Chapter 7 questions
TJC attributes 80% of all medical errors to: 1. Poor hygiene and hand washing 2. Poor hand off communication 3. Poor work environment 4. Lack of care.
Ans: 2 ineffective hand off communication or miscommunication between caregivers during the transfer of care is estimated to contribute to 80% of serious medical errors. Poor hand offs lead to delays in treatment, inappropriate treatment, and prolonged hospital stay.
Who is responsible for accepting, transcribing, and implementing physician orders? 1. Unit clerk 2. Medical intern or resident 3. Professional nurse 4. Medical assistant.
Ans: 3 the nurse is responsible for accepting, transcribing, and implementing health care providers orders. Unit clerks may enter orders into a pt record but the nurse has to sign off before it is implemented.
Implicit bias affects our understanding in an unconscious manner. A persons ability to recognize these biases can improve communication with pts and colleagues alike. Which of the statements is true about implicit bias? 1. Implicit bias forms during a lifetime 2. Implicit bias can influence clinical decision making and treatment 3. Implicit bias contributes to an individuals social behavior 4. All of the above
Ans: 4 implicit bias is formed on a persons culture , it is automatic and subconscious during our interactions with others, and it contributes to social behavior because it is derived from our cultural norms
As Jane speaks with the team, she learns why the staff has had difficulty following policies. Which of these would be considered barriers to effective communication? 1. The charge nurse is unavailable to help the nurses when they have questions about policies. 2. Some staff are afraid to ask particular charge nurses for help for fear of retribution 3. The use of acronyms is confusing to new staff 4. All of the above.
Ans: 4 physical, emotional and semantic barriers could prevent the staff from following policies. Absence of a charge nurse, fear of a charge nurse and acronyms can cause this.
Social media is commonly used to update friends and groups on things we have going on in our lives. Health care organizations routinely use social media to promote medical facts, services, and recognitions. What is important for nurses to remember when deciding to post something work related on a social media site? 1. Nurses should never post protected health information on social media 2. Stories with good outcomes can be posted to your media page 3. Stories and photos can always be shared if the pts name or face isn't visible 4. Posting stories on personal time is okay because the nurse isn't working.
Ans: 1 protected health information must be protected and never shared without expressed written permission. A pts privacy and confidentiality are paramount
The EMR has many disadvantages compared with paper charting. It helps track data through time and can help monitor things such as preventative care in primary practices. Jane is the office nurse, she is meeting a new pt for the first time who says he was recently hospitalized. Jane pulls up the EMR and sees no infection regarding his recent stay. How could this have happened? 1. The pts discharge was so recent that it is not available yet 2. EMRs are usually practice or hospital specific, so the pts info would not be accessible to Jane. 3. The pt was hospitalized from out of state 4. The pt has not signed the necessary consents to give Jane access.
Ans: 2 EMRs are usually hospital or practice specific, so Jane would not have access to the pts hospital EMR. Recent changes in technology and the creation of health info exchanges are making EMR info available to hospital and practice affiliates. General consents for treatment and release of info are part of hospital paperwork.
ISBARR provides a framework for communicating critical pt info. ISBARR is an acronym for: 1. Identify, study, background, assess, recognize, readback 2. Issue, situation, better, advise, refer and recommendations 3. Introduce, situation, background, assess, recommend, readback 4. None of these.
Ans: 3 ISBARR is an acronym for concise review of the pt with other team members to ensure timely intervention and feedback. Introduce the pt, the current situation, and pertinent background that could be contributing to the situation, a clinical assessment with recommendations, and a readback of the instructions or orders to ensure accuracy.
Bedside shift report is one of the things that Jane reviews at the meeting. She stresses the way she would prefer the report to start. Which of these would be the least important to share with the oncoming nurse? 1. Telling the oncoming nurse what happened on the unit during the shift 2. Intruding the pt and their diagnosis to the oncoming nurse 3. Sharing the nurses personal opinion of the pt 4. Reviewing new med orders and the MAR.
Ans: 3 personal opinions may prejudice the oncoming nurses view of the pt, which could compromise care. Answer 2 is the most important thing to do. 1 and 4 are important but not the most or least important.
You are working in trauma today, and your new pt with a femur fracture complains of leg pain and seems diaphoretic and SOB. You assess the pt and prepare to contact the surgeon. In preparation for contacting the HCP you: 1. Immediately page the MD, it could be a PE, and time is of the essence, you will give him the particulars when he arrives 2. Wait for the MD to round on his pt because it should be within the next hour. 3. Medicate the pt for pain and plan to contact the MD when he rounds 4. Jot down notes about the situation, review the pts history, focus your assessment, and determine what you need for this pt.
Ans: 4 describing SBAR is the best. Reporting on situational changes is designed to provide concise, pertinent, and factual info to the HCP. This approach to a sudden change in pt condition allows you to communicate info, your concerns, and the need for action.
Jane is a new manager who will be holding her first staff meeting tomorrow. She has learned that the staff members have not been following important pt care policies. What is the most important communication skill that she should use at the meeting? 1. Talking to the staff 2. Laughing with them 3. Listening 4. Crying.
Ans: 3 listening to staff is the most critical communication skill bc it helps the manager understand the situation and the staffs rationale for their actions. It also demonstrates empathy and openness, which can lead to an agreement on better adherence to the policies. Talking is important but not the most important.
