QUIZ 3

operating (expense) budget includes

(1) the personnel budget (2) costs other than for personnel (3) the revenue budget.

The Joint Commission (TJC) tracks core measures for performance. Which core measures are tracked by TJC? (Select all that apply.)

-Heart failure -Acute myocardial infarction -Childhood asthma

An example of an sentinel event is

A 32-year-old woman with no significant health history who dies in the operating room during an elective surgical procedure

A positive budget variance can be identified by which situation?

A decrease in the budgeted expenditures

A new drug reference book is needed for a unit. The nurse manager would plan to pay for this from which budget?

Cash budget

What documentation must be included to be compliant with TJC pain documentation standard

Chart medication given, patient's response, and your reassessment of the patient's pain.

Which of the following would explain a nurse manager's use of position control in monitoring the budget?

Comparison of actual full-time employees and the number that was budgeted

What area is included when risk management explores the prevention of accidents, injuries, and errors?

Financial risk

Patient satisfaction surveys include questions about quality of care. What has the greatest impact on patient satisfaction?

Responsiveness of staff

Occupational Safety and Health Administration (OSHA)

U.S. Department of Labor agency that ensures the safety and health of America's workers by setting and enforcing standards; providing training, outreach, and education; establishing partnerships; and encouraging continual improvement in workplace safety and health.

U.S. Department of health and Human Services (USDHHS)

U.S. government's principal agency for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves.

The National Database of Nursing Quality Indicators (NDNQI) has established which of the following goals to assist nurses to make practice changes in order to benefit patients?

Unit-specific measures

The National Patient Safety Goals of The Joint Commission (TJC) are established goals to reduce the risks for injuries to patients and provide a safe environment. Which practice has been instituted as a result of these goals established by TJC?

Use of two patient identifiers when providing care or treatments

Total quality management (TQM), which is also referred to as PI or quality improvement (QI), has been used in industry since the 1950s, and has been related to improvements in productivity and quality. Page 250

What is TQM (Total Quality Management)?

Hospital performance improvement standards are primarily focused on the ability of the hospital to

develop an atmosphere that meets and exceeds the expectations of the customers and staff.

National Institute for Occupational Safety and Health (NIOSH)

federal agency responsible for conducting research and making recommendations for the prevention of work-related injury and illness. NIOSH is part of the CDC within the U.S. Department of Health and Human Services

Operating expense budget

financial plan for the day-to-day activities of the organization

Cash budget

financial plan that tracks cash received and spent

The personnel budget is based on the calculations of which factors? (Select all that apply.)

-Average daily census -Hours per patient day -Number of staff

What benchmarks might be expected to be measured for hospital performance? (Select all that apply.)

-Average length of hospital stay for cardiac surgery -Total admissions for cardiac surgery -Infection rates for cardiac surgery

Risk management is a hospital program organized to prevent the incidences of preventable accidents, injuries, and errors. Which of the following situations would a hospital risk manager need to investigate?

A patient breaks his wrist from a fall caused by a wet floor

A sentinel event is usually one that results in an unexpected outcome for the patient and "signals" the need for investigation and response. Which of the following would be considered a sentinel event?

A patient who requires a left leg amputation after developing an arterial occlusion at the access site

Expected outcomes of a hospital being accredited by the Joint Commission (i.e., improved patient outcomes).

Accreditation organization that strives to continuously improve the safety and quality of care provided to the public through the provision of health care accreditation and related services that support performance improvement in health care organizations

What is the focus of the Center for Disease Control and Prevention (CDC)? What types of conditions would you think that this organization would investigate?

Agency charged with the promotion of health and quality of life by preventing and controlling disease, injury, and disability; has created multiple infection control standards that are now part of standard Joint Commission accreditation.

Unit yearly budgets may change based on variances. What does the nurse manager understand to be the cause of budget variances?

An increase in staffing

Indirect Costs

Generalized costs for support of the program and billed to the program; often called support costs.

Lean

Getting rid of waste in all work processes

What qualifies a person for hospice care?

Medicare added hospice benefits for the last 6 months of life to cover services for the patient who is terminally ill. diagnosed with terminal illnesses and have a limited life span.

Time Management is key in nursing practice. What are some examples of time-wasting activities that impair effective time management?

Not delegating task Reading and responding to emails

What is the best method for hospitals to track patient satisfaction?

Patient completes a patient survey after returning home from the hospital.

A sentinel event (signals need for investigation) example is

Patient dies because there is no bed available in the ICU.

What are HCAHP scores used to measure- It measures the patient's perspectives of hospital care

Patient satisfaction survey results

Root Cause Analysis: A nurse is learning about quality improvement measures taken by the hospital. Root cause analysis is a process for identifying the cause of an error. What is the greatest benefit to establishing the root cause?

Prevention of future similar incidents The purpose of investigations of errors is to prevent incidents in the future.

referred provider organization (PPO)

Prior authorization Referral required

Which of these is a measured outcome from a performance improvement process perspective?

Sternal infection rates in cardiac surgery patients

Accreditation

a self-assessment and external peer assessment process used by health care organizations to accurately assess their level of performance in relation to established standards and to implement ways to continually improve.

What are functions of the FDA (Food and Drug Administration)?

a. The U.S. Food and Drug Administration (FDA) is a federal agency that regulates drugs, medical devices, and radiation-emitting products. b. These regulations also form the basis of the medication management standard of the accreditors.

The Joint Commission (TJC)

accreditation organization that strives to continuously improve the safety and quality of care provided to the public through the provision of health care accreditation and related services that support performance improvement in health care organizations

Centers for Disease Control and Prevention (CDC)

agency charged with the promotion of health and quality of life by preventing and controlling disease, injury, and disability; has created multiple infection control standards that are now part of standard Joint Commission accreditation.

When developing a zero-based budget, nurse managers understand?

all budget needs are justified annually

cash on hand

amount of cash readily available to the organization

Indirect Loss

generalized costs (housekeeping, information technology, etc.) for support of the program and billed to the program; often called support costs

Medicare

health insurance program for people age 65 and older or under age 65 with certain disabilities or any age with end-stage renal disease.

examples of indirect costs

housekeeping, information technology, registered nurse salary, Utilities

Revenues

income received for goods or services provided

Core measures identified by The Joint Commission include standard orders regarding care and data collection for

infection rates

As the nurse you have given the wrong medication. What actions are priority after identifying the mistake?

instruct patient to remain in bed for now, & check vital signs, call the provider, complete the incident report, contact risk management

Medicaid

joint federal and state assistance program designed to pay for medical long-term care assistance for individuals and families with low income and limited resources

Preferred Provider Organization (PPO)

managed care company that contracts with health care providers (both physicians and hospitals) and payers (self-insured employers, insurance companies, or managed care organizations) to provide health care services to a defined population for predetermined fixed fees

Continuum of Care

matching an individual's ongoing needs with the appropriate level and type of medical, psychological, health, or social care or service within an organization or across multiple organizations

not-for-profit organizations

organizations with financial structures that project financial goals with particular tax and legislative protection or shelters

For-profit organizations

organizations with stated financial structures that include profit goals and tax liabilities Example: a physician opening their own same-day surgery center.

Value-Base Purchasing

reimbursement for health care services based on quality of care

When developing an incremental type budget, the nurse manager understands?

yearly budgets are dependent on the previous year's budget. The budget must be recreated every year.

Magnet Hospitals

support organizational goals, advance the nursing profession, and promote professional development by extending their influences on both professional and community groups