Continuous quality improvement (CQI) in health care includes which of the following actions?
- A. Controlling the staffing budget
- B. Integrating internet technology into practice
- C. Educating staff on principles of primary health care
- D. Reinforcing a positive work environment
Correct Answer: D
Rationale: Patient experience (satisfaction) is an important quality indicator that is used widely in nursing management. Patient experience surveys are meant to help organizations understand whether the patient felt safe, whether the patient felt involved as a partner in their care planning, and whether they felt they were treated with dignity and compassion.
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For which percentage of the time were critical standards expected to be achieved in quality assurance programs, in relation to the level established by the program directors?
- A. $50 \%$
- B. 50%
- C. $90\%
- D. $100\%
Correct Answer: D
Rationale: The foundation of quality assurance programs- achieving predetermined standards in the clinical setting- was seen as somewhat arbitrary. Administrators and program directors established the level to which each standard was to be achieved. Critical standards were expected to be achieved $100\%$ of the time, while less critical standards, perhaps $80\%$ to $90\%$ of the time.
Which statement is true regarding the public perception of health care?
- A. Health care is considered to be a right.
- B. Health care is believed to be accessible to all.
- C. Health care is considered to be a privilege.
- D. Health care providers administer minimal care.
Correct Answer: A
Rationale: The Canadian public perceives health care to be a right, not a privilege, and expects that health care providers will administer not just care, but quality care.
Which of the following is the common denominator of all quality assurance programs?
- A. Process
- B. Outcome
- C. Standards
- D. Structure
Correct Answer: C
Rationale: The common denominator of all quality assurance programs is standards.
What clinical outcome was supported in the Canadian Council on Health Services Accreditation (CCHISA) Survey Standards in the early 1990s and is now reflected in the C-HOBIC standards of care in Canada?
- A. A quality improvement focus
- B. Facility-wide integration of processes
- C. Clinical outcomes for evidence-informed nursing practice
- D. Methods for identifying unsafe practice by health care providers
Correct Answer: C
Rationale: In the early 1990s, the CCHSA Survey Standards included clinical outcomes to support evidence-informed nursing care that are now reflected in the C-HOBIC standardized clinical outcomes.
Which one of the following is a limitation of most quality assurance programs?
- A. The high validity of the instruments used for evaluation
- B. The retrospective focus on achievement of standards
- C. The need to achieve predetermined standards in the clinical setting
- D. The acceptable reliability of the instruments used for assessment
Correct Answer: B
Rationale: A limitation of quality assurance programs is the retrospective focus on achievement of standards. Considerable emphasis of quality-monitoring activities occurred after the fact when it was least possible to make necessary changes.
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