits and program audits

-Process audits and structure audits

A nurse leader works at a facility that has total quality management (TQM) as the backbone of its organizational goals and objectives for quality control. Which activity reflects how the leader can practice TQM on their unit? -Encourage employees to think of a unit slogan. -Develop a quota system for number of patients cared for. -Explain to the staff that 'if it's not broke, don't fix it.' -Promote teamwork rather than individual accomplishments.

-Promote teamwork rather than individual accomplishments.

A nurse manager is implementing a comprehensive program to prevent the chances of chemical impairment in the work setting. What should the nurse manager include as part of the program? -Train and assign a dedicated narcotic administration nurse for each shift -Implement mandatory staffing ratios with mandatory overtime as necessary to meet ratios -Provide continuing education on substance use and its detection in the workplace -Develop a zero-tolerance policy that mandates immediate termination if impaired

-Provide continuing education on substance use and its detection in the workplace

A chemically impaired night shift nurse has completed a treatment program and is returning to the work setting. The nurse manager is reviewing reentry guidelines with the returning nurse. What should the returning nurse expect as part of these guidelines? (Select all that apply.) -Assignment to the day shift for the first two months after returning to work -Provide evidence of continued involvement in support groups (e.g., Narcotics Anonymous) -Consent to random urine screening for drugs and alcohol -Give an in-service to unit nurses about his experience in the drug treatment program -Peer mentoring and support from a successfully recovered nurse

-Provide evidence of continued involvement in support groups (e.g., Narcotics Anonymous) -Consent to random urine screening for drugs and alcohol -Peer mentoring and support from a successfully recovered nurse

A chemically impaired nurse has voluntarily entered a state diversion program for treatment. What is the most important function of the diversion program? -Public safety -Treatment for addiction -Nurse reentry to practice -Suspension of impaired nurses

-Public safety

An older adult patient recently had a hip replacement with an indwelling catheter inserted. The patient developed symptoms of a urinary tract infection (UTI) postoperatively, and the nurse placing the catheter was reeducated by the nurse leader regarding avoidance of UTIs when inserting catheters. Which quality approach did the nurse leader use? -Quality assurance techniques -Total quality management techniques -Continuous quality improvement techniques -Continuous quality management techniques

-Quality assurance techniques

Which action by a nurse can result in disciplinary action by a State Board of Nursing? (Select all that apply.) -Refusal to care for a pediatric client who has not been immunized -Caring for patients in an intoxicated state -Administration of a prescribed medication from which the client experienced an anaphylactic reaction -Refusal of a nurse to work on Sundays due to religious reasons -Release of a client's diagnosis to a neighbor

-Refusal to care for a pediatric client who has not been immunized -Caring for patients in an intoxicated state -Release of a client's diagnosis to a neighbor

The nurse manager may use which quality assurance or performance improvement technique to identify underlying process flaws in the reporting of suspected child or elder abuse? -Root cause analysis -Small group process -People at fault process -Cause and effect

-Root cause analysis

A nursing student is discussing incivility in a leadership class. Which behaviors or statements, if demonstrated by students, would be considered incivility in a classroom setting? (Select all that apply.) -Telling the instructor, "I've never failed a test before, so it must be your fault for not covering the material better." -Telling the instructor, "These are awful exam questions. I can't believe someone would actually write them!" -Stating, "I don't know and I don't care," when asked a question about the assigned reading. -Rolling eyes when the instructor praises another student for a task done well. -Asking the instructor, "You've got to repeat that. I don't understand."

-Telling the instructor, "I've never failed a test before, so it must be your fault for not covering the material better." -Telling the instructor, "These are awful exam questions. I can't believe someone would actually write them!" -Stating, "I don't know and I don't care," when asked a question about the assigned reading. -Rolling eyes when the instructor praises another student for a task done well.

A new graduate asks the nurse manager what organization develops the standards of the nursing profession so that the quality of practice can be measured. What is the best response by the manager? -The Joint Commission (JC) -The American Medical Association (AMA) -The American Nurses Association (ANA) -The Institute of Medicine (IOM)

-The American Nurses Association (ANA)

The new graduate is hoping to get his first job in a hospital that has a shared governance organizational structure. What describes shared governance? -The governance of a unit occurs by unit councils who make recommendations to the nurse manager. -A process by which the Chief Nursing Office consults with all nurse managers before making patient care delivery decisions. -The governance of the hospital is shared among board members, nurses, providers, and management, which emphasizes the empowerment of nurses. -A process by which nurse managers from all units in the hospital work together to implement the same processes to assure that all staff are treated equally.

-The governance of the hospital is shared among board members, nurses, providers, and management, which emphasizes the empowerment of nurses.

Which statement best defines insubordination? -The refusal to administer a medication order that the nurse feels is unclear or incomplete. -The refusal to "float" to another unit because the nurse has not been oriented to that unit. -The refusal to work additional hours if the nurse is fatigued and is concerned about the ability to deliver safe patient care. -The refusal to comply with a directive of a superior or manager.

-The refusal to comply with a directive of a superior or manager.

The Institute of Medicine (IOM) would consider which behaviors as an indicator of quality care? (Select all that apply.) -The use of nationally developed and approved patient education materials -The implementation of a shared governance nursing model -Nurses returning to school to obtain a baccalaureate degree in nursing -A hospital requiring annual retraining for all staff in CPR and AED use -Nurses taking population-specific classes to keep their professional knowledge updated

-The use of nationally developed and approved -Nurses returning to school to obtain a baccalaureate degree in nursing -A hospital requiring annual retraining for all staff in CPR and AED use -Nurses taking population-specific classes to keep their professional knowledge updated

Which verbal response by the nurse manager is most appropriate when working with an employee whose communication skills are consistently identified as uncivil? -I'm sorry, but your behavior has not changed as you promised me it would. I am going to move you to a different unit. -I'm telling you to take some time off to cool down. When you come back, I will send you to classes on dealing with difficult patients. -I have had numerous complaints about your poor communication style. Even though I haven't mentioned it to you, I am going to have to let you go. -We need to sit down privately in my office so we can talk about this inappropriate work behavior.

-We need to sit down privately in my office so we can talk about this inappropriate work behavior.

A nurse leader wants to ensure that the team is always practicing proper hygiene after caring for a patient. A complaint was filed against a nurse for not washing the hands before examining a wound on a child's knee. What is the nurse leader's control criteria? -Why the team is not practicing proper hygiene -Whether the team is practicing proper hygiene -Who on the team is not practicing proper hygiene -If there are enough hygiene reminders in each patient's room

-Whether the team is practicing proper hygiene

Which response by the nurse would be correctly identified by the nurse manager as insubordination? -I'm not qualified to perform that procedure. I can't do it. -You're asking me to ambulate that patient? She hit me yesterday, so sorry, no way! -I can do that bed change, but I'm going to have to ask someone else to help me. -This isn't something I think we should be doing, but I'll do it just this once.

-You're asking me to ambulate that patient? She hit me yesterday, so sorry, no way!

What is the final step of the quality improvement process that the nurse leader must complete in order to improve patient care?

Evaluation

Quality control is the process of being reactive in order to minimize continued risks or hazards. TRUE FALSE

False

Several of a nurse's patients over the last few weeks have stated they are not getting any pain medication. However, the nurse has charted medication administration for these patients. What is the nurse manager's best initial action to address the situation? -Gather data on the nurse's behavior, medication delivery, and charting inconsistencies. -Call security and have them escort the nurse to the emergency department. -Stop the nurse in the hallway and ask why these patients are saying they did not get pain medication. -Confront the nurse the next time the nurse gets pain medications.

Gather data on the nurse's behavior, medication delivery, and charting inconsistencies.

Health care shifted focus from patient care to issues of cost and quality. TRUE FALSE

True

Nurse leaders should understand the criteria or standards that are needed to establish effective quality control process. TRUE FALSE

True

Total quality management is referred to as continuous quality improvement and is used to meet the Healthy People Living 2020 goals. TRUE FALSE

True

Which of these patient safety solutions that you as the Nurse Leader have the power to implement and measure team performance against demonstrate the ability to prevent or mitigate patient harm? Select all that apply. -look-alike, sound-alike medication names -patient identification -communication during patient hand-overs -performance of correct procedure at correct body site -control of concentrated electrolyte solutions -assuring medication accuracy at transitions in care -avoiding catheter and tubing misconnections -single use of injection devices -improved hand hygiene to prevent health-care associated infections

all except look-alike, sound-alike medication names

What are the focus areas of the To Err is Human recommendations? (Select all that apply.) -Enhance knowledge -Identify errors and provide solutions for prevention -Set performance standards for safety -Implement safety systems -Enhance leadership

all of the above