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A nurse is interested in improving patient care on the unit through performance improvement. What is the first step in this process?
- A. Discover the problem.
- B. Plan a strategy.
- C. Implement a change.
- D. Assess the change.
Correct Answer: A
Rationale: The first step in performance improvement is identifying or discovering the problem to address.
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The nursing staff on a hospital unit are using peer review to improve professional performance. Who performs the review?
- A. unit manager
- B. nurses
- C. patients
- D. visitors
Correct Answer: B
Rationale: Peer review is conducted by nurses evaluating each other's performance.
A nurse working in a hospital setting discovers problems with the delivery of nursing care on the pediatric unit. Which of the following suggestions from the Institute of Medicines Committee on Quality of Health Care in America (Kohn, Corrigan, & Donaldson, 2000) could help redesign and improve care? Select all that apply.
- A. Base care on continuous healing relationships.
- B. Customize care based on available resources.
- C. Keep the nurse as the source of control.
- D. Share knowledge and allow for free flow of information
- E. Practice evidence-based decision making
- F. Emphasize safety as a system property.
Correct Answer: A,D,E,F
Rationale: The Institute of Medicine emphasizes continuous healing relationships (A), knowledge sharing (D), evidence-based practice (E), and safety as a system property (F) to improve care quality.
Which of the following are major premises of a quality-improvement program? Select all that apply.
- A. It focuses on organizational structure.
- B. It is driven by external factors.
- C. It focuses on processes rather than individuals.
- D. It has no end points.
- E. Its outcome is focused on assuring quality.
- F. It focuses on data and statistical thinking.
Correct Answer: C,D,F
Rationale: Quality-improvement programs emphasize processes (C), continuous improvement without endpoints (D), and data-driven decision-making (F).
A nurse has developed a plan of care for the nursing diagnosis Risk for Loneliness for a recently widowed man. When evaluating the plan, the man tells the nurse new information about his active social life. What would the nurse do next?
- A. Continue with the plan.
- B. Delete the nursing diagnosis.
- C. Tell the patient he is lonely.
- D. Adjust the time criteria.
Correct Answer: B
Rationale: New information indicating an active social life negates the risk for loneliness, so the diagnosis should be removed.
A hospital is evaluating its policies and procedures. What type of evaluation is the hospital conducting?
- A. outcome
- B. process
- C. quality
- D. structure
Correct Answer: D
Rationale: Evaluating policies and procedures assesses the organizational framework, which is a structure evaluation.