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CPPS REVIEW COURSE EXAM
QUESTIONS AND ANSWERS 100%
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A staff member discovered a medication with an incorrect label. The staff immediately notified the pharmacist and the correct label was sent prior to medication administration. Then, the staff completed an event report through the organization's reporting tool. Which of the following actions should the unit manager take in response to this event? A.) Document the incident in the employee's performance review. B.) Investigate system failures and recognize the employee for reporting a near-miss event. C.) Notify the director of pharmacy about the pharmacist's error. D.) No action, since the incident did not cause patient harm. - correct answer B.) Investigate system failures and recognize the employee for reporting a near-miss event. You are educating clinical managers in your health care facility on how to identify appropriate events for conducting a root cause analysis (RCA). Which event provides the BEST opportunity for an RCA? A.) A post-operative 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.) In the last four months, there have been three occurrences of depressed respirations related to sedation in the same department. - correct answer C.) The biopsy samples from a colonoscopy are never received by pathology after the procedure. A hospital is using the AHRQ Hospital Survey on Patient Safety Culture. There were 80 employees who responded. Responses to the survey item that states "we have patient safety problems in this unit" were as follows: Strongly Agree: 16 Agree: 32 Neither Agree nor Disagree: 12 Disagree: 17 Strongly Disagree: 3 A.) 75% B.) 60% C.) 25% D.) 20% - correct answer C.) 25%The AHRQ Hospital Survey on Patient Safety Culture User Guide scoring guidance says to use the "Strongly Agree/Agree" response sum, or, for negatively worded items— such as this one—use the "Strongly Disagree/Disagree" sum. In this example, 17+3 gives us the response sum (i.e., 20), which we divide by total number of respondents (i.e., 80): 20/80 = 25%. What is one example of a communication technique providers can use to improve communication with patients?
2.) Clinicians and staff are accountable for the quality of their choices (i.e. striving to make the best possible choices as professionals) - correct answer Just Culture At the conclusion of a surgical procedure at your hospital, the instrument count is incorrect. The hospital policy does not stipulate that the surgeon must remain on the premises until an x-ray is obtained to check for retained foreign objects. By the time the x-ray results come in to reveal that there is, in fact, a retained instrument, the original surgeon has left the hospital to catch a flight. Another surgeon is contacted to remove the retained instrument. How should leadership respond to this event? A.) Revise the hospital policy to make it clear that surgeons must stay in the operating room (OR) until instrument count issues are resolved. B.) Using an appropriate accountability system, counsel the surgeon about customary clinical standards. C.) Re-educate the OR nursing staff on keeping track of instruments on the sterile field. D.) Create a process map of how instruments are managed during surgery, looking f - correct answer B.) Using an appropriate accountability system, counsel the surgeon about customary clinical standards. This term reflects a group of individuals who understand the importance of self- and group- regulation. - correct answer Professionalism
The human resources department at your organization has asked your patient safety specialist for recommendations on new policies to help support safety culture. Which recommendation sounds best? A.) Sending human resources all event data so that they can record involvement in adverse events in personnel files B.) Including human resources in all root cause analyses so that they can provide guidance on recommended training updates for staff C.) Implementing routine use of a tool to determine which events are attributed to human error, at-risk behavior, and reckless behavior D.) Implementing routine use of a tool to determine which events are attributed to human error, at-risk behavior, and reckless behavior AND consulting with human resources on at- risk and reckless behavior cases - correct answer D.) Implementing routine use of a tool to determine which events are attributed to human error, at-risk behavior, and reckless behavior AND consulting with human resources on at- risk and reckless behavior cases At the end of a long, exhausting shift, an experienced nurse administered the wrong medication by picking up the wrong syringe. The wrong medication was an analgesic, and the patient didn't suffer any problems. After recalling that his colleague was fired last month over a medication error, he decides not to file an incident report. Safety culture would be improved if the hospital provided this employee with which of the following? A.) Situational awareness training B.) Training on reporting C.) Psychological safety D.) An electronic reporting system - correct answer
A.) Instruct team members to act in a safe and respectful manner. B.) Focus on a list of projects identified by senior stakeholders. C.) Review annual data on defects and successes. D.) Apply best evidence with the goal of failure-free operation over time. - correct answer D.) Apply best evidence with the goal of failure-free operation over time. As your organization's patient safety officer, you are reviewing unit results on the AHRQ Culture of Safety Survey. You are speaking with the manager of a unit for which the unit percent positive score is 30 percent for the following statement: "Staff in this unit work longer hours than is best for patient care." What do you tell the manager the positive answer in this statement means? A.) 30% of the staff agree with the statement. B.) 30% of the staff work longer hours. C.) 30% of the staff disagree with the statement. D.) 70% of the staff work longer hours. - correct answer C.) 30% of the staff disagree with the statement. The Just Culture model includes creating a learning culture, designing safe systems, and which of the following activities? A.) Providing punishment equal to the harm caused B.) Decreasing the amount of reported errors C.) Finding the individual to blame D.) Managing behavioral choices - correct answer D.) Managing behavioral choices
Which of the following is the best first step in changing the culture of safety in a health care organization? A.) Conduct an assessment and gather focused data. B.) Develop, policies, procedures, and checklists for safety. C.) Hire an experienced patient safety officer with a strong performance record. D.) Implement communication and teamwork tools. - correct answer A.) Conduct an assessment and gather focused data. A nurse on a medical-surgical unit does not comply with the barcode medication administration (BCMA) procedure while caring for one of her patients. Her supervisor is deciding how to respond. As her supervisor, what would you do? A.) Ask the nurse what was occurring at the time, and why she chose to bypass the policy. B.) Counsel the nurse on the importance of following policy C.) Ask staff if there are adequate scanners to meet their needs. D.) Request that the pharmacy run a report of the BCMA compliance rates of the unit. - correct answer A.) Ask the nurse what was occurring at the time, and why she chose to bypass the policy. What are the 3 key areas of Patient Safety leadership? - correct answer Strategy, Operations, and Engagement When setting organizational safety priorities, it is best to: A.) Review the current literature to identify areas of frequent concern.
You are meeting with your organization's CFO to review the likely Return on Investment (ROI) for several possible patient safety initiatives. Based only on the projected ROI, which project is most likely to receive the CFO's approval? A.) Implementation of Computerized Provider Order Entry to reduce the number of medication errors with an ROI of 1.0, or 100 percent. B.) Procurement of new beds with built-in alarms to reduce falls with an ROI of 0.9, or 90 percent. C.) Implementation of evidence-based guidelines to reduce the rate of catheter-associated urinary tract infections with an ROI of 3.0, or 300 percent. D.) Implementation of a sitter program, which has been shown to reduce falls and improve patient satisfaction with an ROI of 0.5, or 50 percent. - correct answer C.) Implementation of evidence-based guidelines to reduce the rate of catheter-associated urinary tract infections with an ROI of 3.0, or 300 percent. The free, uninhibited flow of information that is open to the scrutiny of others is the definition of: A.) Quality care B.) Just Culture C.) Transparency D.) High reliability - correct answer C.) Transparency When an adverse event occurs with a patient: A.) An investigation should commence to determine the staff member at fault. B.) The event should be openly discussed with the patient, family, and staff.
C.) A root cause analysis should be completed and submitted to the Joint Commission. D.) The patient should not be told about the event because of the possibility of legal action. - correct answer B.) The event should be openly discussed with the patient, family, and staff. Which of the following changes to operations would best highlight leadership's commitment to patient safety? A.) Executive leadership regularly participating in leadership rounds and daily safety briefings B.) The hospital executive reporting on patient safety at every board meeting C.) Implementing quarterly town hall meetings to share organizational information D.) Including an executive representative on all root cause analysis teams - correct answer A.) Executive leadership regularly participating in leadership rounds and daily safety briefings Which of the following tactics is the best approach to increase near-miss event reporting? A.) Include staff names in event reports. B.) Give staff up to a week to report events. C.) Require staff to report all errors and near-misses. D.) Provide event reporters with feedback and follow-up - correct answer D.) Provide event reporters with feedback and follow-up You are charged with identifying and recommending a new event reporting system for your organization. Which of the
A patient safety professional wants to ensure engagement of employees in a new patient safety initiative in the hospital. He should: A.) Use staff recommendations for workflow. B.) Collect data on previous initiatives. C.) Communicate the purpose of the initiative to the governing board. D.) Train staff on patient safety principles. - correct answer A.) Use staff recommendations for workflow. A medication error at a nearby hospital has recently received media attention. In examining your own organization, you find similar processes are in place to the ones that contributed to the error. You'd like to change your hospital's processes but worry people will be resistant to change. What would be the best method to use to influence others as to the need for change? A.) Reference accreditation standards and hospital policy as the need to make a change in process. B.) Present the story in conjunction with your own facility's data. C.) Develop a staff recognition program for reporting actual events that occur in your facility. D.) Conduct a root cause analysis on a similar event that has occurred at your own facility. - correct answer B.) Present the story in conjunction with your own facility's data. You have been asked to present an overview of safety events to your hospital's board of trustees. In order to best represent safety issues, you should: A.) Present cases of harm with contributing root causes and actions taken.
B.) Highlight system-wide improvements that have been implemented in the past year. C.) Lead an open discussion of board members' safety concerns and recommendations. D.) Display a graph of the numbers and types of safety events reported in the past year. - correct answer A.) Present cases of harm with contributing root causes and actions taken. Your patient safety team performs a root cause analysis on a recent wrong-side surgery event. Which of the following action items reflects the highest level of reliability? A.) Change the color of surgical site markers from black to red. B.) Implement a process in which the surgical technician holds the scalpel (and does not hand it to the surgeon) until a timeout with all team members at attention has taken place. C.) Educate surgeons to be present for surgical timeouts. D.) Every month, perform multidisciplinary simulations empowering all staff to speak up for safety. - correct answer B.) Implement a process in which the surgical technician holds the scalpel (and does not hand it to the surgeon) until a timeout with all team members at attention has taken place. Your hospital's leadership is concerned about low safety culture survey scores in the category of "communication openness." The percentage of positive responses related to questioning someone with higher authority is well below national averages. The lead patient safety professional has been asked to make recommendations on increasing the questioning of those with higher authority. To maximize risk reduction, when should staff be asked to stop and question a situation? A.) When something doesn't seem right
Your hospital implements patient safety WalkRounds as part of a series of changes to improve safety. Six months after the implementation, informal staff feedback suggests inconsistency in the WalkRounds' effectiveness. As the patient safety professional charged with ensuring the success of the effort, what is the best assessment technique to gain insight into current performance? A.) Review information boards in the areas included in the WalkRounds to determine the scope of issues raised. B.) Discuss the informal feedback you have been receiving with the CEO. C.) Gather data about the frequency and content of the WalkRounds to establish current baseline performance. D.) Survey staff and leaders about their views on patient safety WalkRounds. - correct answer D.) Survey staff and leaders about their views on patient safety WalkRounds. In cause analysis, the role of the Executive Sponsor is to: A.) Coordinate all efforts of the cause analysis team and conduct performance management discussions. B.) Prepare for a visit by the department of health if the event meets criteria for reporting to the state. C.) Help scope the objectives and maintain accountability for effective and timely action plans. D.) Complete the initial debrief following a patient safety event and ensure the safety of all involved. - correct answer C.) Help scope the objectives and maintain accountability for effective and timely action plans. A patient safety professional wants to enhance a culture of reporting by introducing a visual tool that quickly provides the opportunity for frontline staff to share defects, promote their
risk awareness, and share in resolution of defects. The most suitable tool is: A.) Failure modes and effects analysis B.) Patient safety leadership WalkRounds C.) Root cause analysis D.) Learning boards - correct answer D.) Learning boards A learning board is a visual tool that enhances frontline staff participation in the resolution of defects. The other options to do meet the criteria mentioned: Failure modes and effects analysis is a proactive tool for risk assessment. Root cause analysis happens after reporting. Patient safety leadership WalkRounds are not a visual tool. Your health system learns about an incident involving a retained sponge following surgery, and an RCA will be performed. The root cause analysis is credible if: A.) A single, clearly defined root cause has been identified. B.) It is reviewed and signed by a patient safety professional. C.) There is participation by leadership and individuals closely involved in the process. D.) Corrective actions have been developed and completed. - correct answer C.) There is participation by leadership and individuals closely involved in the process. The Joint Commission Comprehensive Accreditation Manual for Hospitals states that RCAs for sentinel events, such as this, will be considered acceptable if they are thorough and credible with "credible" defined as: 1) including participation by leadership and individuals most closely involved in the process
D.) Utilize barcode scanners to generate a specimen label at the bedside. - correct answer D.) Utilizing bar code scanners is the correct answer because it entails a forcing function at the bedside. After scanning the armband, the correct label for that patient will print from the scanner.In regard to the other options: Education is always the lowest impact (soft fix) in any action plan. Changing processes is better but will still rely on individuals to do the right thing, e.g., the nurse/phlebotomist would need to make sure multiple labels were not on the tray, which is a common shortcut to avoid having to walk back and forth between specimen collections. Direct observation would be required to make sure people didn't introduce workarounds. In the context of failure modes and effects analysis (FMEA), how is the risk priority number (RPN) used? A.)It calculates the failure modes that will create the most errors. B.) It specifies the failure modes that have been shown to cause harm. C.) It identifies the highest priority failure modes to address. D.) It prioritizes the failure modes that do not require action. - correct answer C.) It identifies the highest priority failure modes to address. The Risk Priority Number (RPN) is a score that provides the team a way to identify the highest risk failure modes in descending order. If the team does not have the resources to address all the identified risks, this number can be used to filter out failure modes that are acceptable in the current state.In regard to the other answer options: The RPN does not determine that an action is not required; that determination comes from the team evaluating the issue at hand, and, to
some degree, may be decided based on time and resources available. The RPN does not identify error potential or represent harm that has already occurred; it identifies the impact of a failure mode if it does occur. Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) is a process improvement program that can be used to: A.) Eliminate variation. B.) Help address disruptive behavior. C.) Find the root cause of an incident. D.) Reduce waste. - correct answer B.) Help address disruptive behavior TeamSTEPPS can be used to increase communication skills with teams and reduce the risk of miscommunication that can lead to disruptive behavior.In regard to the other answer options: Finding the root cause of an incident is performing a root cause analysis. Reducing waste is Lean process improvement, and eliminating variation is Six Sigma. 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: What would you do for next steps to identify a replacement system? A.) Purchase the least expensive software. B.) Ask Information Systems to either fix the old system or build a new one. C.) Poll colleagues and purchase what they use. D.) Identify key stakeholders and perform a gap analysis of current state to ideal state. - correct answer
