Nokea
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.
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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.
What is the goal of methods used to standardize the process of continuous quality improvement?
- A. Detection of errors
- B. Prevention of errors
- C. Detection of people problems
- D. Evaluation of organizational functioning
Correct Answer: B
Rationale: The goal of continuous quality improvement is prevention, not detection, of errors. Quality improvement is a continuous cycle of improving processes before errors are made or complaints are reviewed. Doing the right thing the first time and all the time is considered much more cost-effective than redoing work.
The first documented study in health care and nursing based on standards is attributed to which following person?
- A. Jean Watson
- B. Virginia Henderson
- C. Florence Nightingale
- D. Sister Mary Dorothy Ross
Correct Answer: C
Rationale: The first documented study in health care and nursing, based on the use of standards, is attributed to Florence Nightingale, who, in 1858, investigated the quality of care provided to military personnel.
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 type of validity was established with the majority of instruments that were developed to measure quality assurance?
- A. Face validity
- B. Content validity
- C. Concurrent validity
- D. Predictive validity
Correct Answer: A
Rationale: Most instruments have demonstrated little more than face validity, raising questions about the value of results in quality assessment programs using inadequately tested instruments.