Quality Control & Assurance Flashcards

A CNS is leading a failure mode and effects analysis (FMEA) on a new central line insertion process before implementation. Which statement best describes FMEA's primary purpose?

Answer: To proactively identify potential failure modes, their causes, and effects before an adverse event occurs

FMEA is a proactive risk analysis tool — it identifies potential failures before they occur, unlike RCA which is reactive (after an event).

A CNS is developing a balanced scorecard for a cardiology unit. Which combination of metrics represents all four balanced scorecard perspectives?

Answer: Patient satisfaction (customer), CLABSI rate (internal process), staff engagement (learning/growth), and cost per case (financial)

The balanced scorecard requires metrics in four perspectives: financial, customer (patient), internal processes, and learning/growth — one metric from each.

When conducting a retrospective chart audit for a CNS-led QI project, which sampling strategy provides the most statistically valid results with the least resource burden?

Answer: Random sampling of an appropriate sample size using a power calculation

Random sampling with an adequate sample size (determined by power calculation) provides statistically valid, generalizable results without the burden of auditing every chart.

A CNS is reviewing a proposed change to the hospital's sepsis protocol. The evidence for the proposed change comes from a single RCT with n=120. How should the CNS evaluate this evidence?

Answer: Evaluate the RCT's quality (blinding, randomization, allocation concealment), sample size adequacy, population generalizability, and look for corroborating evidence

Critical appraisal of a single RCT requires evaluating methodological quality, sample adequacy, generalizability, and whether the finding is supported by other evidence before protocol change.

A CNS is evaluating the cost-effectiveness of a new rapid response team (RRT) program. Which calculation best demonstrates the program's financial value?

Answer: Cost of program implementation vs. cost savings from prevented ICU transfers, reduced code blue events, and decreased length of stay

Cost-effectiveness analysis compares program costs against measurable financial benefits (prevented ICU admissions, reduced LOS, avoided codes) to demonstrate ROI.

Which quality improvement framework is best suited for redesigning a complex, multi-department patient handoff process that requires significant workflow restructuring?

Answer: DMAIC (Define-Measure-Analyze-Improve-Control) — data-driven framework for eliminating defects in complex processes

DMAIC (Six Sigma methodology) provides a rigorous data-driven framework for analyzing and redesigning complex processes with multiple variables and stakeholders.