N255

Which principal nursing actions best support a focus on patient safety?

* Handwashing * Preoperative checklists * Five rights of drug administration Handwashing is the number-one way to prevent infection in patients. Checklists can help prevent mistakes in care for a surgical patient, thus ensuring a safe environment. Adhering to the five rights of medication administration helps to prevent errors in this important nursing care activity, providing for increased safety in patient care.

The nurse instructor is teaching nursing students about the knowledge, skills, and attitudes (KSAs) needed to develop core competencies based on the Institute of Medicine (IOM) and Quality and Safety Education for Nurses (QSEN) initiative. What KSAs are needed to develop the Quality Improvement competency?

* Participate in root cause analyses of issues * Implement activities to improve care processes Participating in root cause analyses of issues and implementing activities to improve care processes are KSAs needed to develop the QSEN Quality Improvement core competence. To meet the Quality Improvement competency, nurses are expected to "use data to monitor the outcomes of care processes and use improvement methods to design and test changes to continuously improve the quality and safety of health care systems." Patient education and empowerment is a KSA needed for Patient-Centered Care competency and preparing an interdisciplinary plan of care is needed for Teamwork and Collaboration competence. Using tools to reduce reliance on memory is a Safety core competence.

Which health care organizations are obligated to follow the evidence-based interprofessional Core Measures?

* Those that receive Medicare funding * Those that receive Medicaid funding Health care organizations that receive Medicare and/or Medicaid funding are obligated to follow the evidence-based interprofessional Core Measures.

Research has shown that which factors generally cause patient harm and errors?

* Unclear and inadequate communication * Errors in interpretation of provider prescriptions * Lack of mandatory reporting in the health care setting

Who are members of the Medical Emergency Team (MET)?

*Intensivist (Dr. specialized in Intensive Care) *Medical resident *Respiratory therapist (RT) The membership of the MET or the Rapid Response Team (RRT) varies among facilities, but may include an intensivist, medical resident, and RT. The intensivist is a physician who specializes in critical care. The RT cares for patients who have trouble breathing. A medical resident is a person with a medical degree who practices in a healthcare facility.

What is beneficence?

Beneficence is the promotion of positive actions.

The medical-surgical nurse is delegating tasks to the unlicensed assistive personnel (UAP). Which task is appropriate for the nurse to delegate?

Ambulation of the patient with a walker Before assigning tasks to a UAP, the nurse must ensure the task is within the UAP's scope of practice. The most appropriate task to delegate to the UAP is ambulation of a patient with a walker. Dressing changes, medication administration, and patient education require the skill and knowledge of a licensed nurse.

Evidence shows that the SBAR process improves communication among members of the health care team. What does the "A" in SBAR stand for?

Assessment

After surgery, a patient states, "I'm capable of taking care of myself at home. I don't need a nurse for my care." The nurse comes to the home anyway. Which ethical principle has the nurse violated?

Autonomy Autonomy, also known as self-determination or self-management, is the ethical principle that requires the nurse to respect the patient's decisions regarding his or her own care.

Nurses plan, implement, and evaluate patient care together using an interdisciplinary plan of action. What term best describes this activity?

Collaboration Collaboration refers to planning, implementing, and evaluating patient care together using an interdisciplinary plan of action.

What is collaboration?

Collaboration entails planning, implementing, and evaluating patient care together using an interdisciplinary plan of care. A group of people working together to achieve a common goal via a process of feedback and iteration

A nurse is planning which tasks to delegate to the unlicensed assistive personnel (UAP). In explaining how to perform the task, which "right" of delegation is the nurse following?

Communication The right communication involves clearly and concisely explaining how to perform a task when delegating it to unlicensed assistive personnel (UAP). The right task is ensuring the UAP is competent to perform it and it is within the UAP's scope of practice. The right supervision involves monitoring and evaluating the UAP and intervening when necessary. The right circumstances involve ensuring the patient care setting and resources are appropriate.

What is DMAIC?

DMAIC is the acronym for a quality improvement process.

What is delegation?

Delegation is the process of making that assignment.

What is delegation?

Delegation means authorizing a competent person to perform a selected nursing task or activity in a selected patient care situation.

What is fidelity?

Fidelity is keeping promises to patients to follow through with care.

MET / RTT

MET is an acronym for the Medical Emergency Team, also referred to as the RRT or the Rapid Response Team, which saves patient lives and reduces risk of harm to patients by providing care before a respiratory or cardiac arrest occurs.

Which method was implemented based on evidence that it decreases medication discrepancies that can cause negative patient outcomes?

Medication reconciliation Medication reconciliation is an evaluative process that addresses duplications, omissions, and interactions. This process has been demonstrated to decrease medication discrepancies that can cause negative patient outcomes.

What is PDSO?

PDSO is the acronym for the Plan-Do-Study-Act quality improvement model.

What is quality improvement?

Quality improvement is achieved by using data to monitor the outcomes of care processes and use improvement methods to design and test changes to continuously improve the quality and safety of health care systems.

Which systems have been shown to improve safety through technology?

RFID & BCMA RFID, or radiofrequency identification, and BCMA, or barcode medication administration, are examples of systems that have been shown to improve safety through technology.

To improve communication between staff members and health care agencies, procedures for hand-off communication have been established. Which acronym represents a method of hand-off communication used in nursing practice?

SBAR & I-SBAR SBAR and I-SBAR are acronyms representing methods of communication used in nursing practice. SBAR includes communication about the situation, background, assessment, and recommendation. I-SBAR is a modification of SBAR. The "I" reminds the individual to identify himself or herself.

What is SBAR?

SBAR is a process of communication that does not necessarily involve technology. S: Situation B: Background A: Assessment R: Recommendation

In its report, Health Professions Education: A Bridge to Quality, the Institute of Medicine (IOM) identified five broad core competencies for health care professionals. Which core competency was later added in the Quality and Safety Education for Nurses (QSEN) initiative?

Safety Safety was added later as a separate competency in the QSEN initiative. The earlier report had identified Patient-Centered Care, Teamwork and Collaboration, and Quality Improvement in care as core competencies of healthcare professionals.

What competency did the QSEN Institute add to the Institute of Medicine's (IOM) competencies?

Safety Several years after the IOM established five core competencies for health care professionals, the QSEN Institute added safety as a sixth competency. Informatics, patient-centered care, and evidence-based practice were existing IOM competencies.

What is self-management?

Self-management is patient autonomy where the patient is recognized as an autonomous individual capable of making informed decisions about his or her care.

What is social justice?

Social justice is the equal treatment of all patients.

The SBAR process includes four steps. Which step taken by the nurse refers to Recommendation?

State what is needed at the time or what the desired outcome is. Stating what is needed or the desired outcome is a recommendation that the nurse makes. By describing what is happening at the time, the nurse explains the situation to the receiver of the information. When providing an analysis of the problem or the patient needs, the nurse is communicating his or her assessment. The nurse provides a background when communicating the background information relevant to the particular situation.

When assigning a task to unlicensed assistive personnel, which process will the nurse undertake to ensure the task is performed appropriately?

Supervision Supervision is guidance or direction, evaluation, and follow-up to ensure the task or activity assigned to the unlicensed assistive personnel is performed appropriately.

What is supervision?

Supervision is guidance or direction, evaluation, and follow-up by the nurse to ensure that the task or activity is performed appropriately.

A nurse is implementing the FOCUS-PDCA model for quality improvement. Which step will be conducted first?

The nurse will identify which process needs improvement. The first step in the FOCUS-PDCA model is to find a process to improve, so the nurse will first identify which process needs improvement. Planning improvements, clarifying how the process is currently conducted, and organizing a team are later steps in the model.

While preparing a patient for surgery, a surgeon explains the positive and negative outcomes of the surgery. Which ethical principle of truth telling is followed?

Veracity Veracity is the ethical principle of being truthful to the best of one's knowledge. Under this principle, the nurse should tell the truth to the patient about the surgery's positive and negative outcomes.