Nurse Executive Test Patient Safety & Care Quality 1 — Questions and Answers
Question 1: Which organization publishes the annual National Patient Safety Goals that accredited hospitals must implement?
- Agency for Healthcare Research and Quality (AHRQ)
- The Joint Commission (TJC) (Correct answer)
- Centers for Medicare & Medicaid Services (CMS)
- Institute for Healthcare Improvement (IHI)
Correct answer: The Joint Commission (TJC)
The Joint Commission publishes and updates the National Patient Safety Goals annually, which all TJC-accredited organizations are required to implement.
Question 2: A 'Never Event' in healthcare is best defined as:
- A patient complaint that was never formally addressed
- A medication error that caused no patient harm
- A serious, largely preventable adverse event that should never occur in a healthcare setting (Correct answer)
- An incident that was never reported to regulatory agencies
Correct answer: A serious, largely preventable adverse event that should never occur in a healthcare setting
Never Events are serious, largely preventable patient safety incidents that should not occur if appropriate safeguards are in place, such as wrong-site surgery.
Question 3: The 'Swiss Cheese Model' of patient safety, commonly used to explain how errors cause harm, was developed by:
- Dr. Lucian Leape
- James Reason (Correct answer)
- Dr. Peter Pronovost
- Florence Nightingale
Correct answer: James Reason
James Reason developed the Swiss Cheese Model, which illustrates how multiple defensive layers each containing holes (weaknesses) can align to allow errors to reach the patient.
Question 4: Which quality improvement methodology uses the DMAIC framework (Define, Measure, Analyze, Improve, Control) to reduce process variation?
- Plan-Do-Study-Act (PDSA)
- Six Sigma (Correct answer)
- Lean methodology
- Root Cause Analysis (RCA)
Correct answer: Six Sigma
Six Sigma uses the DMAIC framework as a data-driven approach to eliminate defects and reduce variation in healthcare processes.
Question 5: A Failure Mode and Effects Analysis (FMEA) is best described as:
- A retrospective review of adverse events that have already caused patient harm
- A proactive risk assessment tool that identifies potential process failures before they occur (Correct answer)
- A method for determining disciplinary action after a medication error
- A mandatory regulatory report submitted after a sentinel event
Correct answer: A proactive risk assessment tool that identifies potential process failures before they occur
FMEA is a prospective, proactive tool used to systematically identify potential failure modes in a process and assess their likely effects before harm reaches the patient.
Question 6: Which of the following is a core principle of a High Reliability Organization (HRO) as applied to healthcare?
- Assuming errors are inevitable and therefore uncontrollable
- Prioritizing operational efficiency over safety to meet financial benchmarks
- Maintaining a preoccupation with failure and sensitivity to operations (Correct answer)
- Relying on individual clinical expertise rather than standardized team protocols
Correct answer: Maintaining a preoccupation with failure and sensitivity to operations
HROs are defined by five principles including preoccupation with failure, sensitivity to operations, reluctance to simplify, deference to expertise, and commitment to resilience.
Question 7: Which metric is used to compare a hospital's actual number of healthcare-associated infections to the predicted number based on national baseline data?
- Standardized Infection Ratio (SIR) (Correct answer)
- Net Promoter Score (NPS)
- Case Mix Index (CMI)
- Length of Stay (LOS) variance
Correct answer: Standardized Infection Ratio (SIR)
The Standardized Infection Ratio (SIR) compares observed HAI counts to predicted counts derived from national baseline data, adjusting for patient risk factors.
Nurse Executive Test Patient Safety & Care Quality 1
Which organization publishes the annual National Patient Safety Goals that accredited hospitals must implement?