Certified Midwife Exam Prep Quality Control & Assurance 2 — Questions and Answers
Question 1: A midwife notices that the rate of postpartum hemorrhage at her birth center has increased over the past quarter. What is the FIRST step in a quality improvement process?
- Implement a new oxytocin protocol immediately
- Collect and analyze data to identify the root cause (Correct answer)
- Report the issue to the state licensing board
- Require all staff to attend hemorrhage training
Correct answer: Collect and analyze data to identify the root cause
Quality improvement begins with data collection and root cause analysis before implementing interventions.
Question 2: Which tool is MOST commonly used in midwifery practice to systematically identify the root causes of an adverse event?
- PDSA cycle
- Fishbone (Ishikawa) diagram (Correct answer)
- Run chart
- Gantt chart
Correct answer: Fishbone (Ishikawa) diagram
The fishbone (Ishikawa) diagram is a root cause analysis tool that maps contributing factors to an adverse outcome.
Question 3: A quality assurance audit reveals that informed consent documentation is missing in 30% of charts. This finding is BEST described as:
- A sentinel event
- A process measure gap (Correct answer)
- An outcome measure failure
- A near-miss incident
Correct answer: A process measure gap
Missing documentation of informed consent reflects a gap in the process of care, making it a process measure issue.
Question 4: In the context of midwifery quality improvement, what does the acronym PDSA stand for?
- Plan, Document, Supervise, Assess
- Plan, Do, Study, Act (Correct answer)
- Prioritize, Delegate, Schedule, Audit
- Prevent, Detect, Screen, Analyze
Correct answer: Plan, Do, Study, Act
PDSA (Plan, Do, Study, Act) is the standard rapid-cycle quality improvement model used in healthcare.
Question 5: A certified midwife is reviewing maternal satisfaction surveys. Satisfaction scores are classified as which type of quality measure?
- Structure measure
- Process measure
- Outcome measure (Correct answer)
- Balancing measure
Correct answer: Outcome measure
Patient satisfaction is an outcome measure because it reflects the result of care from the patient's perspective.
Question 6: Which national organization sets standards for accreditation of birth centers in the United States?
- The Joint Commission (TJC)
- The Commission for the Accreditation of Birth Centers (CABC) (Correct answer)
- The American College of Nurse-Midwives (ACNM)
- The Centers for Medicare & Medicaid Services (CMS)
Correct answer: The Commission for the Accreditation of Birth Centers (CABC)
The Commission for the Accreditation of Birth Centers (CABC) is the primary accrediting body for freestanding birth centers in the US.
Question 7: A midwife's practice tracks the percentage of clients who receive Group B Streptococcus (GBS) screening at 35–37 weeks. This metric is an example of a:
- Outcome measure
- Structure measure
- Balancing measure
- Process measure (Correct answer)
Correct answer: Process measure
Tracking whether a recommended screening is performed reflects a process measure, assessing adherence to clinical guidelines.
Certified Midwife Exam Prep Quality Control & Assurance 2
A midwife notices that the rate of postpartum hemorrhage at her birth center has increased over the past quarter.
What is the FIRST step in a quality improvement process?