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A nurse is serving on a continuous quality improvement (CQI) committee that has been assigned to develop a program to reduce the number of medication administration errors following a sentinel event at the facility. Which of the following strategies should the committee plan to initiate first?
- A. Review the events leading up to each medication administration error.
- B. Require staff nurses to demonstrate competency by passing a medication administration examination.
- C. Develop a quality improvement program for nurses involved in medication administration errors.
- D. Provide an inservice on medication administration to all the nurses.
Correct Answer: A
Rationale: The correct answer is A: Review the events leading up to each medication administration error. This is the first strategy the committee should initiate because it helps identify root causes of errors. By conducting a thorough review of the events leading up to each error, the committee can identify systemic issues, communication breakdowns, and other factors contributing to errors. This information is crucial for developing targeted interventions to prevent future errors.
Choice B is incorrect because competency testing alone may not address underlying system issues leading to errors. Choice C is incorrect because focusing solely on nurses involved in errors may overlook broader system issues. Choice D, providing an inservice, is also not as effective as reviewing events leading to errors, as it may not address specific causes of errors.
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A charge nurse allows a nurse an additional twenty minutes for his lunch break to take care of a personal matter. The charge nurse agrees to watch his patients for the additional twenty minutes, only if he agrees to help with the end-of-shift drug count. The charge nurse is demonstrating which of the following types of conflict management?
- A. Avoiding
- B. Compromising
- C. Cooperating
- D. Competing
Correct Answer: B
Rationale: The correct answer is B: Compromising. Compromising involves finding a middle ground where both parties give up something to reach a mutually acceptable solution. In this scenario, the charge nurse and nurse both make concessions - the charge nurse agrees to watch the patients for an additional twenty minutes, and the nurse agrees to help with the end-of-shift drug count. This approach allows both parties to achieve their goals partially, demonstrating a compromise. Avoiding (A) would be ignoring the issue, cooperating (C) would involve working together without concessions, and competing (D) would be a win-lose situation.
Mary is a newly-hired, new graduate nurse. Mary adapts her practice to imitate her co-workers on the unit. She is demonstrating:
- A. cultural awareness.
- B. cultural sensitivity.
- C. acculturation.
- D. cultural marginality.
Correct Answer: C
Rationale: Mary is demonstrating acculturation by adapting her practice to imitate her co-workers. Acculturation involves adopting the cultural norms and behaviors of a dominant group. In this scenario, Mary is assimilating into the culture of her workplace. Cultural awareness (A) is about understanding and respecting different cultures. Cultural sensitivity (B) is being aware of and respectful towards different cultures. Cultural marginality (D) refers to feeling disconnected from one's own culture and the dominant culture. In this case, Mary is actively assimilating, not feeling disconnected. Therefore, the correct answer is C.
A nurse in an acute care setting is serving on a committee whose charge is to use the auditing process to client care. Which of the following aspects of client care is measured by an outcome audit?
- A. Incidence of catheter-induced urinary tract infections.
- B. Nursing staff ratios.
- C. Availability of resources, such as fire extinguishers.
- D. Quality of nursing care provided.
Correct Answer: A
Rationale: The correct answer is A because an outcome audit measures the results or outcomes of client care, such as the incidence of catheter-induced urinary tract infections. This type of audit evaluates the effectiveness of the care provided and focuses on patient outcomes. Choices B and C are incorrect as they pertain to process audits, which assess how care is delivered and the availability of resources, respectively. Choice D is incorrect because it is too broad and does not specifically address a measurable outcome. Choices E, F, and G are not provided, but they would likely be incorrect unless they specifically relate to measurable outcomes of client care.
A nurse manager has recently become aware of a conflict between the pharmacy and the staff nurses regarding sending and receiving medications. Which of the following actions should the nurse take first to resolve the conflict?
- A. Evaluate the results.
- B. Identify the problem.
- C. Brainstorm solutions.
- D. Implement a resolution.
Correct Answer: B
Rationale: The correct answer is B: Identify the problem. The first step in resolving any conflict is to understand the root cause. By identifying the problem between the pharmacy and staff nurses, the nurse manager can gain insight into the specific issues causing the conflict. This step allows for a targeted and strategic approach to finding solutions. Evaluating results (A) comes after implementing a resolution, brainstorming solutions (C) is premature without a clear understanding of the problem, and implementing a resolution (D) should only occur once the problem has been fully identified and a plan developed.
A manager notes that the incidence of medication errors has increased since the implementation of staffing changes. What strategy should the manager consider to reduce errors?
- A. Deter mistakes by emphasizing the consequences of committing a medication error.
- B. Include the bedside nurses in the decision-making process involving their practice.
- C. Encourage nurses who commit medication errors to file incident reports, placing them in the patient's chart.
- D. Relinquish responsibility by asking a separate department to oversee quality improvement.
Correct Answer: B
Rationale: The correct answer is B: Include the bedside nurses in the decision-making process involving their practice. By involving the nurses in decision-making, the manager can gain valuable insights into the root causes of the medication errors and collaboratively develop solutions to address them. This participatory approach fosters ownership, accountability, and engagement among the nurses, leading to a sense of empowerment and motivation to improve patient care.
A: Deter mistakes by emphasizing the consequences of committing a medication error - This approach may create a culture of fear and discourage open communication about errors, hindering the identification and resolution of underlying issues.
C: Encourage nurses who commit medication errors to file incident reports, placing them in the patient's chart - While incident reporting is important for learning from errors, placing them in the patient's chart may not address the systemic issues contributing to the errors.
D: Relinquish responsibility by asking a separate department to oversee quality improvement - This approach shifts accountability away from the nursing staff and may not effectively address