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The hospital is having a problem with healthcare-associated infections. A committee has been established to study the problem and make recommendations. The nurse working on the committee knows that this work addresses what?
- A. Inpatient quality indicators
- B. Prevention quality indicators
- C. National Patient Safety Goals
- D. Patient safety indicators
Correct Answer: C
Rationale: The Joint Commission has established National Patient Safety Goals that are updated annually. These safety goals have changed how patients are identified and prevent adverse effects. Some of the 2016 goals include reducing the risk of healthcare-associated infections. Patient safety indicators reflect the quality of care in hospitals but focus on potentially avoidable complications. Prevention indicators identify hospital admissions that could be avoided through high-quality outpatient care. Inpatient indicators reflect quality of care inside the hospital.
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The client is referred from the physician to a cardiologist for a cardiac catheterization to determine if the client has coronary artery disease. What type of care does the nurse understand that this is?
- A. Primary care
- B. Secondary care
- C. Tertiary care
- D. Acute care
Correct Answer: B
Rationale: Secondary care includes referrals to facilities for additional testing such as cardiac catheterization, consultation, and diagnosis as well as emergency and acute care interventions. This client falls into this category due to the referral to the cardiologist for the cardiac catheterization. The client does not fall into the acute care category. Primary care would include being seen by the client's primary physician. Tertiary care focuses more on complex medical and surgical interventions, cancer care, rehabilitative services, long-term care such as burn care, and palliative and hospice care.
A client complaining of bloody urine has scheduled an appointment with a family practitioner. What type of care is the client receiving?
- A. Tertiary
- B. Secondary
- C. Skilled nursing care
- D. Primary
Correct Answer: D
Rationale: The first provider that clients contact about a health need provides primary care; this person is typically a family practitioner or nurse practitioner. Secondary care includes referrals to facilities for additional testing. Tertiary care focuses on more complex medical and surgical intervention. Skilled nursing care occurs in facilities or units that offer prolonged health maintenance or rehabilitative services.
The nurse is aware of the various changes in the healthcare field. What important factor remains the same in this time of change?
- A. Nurses must provide safe, high-quality, cost-effective care to individuals, families, and communities.
- B. Nurses must inform clients that they will have to use facilities that are within their service area.
- C. Clients must become actively involved in the process of standardizing care.
- D. Nurses will have to work in unsafe conditions in order to provide care to clients.
Correct Answer: A
Rationale: In the midst of these dramatic changes and challenges, nurses must continue to provide safe, high-quality, cost-effective care to individuals, families, and communities. It is also imperative that nurses distinguish and communicate to clients the various choices that the clients may make about their healthcare. Clients have a choice as to location of care providers and are not limited to local facilities. Clients are not involved in standardizing care; this is a healthcare provider function. Nurses will not have to work in unsafe conditions in order to provide care to clients.
A client with terminal cancer is being referred to hospice services to assist with care of the client and the family in the home environment. What type of care does the nurse determine this is?
- A. Primary care
- B. Secondary care
- C. Tertiary care
- D. Acute care
Correct Answer: C
Rationale: Tertiary care focuses more on complex medical and surgical interventions, cancer care, rehabilitative services, long-term care such as burn care, and palliative and hospice care. This client is terminally ill and being referred for hospice service. Secondary care includes referrals to facilities for additional testing such as cardiac catheterization, consultation, and diagnosis as well as emergency and acute care interventions. The client does not fall into the acute care category. Primary care would include being seen by the client's primary physician.
The nurse has been asked to assist in gathering data regarding the incidence of falls in the hospital as part of a project that is geared toward identifying avoidable contributing factors and their effects. What type of quality indicators (QI) is this considered?
- A. Prevention QI
- B. Inpatient QI
- C. Client safety QI
- D. Pediatric QI
Correct Answer: C
Rationale: Client safety QIs reflect quality of care within hospitals but focus on potentially avoidable complications and adverse effects. Prevention QIs identify hospital admissions that could be avoided through high-quality outpatient care. Inpatient QIs reflect quality of care inside hospitals, including inpatient mortality for medical conditions and surgical events. The question does not indicate that client age is considered when gathering data, so Pediatric QIs would not be relevant here.