Health Care Quality
What does a nurse understand by the Quality and Safety Education for Nurses (QSEN) competency called informatics?
A nurse should use information and technology to communicate, manage knowledge, mitigate error, and support decision-making. According to informatics, a nurse should use information and technology to communicate, manage knowledge, mitigate errors, and support decision-making. According to the Quality and Safety Education for Nurses (QSEN) competency called safety, a nurse should ensure that the risk of harm to clients and healthcare workers is decreased by improving professional performance. The QSEN competency called evidence-based practice states that a nurse should integrate best current evidence with clinical expertise along with client preferences and values to deliver quality healthcare. The QSEN competency called quality improvement states that a nurse should use data to monitor the outcomes of healthcare processes and implement improvement methods to design and test changes to improve quality of health care.
Which nursing action is most important when caring for a client using medications to manage disease in the hospital?
Administering the medications The most important part of nursing practice when caring for a client using medications to manage disease in the hospital setting is administering those medications. Administering medications safely requires an understanding of the legal aspects of healthcare, pharmacology, pathophysiology, human anatomy, and mathematics. Teaching about the medications, encouraging adherence to them, and evaluating the client's ability to self-administer them are nursing responsibilities performed before or after medication administration.
Who would the registered nurse state is accountable for establishing systems to communicate competency requirements related to delegation?
Chief nursing officer (CNO) CNOs are accountable for establishing systems to communicate competency related to delegation. The registered nurse delegates the task to LPN and UAP. In delegation, the RN implements in clinical practice to improve the safety and quality of client care. LPNs provide direct care to the client. UAP provide direct care to the client under the supervision of the registered nurse who retains accountability for client care outcomes.
What is the purpose of an administrative review debriefing session after a disaster?
Determine what went right and what went wrong The goal of the administrative review debriefing is to discern what went right and what went wrong during activation and implementation of the emergency preparedness plan. This debriefing is not used to change responsibility roles. Preventing the development of burnout is the goal of critical incident stress debriefing (CISD). Analyzing resource use would occur after the disaster plan is discontinued.
Which professional standard does the nurse feel is most important for critical thinking?
Evaluation criteria An evaluation criterion is an important professional standard required for critical thinking. Logical thinking, accurate knowledge, and relevant information are important intellectual standards required for critical thinking.
Which critical thinking skill in nursing practice requires the nurse to possess knowledge and experience for choosing care strategies for clients?
Explanation Explanation requires knowledge and experience for choosing strategies for care of clients. Analysis is a critical thinking skill that requires open-mindedness while looking at the client's information. The skill of inference is associated with noticing relationships in the findings. Interpretation is associated with an ordered data collection.
A nurse finds that there is an inaccurate match between clinical cues and the nursing diagnosis. What is the category of the diagnostic error?
Interpreting An inaccurate match between clinical cues and the nursing diagnosis is an interpreting error. Interpreting errors include failing to consider conflicting cues, using an insufficient number of cues, and using unreliable or invalid cues errors. A labeling error is a failure to validate data. Collecting errors include inaccurate data, missing data, or disorganization. Errors at the clustering level include an insufficient cluster of cues, premature or early closure, or incorrect clustering.
Which factor is used to assess the quality of health care provided to a client?
Functional health status of the client after discharge Health care providers determine the quality of care provided to the client by measuring outcomes that show how a client's health status has changed. One method of measuring the quality of health care provided to the client is the functional health status of the client after discharge. The nursing staff should take necessary fall prevention measures for the client; however, this is not a measurable outcome. All health care personnel should practice hand hygiene to prevent infection, which is a quality measure, not an outcome of health care. Teamwork and coordination among health care personnel is important to provide efficient health care to the client. It is not an outcome of health care.
Which skill in critical thinking requires to be orderly in data collection?
Interpretation Interpretation is involved in the orderly collection of data. When information about a client is collected with an open mind, then the skill called analysis is being used. When the data collected about the client helps in solving an existing problem, then the skill called inference is being used. Evaluation is used when the results of nursing actions are determined.
Which nursing intervention can be classified under complex physiologic domain according to the Nursing Interventions Classification (NIC) taxonomy? Select all that apply.
Interventions to restore tissue integrity Interventions to optimize neurologic functions Interventions to provide care before, during, and immediately after surgery Interventions such as restoring tissue integrity, optimizing neurologic functions, and providing care before, during, and immediately after surgery are classified under physiologic domain according to the Nursing Interventions Classification (NIC) taxonomy [1] [2]. Interventions to manage restricted body movements are classified under the simple physiologic domain. Interventions to promote comfort using psychosocial techniques are classified under the behavioral domain.
Which statement defines "information" gathered by the nurse?
It is the organization and interpretation of data. Information is defined as the organization and interpretation of data or pieces of reality. Datum is an individual piece of reality. When data are combined and relationships among data are identified, the nurse obtains knowledge.
What criteria should the nurse consider when determining if an infection should be categorized as a health care-associated infection?
Occurred in conjunction with treatment for an illness Health care-associated infections are classified as those that are contracted within a health care environment (e.g., hospital, long-term care facility) or result from a treatment (e.g., surgery, medications). Originating primarily from an exogenous source is not a criterion for identifying a health care-associated infection. The source of health care-associated infections may be endogenous (originate from within the client) or exogenous (originate from the health care environment or service personnel providing care); most health care-associated infections stem from endogenous sources and are caused by Escherichia coli and Staphylococcus aureus. Association with a drug-resistant microorganism is not a criterion for identifying a health care-associated infection. A health care-associated infection may or may not be caused by a drug-resistant microorganism. Still having the infection despite completing the prescribed therapy is not a criterion for identifying a health care-associated infection.
What is the primary focus of the nurse when providing evidence-based care to the client?
Problem-solving approach Evidence-based practice is first and foremost a problem-solving approach to care. This problem-solving approach incorporates application of current best practice along with knowledge from research studies and clinical expertise.
What is a high priority assignment in an emergency department when a nurse is providing care for clients during a mass casualty?
Taking inventory and restocking supplies A high priority assignment in an emergency department during a mass casualty is taking inventory and restocking supplies. Collaboration between the emergency department and the central supply department is essential for resolving stock availability problems. Debriefing teams provide sessions for small groups of staff to promote effective coping strategies. Outlining emergency expectations and arrangements should be part of the hospital's overall emergency preparedness plan.
Which system is used by a health care facility to determine certain aspects of client satisfaction?
The Hospital Consumer of Assessment of Healthcare Providers and Systems (HCAHPS) HCAHPS is a standardized survey developed to measure client perceptions of their hospital experience. The survey asks 27 questions about the client's hospital experience. The survey is taken by clients who were discharged from the hospital between 48 hours and six weeks ago. Six Sigma is a data-driven approach to process improvement that reduces variation in the process. Value Stream Analysis focuses on the improvement of processes. It studies each step of a process to determine if that step adds value to that process. It also determines if the process reduces the organization's time, cost, and resources. The National Committee for Quality Assurance (NCQA) created HEDIS to collect various data to measure the quality of care and services provided by different health plans. It is the database of choice for the Centers for Medicare and Medicaid Services.
In what priority order should the actions of care be implemented for clients in an emergency?
The client care begins firstly by contact with clients and secondly, identification of clients' requirements for immediate treatment followed by the determination of appropriate interventions and the initiation of treatment.
According to Avedis Donabedian, which is the most important validator of quality and effectiveness of health care in a hospital?
The client outcomes achieved by the care provided Avedis Donabedian was a physician and founder of the Donabedian model of care. According to him, the client outcomes obtained by health care delivery determines the quality and effectiveness of the health care. The number of clients admitted to a hospital does not indicate the quality of the health care delivered in the hospital. The values and goals presented by the hospital define the quality of the medical system. Similarly, the number of health care workers in the hospital does not determine the quality or effectiveness of the health care system.
Which example indicates that the nurse is following evidence-based practice?
The nurse reads current nursing journals and uses the latest scientific methods. Evidence-based practice requires the nurse to read current nursing journals and use the latest scientific methods. It also requires the integration of best current evidence with clinical expertise and client preferences while providing health care. The nurse uses informatics to document client care in an electronic health record. The nurse uses flowcharts and diagrams to record the client's progress and monitor the outcomes of client care. This helps the nurse to improve the quality of care. The nurse provides client-centered care by encouraging the hospitalized client's family to bring home-cooked food.
A health care worker is collecting data on the quality of health care provided in a health care center. The health care worker finds that too many nurses are attending to a single client. What does the health care worker conclude from this?
The nursing team is not providing efficient care. Too many nurses attending to a single client indicates that the work that can be performed by a few nurses is being performed by many nurses. This indicates that the nursing team lacks efficiency. The inability of the nursing team to avoid injuries in the client indicates that the nursing team is unable to perform safe care. The inability to address the problems of the vulnerable groups indicates that the nursing team is unable to provide effective care. The inability to address all the problems of the client while providing care indicates that the nursing team is unable to provide patient-centered care.
