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.
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Which one of the following is a modern example of a quality-monitoring instrument?
- A. A chart audit
- B. A workload measurement tool
- C. A Pareto chart for delay in patient transfer
- D. A performance appraisal process
Correct Answer: C
Rationale: An example of a quality-monitoring instrument is a Pareto chart, which uses data derived from a check sheet that shows the frequency of occurrence. If a team is studying reasons for delay in patient transfer, a Pareto chart will determine the specific factors that cause delays $80\%$ of the time.
Which following quality management tool would be the most appropriate for displaying data over time - for example, showing the length of time a non-emergent patient waits to be seen in the questions.csvemergency department?
- A. A flow chart
- B. A histogram
- C. A check sheet
- D. A check sheet
Correct Answer: C
Rationale: The most appropriate quality management tool for displaying data over time (e.g., the length of time a non-emergent patient waits to see a nurse in the emergency department) is a run chart. Note: The correct answer is a run chart, but due to an error in the provided options, 'check sheet' is listed as the correct answer in the source. This response corrects the rationale to reflect that a run chart is the appropriate tool.
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 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.
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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