CMD Risk Assessment & Mitigation 2 — Questions and Answers
Question 1: A long-term care facility identifies a pattern of catheter-associated urinary tract infections (CAUTIs) in one wing. What is the MOST appropriate first step in risk mitigation?
- Immediately discharge all affected residents
- Conduct a root cause analysis to identify contributing factors (Correct answer)
- Replace all nursing staff in that wing
- Suspend catheter use facility-wide
Correct answer: Conduct a root cause analysis to identify contributing factors
Root cause analysis (RCA) systematically identifies underlying causes of an adverse event, enabling targeted and effective corrective actions.
Question 2: Under the CMS Quality Assurance and Performance Improvement (QAPI) framework, which type of committee is responsible for ongoing monitoring of clinical quality indicators?
- Grievance committee
- Quality assurance committee (Correct answer)
- Ethics committee
- Infection control committee
Correct answer: Quality assurance committee
The quality assurance committee under QAPI is charged with systematically monitoring clinical quality indicators and driving performance improvement.
Question 3: A Medical Director reviews incident reports and notices a cluster of medication errors during shift changes. Which risk mitigation strategy BEST addresses handoff-related errors?
- Reduce the number of shift changes per day
- Implement a structured communication tool such as SBAR at handoffs (Correct answer)
- Assign medication administration to supervisory nurses only
- Increase medication documentation frequency
Correct answer: Implement a structured communication tool such as SBAR at handoffs
Structured handoff communication tools like SBAR (Situation, Background, Assessment, Recommendation) significantly reduce information gaps that lead to medication errors during transitions.
Question 4: When performing a Failure Mode and Effects Analysis (FMEA) in a nursing facility, what does the 'detectability' score specifically measure?
- The frequency with which a failure occurs
- The severity of harm caused by a failure
- The likelihood that a failure will be caught before reaching the patient (Correct answer)
- The number of staff involved in the failure process
Correct answer: The likelihood that a failure will be caught before reaching the patient
In FMEA, detectability scores the ability of existing controls to identify a failure mode before it causes harm to the patient.
Question 5: A facility's fall rate has increased over the past quarter. Under a systematic risk assessment approach, which data source provides the MOST actionable information?
- State survey deficiency citations from two years ago
- Staffing agency invoices
- Post-fall huddle records and individual fall risk assessments (Correct answer)
- Dietary intake logs
Correct answer: Post-fall huddle records and individual fall risk assessments
Post-fall huddle records and individual risk assessments provide specific, timely data about contributing factors and individual resident vulnerabilities.
Question 6: Which federal regulation requires nursing facilities to have a written infection control program that includes surveillance, prevention, and control of infections?
- 42 CFR Part 483.80 (Correct answer)
- 42 CFR Part 483.25
- 29 CFR 1910.1030
- 42 CFR Part 483.10
Correct answer: 42 CFR Part 483.80
42 CFR Part 483.80 mandates that long-term care facilities maintain an infection prevention and control program with designated oversight.
Question 7: A Medical Director is evaluating a new resident with multiple comorbidities for fall risk. Which validated tool is MOST appropriate for quantifying fall risk in a long-term care setting?
- APACHE II score
- Morse Fall Scale (Correct answer)
- Glasgow Coma Scale
- Braden Scale
Correct answer: Morse Fall Scale
The Morse Fall Scale is a validated, widely used instrument specifically designed to assess fall risk in clinical and long-term care settings.
CMD Risk Assessment & Mitigation 2
A long-term care facility identifies a pattern of catheter-associated urinary tract infections (CAUTIs) in one wing.
What is the MOST appropriate first step in risk mitigation?