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Leadership and Management for Nurses, 3e (Finkelman)
Chapter 17 Healthcare Quality: A Critical Health Policy Issue
1) The nurse is interested in educating patients to become active participants in their own
healthcare. Which information should the nurse review to develop a program for the hospital?
1. "Speak Up: Help Prevent Errors in Your Care."
2. Crossing the Quality Chasm.
3. To Err Is Human: Building a Safer Health System.
4. Envisioning the National Healthcare Quality.
2) The quality improvement nurse is working to increase the efficiency of resource utilization in
the medical center. This nurse is focusing on which element of healthcare quality?
1. Process
2. Structure
3. Outcome
4. Function
3) What has been the historical importance of the Institute of Medicine (IOM) reports since
1999?
1. They stimulated the development of strategies that will improve quality of care.
2. They are responsible for accrediting hospitals and other types of healthcare organizations.
3. They establish minimum standards and benchmarks for healthcare organizations.
4. They support research designed to improve the outcomes and quality of healthcare.
4) Which factors are evidence of an increased interest in quality care? Select all that apply.
1. Increased legislation
2. A change in focus of the major purchasers of healthcare
3. Initiatives by healthcare professional organizations
4. An increased number of accreditation organizations
5. A major decrease in the number of malpractice lawsuits
5) Which statement, made by a staff nurse, reflects correct identification of the primary goal of
quality improvement (QI)?
1. "This process will save us money."
2. "I like that this intervention saves time."
3. "It seems as if the physicians like our new charting system."
4. "My patients do better since we are using this system."
6) A serious medication administration error occurred on the unit last night. What statement,
made by the nurse manager, reflects the current focus of quality improvement (QI) related to this
situation?
1. "Was this a nursing error or a physician error?"
2. "How did the error occur?"
3. "Who gave the medication?"
4. "What pharmacist was on duty?"
7) Which statements regarding the Consumer Bill of Rights, Protections, and Responsibilities are
accurate? Select all that apply.
1. This was an initiative of President Clinton's Presidential Advisory Commission on Consumer
Protection and Quality in the Healthcare Industry.
2. Patient privacy was considered during this work.
3. The United States still does not have a consumer bill of rights, protections, and
responsibilities.
4. The work focused on patient issues, but did not address practitioner qualifications.
5. This has been the most successful of the programs to come out of that decade of work.
8) Information from To Err is Human: Building a Safer Health System (Institute of Medicine,
1999) indicates that at least 44,000 Americans die each year as a result of a medication error.
Nurses from which setting could closely apply this information to their personal practice?
1. Hospitals
2. Long-term care
3. Home health
4. Intensive care units
5. Ambulatory care
9) The medical center quality improvement director issues a report on the "opportunity" costs of
errors occurring in the organization. Which situation would be included in this report? Select all
that apply.
1. A patient sustained a fracture when he falls after being incorrectly restrained.
2. A laboratory test must be repeated because the technician ran the specimen incorrectly.
3. A medicine error necessitates that the patient be dialyzed.
4. The patient says, "A nurse nearly let me die, so I don't trust nurses anymore."
5. The physician enters discharge orders incorrectly and the patient spends another day in the
10) The patient develops postoperative pneumonia when the physician fails to order respiratory
therapy treatments after surgery. Which type of quality problem does this situation most clearly
represent?
1. Misuse
2. Error of planning
3. Underuse
4. Error of benefit
11) The nursing student is writing a paper on the Institute of Medicine's (IOM) 2001 report,
Crossing the Quality Chasm. Which options reflect aims of this report that the student should
include? Select all that apply.
1. Timeliness
2. Effectiveness
3. Reimbursement
4. Equality
5. Safety
