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You are educating clinical managers in your healthcare facility on how to identify appropriate events for conducting a Root Cause Analysis. Which event provides the best opportunity for an RCA? - -
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a. A post-op patient removes his own IV causing a skin tear from the tape b. A patient with no known allergies experiences an anaphylactic reaction to an antibiotic requiring transfer to ICU. c. The biopsy samples from a colonoscopy are never received by pathology after the procedure d. There have been 3 occurrences of depressed respirations in the same department in the last 4 months related to sedation The answer is C. The biopsy samples from a colonoscopy are never received by pathology after the procedure - - - correct answer โ
The instrument count is incorrect at the conclusion of a surgical procedure. The hospital policy does not stipulate that the surgeon remain on the premises until an x-ray is obtained. The surgeon
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leaves the hospital to catch a flight. The x-ray reveals a retained instrument. Another surgeon is contacted to remove the retained instrument. What should leadership do next? - - - correct answer โ
a. Create a process map of how instruments are managed during surgery looking for latent flaws b. Revise the hospital policy to make it clear that surgeons must stay in the OR until instrument count issues are resolved c. Counsel the surgeon about customary clinical standards for a surgeon using appropriate accountability system d. Reeducate the OR nursing staff on keeping track of instruments on the sterile field The answer is C. Counsel the surgeon about customary clinical standards for a surgeon using appropriate accountability system - - - correct answer โ
A nurse on a medical-surgical unit does not comply with barcode medication administration (BCMA) while caring for one of her patients. What should her supervisor do? - - -
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b. A table indicating the CLABSI infection rates of all hospitals in the region relative to the National Healthcare Safety Network benchmark for CLABSI infections for the past 2 years c. A written report summarizing the current CLABSI prevention protocols of each hospital in the region d. A table showing the number of CLABSI infections in each hospital in the region by quarter for the past 2 years The answer is B. A table indicating the CLABSI infection rates of all hospitals in the region relative to the National Healthcare Safety Network benchmark for CLABSI infections for the past 2 years - - - correct answer โ
Your organization utilizes a "home grown" electronic safety event reporting system that is no longer meeting the needs of the organization. Hospital administration is asking for your opinion for next steps. What next steps would you take to identify a replacement system? - - - correct answer โ
a. Ask information systems to either fix the old one or build a new one
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b. Identify key stakeholders and perform a gap analysis of current state to ideal state c. Poll colleagues and purchase what they use d. Purchase the lease expensive software and grow with it The answer is B. Identify key stakeholders and perform a gap analysis of current state to ideal state - - - correct answer โ
Your organization is preparing to change to a new electronic health record. Many departments have been involved with the planning of this huge effort. What would you suggest as part of the preparation strategy? - - - correct answer โ
a. Conduct a root cause analysis b. Conduct a failure modes and effects analysis c. Offer a "plan, do, study, act" session d. Offer to do a claims analysis for any related errors
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A new medication administrative safety process was implemented in a hospital. A team convened to perform a failure mode effects analysis and calculate a risk priority number (RPN). After a targeted medication safety program on the new process was delivered to nurses, the same team convened to perform another FMEA. The team would be happy to see: - - - correct answer โ
a. The detectability increased and RPNs were lower b. The detectability decreased and RPNs were lower c. The frequency numbers decreased and RPNs were higher d. The frequency numbers increased and RPNs were lower The answer is b. (I think) The detectability decreased and RPNs were lower - - - correct answer โ
Sharing lessons learned from RCA's does what? - - - correct answer โ
a. exposes the fallibility of the involved clinician(s)
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b. Allows others to introduce work arounds to avoid the same situation c. Allows co-workers to learn the rationale for why an event occurred and incorporate new lessons learned into practice d. Sharing these events allows for exposure from litigation perspective and should not be encouraged The answer is C. Allows co-workers to learn the rationale for why an event occurred and incorporate new lessons learned into practice -
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Which of the following descriptions best reflects principles of safe system design? - - - correct answer โ
a. Hospital A routinely reviews and updates policies and procedures every 2 years b. Hospital B routinely studies close calls c. Hospital C routinely provides trainings on the use of newly introduced medical equipment
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The answer is c. Human factors science addresses problems by modifying the design of the system to better aid people - - - correct answer โ
A known barrier to patient safety is staff not speaking up when they are concerned or if they see safety violations. You would help foster a culture that supports speaking up by: - - - correct answer โ
a. Putting up posters around the organization that reinforce speaking up as a safety strategy b. Using culture of safety data to assist low performing departments with defining strategies for improvement c. Using tends in event reporting to identify staff who don't speak up d. Re-educating management on the use of Just Culture principles The answer is b. b. Using culture of safety data to assist low performing departments with defining strategies for improvement - - - correct answer โ
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Regulatory and Accreditation standards/requirements can help guide improvement by: - - - correct answer โ
a. Fining people who don't participate b. Outlining specific targets for performance c. Defining required topics of performance d. Providing language for metrics defined in the improvement project the answer is c. Defining required topics of performance - - - correct answer โ
The patient safety team reviewed a sample of patients who had been readmitted within 48 hours of discharge and noticed that the patient's discharge medication lists had not been accurately reconciled. The appropriate next steps for the team to take include:
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a. Reprimand the discharging provider b. Ask nursing to be responsible for all medication reconciliation
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When setting organizational safety priorities, it is best for you to: - -
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a. determine priorities based on pay for performance measurements b. Focus primarily on accreditation standards and requirements c. develop a mechanism to gather input from a variety of sources d. review the current literature to identify areas of concern The answer is C. develop a mechanism to gather input from a variety of sources - - - correct answer โ
You are meeting with the CFO to determine return on investment (ROI) for multiple patient safety initiatives. Which project is most likely to receive approval based on the determined ROI: - - - correct answer โ
a. Procurement of new beds with built-in alarms to reduce falls with a
