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A hospitals current quality improvement program has integrated the principles of the Institute for Healthcare Improvement (IHI) 5 Million Lives Campaign. How can the hospital best achieve the campaign goals of reducing preventable harm and death?
- A. By adhering to EBP guidelines
- B. By reducing nurse-to-patient ratios and increasing accountability
- C. By having researchers from outside the facility evaluate care
- D. By involving patients and families in their care planning
Correct Answer: A
Rationale: The 5 Million Lives Campaign posits that if evidence-based guidelines it advocated were voluntarily implemented by U.S. hospitals, 5 million lives would be saved from either harm or death over a two-year period. Nurse-to-patient ratios, family participation, and independent evaluation are not stated components of the campaign.
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The Joint Commission and the Centers for Medicare and Medicaid Services (CMS) are evaluating a large, university medical center according to core measures. Evaluators should perform this evaluation in what way?
- A. By auditing the medical centers electronic health records
- B. By performing focus groups and interviews with care providers from numerous disciplines
- C. By performing statistical analysis of patient satisfaction surveys
- D. By comparing the centers patient outcomes to best practice indicators
Correct Answer: D
Rationale: Core measures are used to gauge how well a hospital gives care to its patients who are admitted to seek treatment for a specific disease or who need a specific treatment as compared to evidence-based guidelines and standards of care. Benchmark standards of quality are used to compare the care or treatment patients receive with the best practice standards. Patient satisfaction is considered, but this is not the only criterion.
The ANA has identified central characteristics of nursing practice that are applicable across the wide variety of contexts in which nurses practice. A nurse can best demonstrate these principles by performing which of the following actions?
- A. Teaching the public about the role of nursing
- B. Taking action to control the costs of health care
- C. Ensuring that all of his or her actions exemplify caring
- D. Making sure to carry adequate liability insurance
Correct Answer: C
Rationale: The ANA emphasizes the fact that caring is central to the practice of the registered nurse. The ANA does not identify teaching the public about nursing, controlling costs, or maintaining insurance as a central tenet of nursing practice.
Professional nursing expands and grows because of factors driven by the changing needs of health care consumers. Which of the following is a factor that nurses should reflect in the planning and provision of health care?
- A. Decreased access to health care information by individuals
- B. Gradual increases in the cultural unity of the American population
- C. Increasing mean and median age of the American population
- D. Decreasing consumer expectations related to health care outcomes
Correct Answer: C
Rationale: The decline in birth rate and the increase in lifespan due to improved health care have resulted in fewer school-age children and more senior citizens, many of whom are women. The population has become more culturally diverse as increasing numbers of people from different national backgrounds enter the country. Access to information and consumer expectations continue to increase.
Nurses in acute care settings must work with other health care team members to maintain quality care while facing pressures to care for patients who are hospitalized for shorter periods of time than in the past. To ensure positive health outcomes when patients return to their homes, what action should the nurse prioritize?
- A. Promotion of health literacy during hospitalization
- B. Close communication with insurers
- C. Thorough and evidence-based discharge planning
- D. Participation in continuing education initiatives
Correct Answer: C
Rationale: Following discharges that occur after increasingly short hospital stays, nurses in the community care for patients who need high-technology acute care services as well as long-term care in the home. This is dependent on effective discharge planning to a greater degree than continuing education, communication with insurers, or promotion of health literacy.
Leadership of a medical unit have been instructed to integrate the principles of the Quality and Safety Education for Nurses (QSEN) competency of quality improvement. What action should the units leaders take?
- A. Provide access to online journals and Web-based clinical resources for nursing staff.
- B. Use flow charts to document the processes of care that are used on the unit.
- C. Enforce continuing education requirements for all care providers.
- D. Reduce the use of chemical and physical restraints on the unit.
Correct Answer: B
Rationale: One of the quality improvement skills is to use tools, such as flow charts and cause-effect diagrams, to make processes of care explicit. Each of the other listed actions has the potential to benefit patients and care givers, but none is an explicit knowledge, skill, or attitude associated with this QSEN competency.