Understanding High-Reliability Organizations and Patient Safety in Healthcare, Exams of Nursing

Download Understanding High-Reliability Organizations and Patient Safety in Healthcare and more Exams Nursing in PDF only on Docsity! BHA4004 Patient Safety & Quality Improvement in Health Care Pre-Assessment Guide Q & A 2024 1. Multiple Choice: Which of the following is a primary component of a High-Reliability Organization (HRO) in healthcare? a) Punitive response to errors b) Preoccupation with failure c) Low-risk tolerance d) Independent decision-making Answer: b) Preoccupation with failure Rationale: HROs focus on identifying potential points of failure and continuously seek to improve processes, rather than punishing individuals for errors. 2. True/False: Root Cause Analysis (RCA) is a process used for identifying the basic or causal factors that underlie variation in performance, including the occurrence or possible occurrence of a sentinel event. Answer: True Rationale: RCA is a method used to understand the underlying reasons for incidents or near-misses, with the aim of preventing future occurrences. 3. Fill-in-the-Blank: The ________ model is a framework for classifying errors in healthcare that affect patient safety, which includes slips, lapses, mistakes, and violations. Answer: Reason 9. Fill-in-the-Blank: The ________ effect refers to the phenomenon where the presence of safety measures can lead to riskier behavior by individuals. Answer: Risk Compensation Rationale: The Risk Compensation effect can counteract safety interventions if individuals feel overly secure and become less vigilant. 10. Multiple Choice: Effective teamwork in healthcare is best achieved through: a) Hierarchical communication structures b) Multidisciplinary collaboration and communication c) Individual decision-making d) Competition among team members Answer: b) Multidisciplinary collaboration and communication Rationale: Teamwork in healthcare requires the collaboration of various disciplines, with open communication to provide comprehensive patient care. 11. True/False: Sentinel events are always the result of an individual's mistake. Answer: False Rationale: Sentinel events are often the result of systemic issues and require a system-wide approach to prevent recurrence. 12. Fill-in-the-Blank: The ________ is a systematic approach to the analysis of serious medical errors and is used to identify potential improvements in healthcare processes. Answer: Failure Mode and Effects Analysis (FMEA) Rationale: FMEA helps healthcare organizations anticipate potential points of failure and implement improvements to enhance patient safety. 13. Multiple Choice: The Plan-Do-Study-Act (PDSA) cycle is a tool used for: a) Punishing healthcare workers for mistakes b) Implementing new healthcare policies without testing c) Continuous quality improvement d) Documenting patient complaints Answer: c) Continuous quality improvement Rationale: The PDSA cycle is a four-step model for carrying out change and is central to the practice of quality improvement. 14. True/False: Healthcare providers' emotional well-being has no impact on patient safety. Answer: False Rationale: Providers' emotional health can affect their focus, decision- making, and interaction with patients, thereby impacting patient safety. 15. Fill-in-the-Blank: A ________ is a healthcare system's ability to expand beyond normal capacity to meet an increased demand for clinical care. Answer: Surge Capacity Rationale: Surge Capacity is crucial for responding to events that suddenly increase the need for healthcare services, such as pandemics or disasters. Multiple Choice: What is the primary goal of a root cause analysis (RCA) in healthcare? A) Assign blame to individuals B) Identify underlying system issues C) Justify medical errors D) Highlight patient non-compliance Correct Answer: B) Identify underlying system issues Rationale: RCA focuses on understanding the systemic causes of errors to prevent future occurrences rather than blaming individuals. Fill-in-the-Blank: The Plan-Do-Study-Act (PDSA) cycle is a quality improvement method that emphasizes _. Correct Answer: Continuous iterative improvement Rationale: PDSA involves testing changes in small steps and adjusting based on feedback to achieve continuous improvement. Rationale: FMEA helps healthcare teams anticipate and mitigate risks by analyzing possible failure modes and their effects. Multiple Choice: What is the primary purpose of the National Patient Safety Goals (NPSGs) set by The Joint Commission? A) Increase healthcare costs B) Improve patient outcomes C) Reduce staff workload D) Enhance hospital profits Correct Answer: B) Improve patient outcomes Rationale: NPSGs aim to address specific areas of concern in patient safety to enhance care quality and prevent adverse events. Fill-in-the-Blank: The acronym CUSP stands for Comprehensive Unit- based _ Program. Correct Answer: Safety Rationale: CUSP is a structured program designed to improve safety culture and reduce patient harm in healthcare units. True/False: The Swiss Cheese Model is a visual representation of how multiple layers of defense can fail, leading to errors. Correct Answer: True Rationale: The model illustrates how errors can occur when multiple system failures align, akin to holes in slices of swiss cheese lining up. Multiple Choice: Which of the following is a core principle of human factors engineering in healthcare? A) Blaming individual mistakes B) Ignoring staff input on system design C) Minimizing cognitive workload D) Promoting complex workarounds Correct Answer: C) Minimizing cognitive workload Rationale: Human factors engineering aims to design systems that reduce cognitive burden on healthcare providers and prevent errors. Fill-in-the-Blank: The acronym RCA2 stands for Root Cause Analysis and _. Correct Answer: Action Plan Rationale: RCA2 involves not only identifying root causes of errors but also developing action plans to address and prevent them. True/False: High-quality teamwork in healthcare is associated with improved patient outcomes and safety. Correct Answer: True Rationale: Effective teamwork and communication among healthcare professionals are linked to better patient care and reduced errors. Multiple Choice: Which of the following contributes to a culture of safety in healthcare organizations? A) Blaming individuals for errors B) Fear of reporting mistakes C) Open and honest communication D) Lack of training for staff Correct Answer: C) Open and honest communication Rationale: A culture of safety encourages transparency, open communication, and learning from mistakes to improve patient care. Fill-in-the-Blank: The IHI Triple Aim framework focuses on improving _, enhancing patient experience, and reducing costs. Correct Answer: Population health Rationale: The Triple Aim aims to optimize health system performance by focusing on these three key areas. True/False: The Five Rights of Medication Administration include the right patient, right drug, right dose, right route, and right _. Correct Answer: Right time Rationale: Ensuring the medication is given at the right time is essential to prevent errors and promote patient safety. Multiple Choice: Which of the following is a common approach to promoting a culture of safety in healthcare teams? d) Mortality rates after surgery. **Answer: b) The frequency of hand hygiene compliance.** *Rationale:* Leading indicators are proactive measures, such as adherence to hand hygiene protocols, that can prevent adverse events. 5. The primary goal of "root cause analysis" (RCA) in healthcare is to: a) Punish the individual responsible for an error. b) Identify systemic issues leading to errors. c) Determine the financial cost of an incident. d) Develop new policies regardless of findings. **Answer: b) Identify systemic issues leading to errors.** *Rationale:* RCA aims to understand underlying factors and system failures contributing to an adverse event, not to assign blame. ### Fill-in-the-Blank Questions 6. __________ is the term used for the routine or systematic collection and assessment of key indicators to track performance and identify areas for improvement. **Answer: Continuous Quality Improvement (CQI)** *Rationale:* CQI focuses on the ongoing measurement and improvement of healthcare processes and outcomes. 7. The __________ model is a widely recognized conceptual framework for designing safer systems in healthcare by identifying holes and defending against errors. **Answer: Swiss Cheese** *Rationale:* The Swiss Cheese Model by James Reason is used to illustrate how errors occur when multiple layers of defense fail. 8. __________ is the process by which healthcare providers communicate patient information during transitions of care to maintain continuity and safety. **Answer: Handoff Communication** *Rationale:* Effective handoff communication is crucial for ensuring that important information is not lost during care transitions. 9. In healthcare, __________ refers to the consistent application of guidelines, protocols, and procedures to ensure high-quality and safe patient care. **Answer: Standardization** *Rationale:* Standardization helps to reduce variability, ensure compliance with best practices, and improve patient outcomes. 10. __________ is the ethical obligation to act for the benefit of patients by minimizing harm and promoting quality care. **Answer: Beneficence** *Rationale:* Beneficence is a core ethical principle in healthcare focused on doing good and preventing harm to patients. ### True/False Questions 11. Sentinel events are unexpected occurrences involving death or serious physical or psychological injury, or the risk thereof. **Answer: True** *Rationale:* Sentinel events signal the need for immediate investigation and response due to their severity. 12. The main objective of Six Sigma in healthcare is to increase variation and hence improve quality outcomes. **Answer: False** *Rationale:* Six Sigma aims to reduce variation and defects in processes to improve quality outcomes. 13. Patient safety culture surveys are tools exclusively used to evaluate patient's perspectives on safety in healthcare settings. **Answer: False** *Rationale:* These surveys assess the perceptions of healthcare providers regarding safety culture. 14. Evidence-based practice (EBP) in healthcare involves making clinical decisions based solely on physician expertise, without regard to research. **Answer: False** *Rationale:* EBP integrates clinical expertise, patient preferences, and the best available evidence into decision-making. 15. Failure Mode and Effects Analysis (FMEA) is a proactive risk assessment tool used to identify potential failures in processes before they occur. **Answer: True** *Rationale:* FMEA aims to foresee potential failures and their impacts to prevent adverse events. 16. Constructive feedback delivered in a respectful manner can be crucial in fostering a culture of safety. **Answer: True**