Orthopaedic Nurse Test Quality Control & Assurance 3 — Questions and Answers
Question 1: An orthopaedic nurse notices that post-op pain reassessment is frequently skipped after analgesic administration. Which quality improvement model would BEST guide corrective action?
- FMEA (Failure Mode and Effects Analysis)
- PDSA (Plan-Do-Study-Act) cycle (Correct answer)
- Six Sigma DMAIC
- Lean 5S methodology
Correct answer: PDSA (Plan-Do-Study-Act) cycle
The PDSA cycle is a rapid, iterative improvement model well-suited for testing and refining small-scale process changes like pain reassessment compliance.
Question 2: Which National Patient Safety Goal is MOST directly relevant to orthopaedic surgical patients?
- Improving staff communication using SBAR
- Using two patient identifiers before surgery and procedures (Correct answer)
- Reducing catheter-associated urinary tract infections
- Improving hand hygiene compliance in the ICU
Correct answer: Using two patient identifiers before surgery and procedures
Using two patient identifiers before any procedure is a core Joint Commission National Patient Safety Goal to prevent wrong-patient errors.
Question 3: A hospital's orthopaedic unit has a 15% rate of hospital-acquired pressure injuries (HAPIs). Which type of quality indicator does this represent?
- Structure measure
- Process measure
- Outcome measure (Correct answer)
- Balancing measure
Correct answer: Outcome measure
The HAPI rate reflects the end result of care delivery and is therefore classified as an outcome measure of quality.
Question 4: During a surgical timeout in the orthopaedic OR, which information MUST be confirmed by all team members?
- Patient's insurance status and billing code
- Correct patient identity, procedure, and surgical site (Correct answer)
- Surgeon's preference card selections
- Estimated blood loss from prior surgeries
Correct answer: Correct patient identity, procedure, and surgical site
The Universal Protocol requires confirmation of patient identity, correct procedure, and correct site before every surgical incision.
Question 5: Which metric BEST reflects the effectiveness of an orthopaedic unit's fall prevention program?
- Percentage of patients who signed a fall prevention agreement
- Rate of falls per 1,000 patient days (Correct answer)
- Number of fall risk assessments completed at admission
- Staff attendance at fall prevention in-service training
Correct answer: Rate of falls per 1,000 patient days
Falls per 1,000 patient days is the standard outcome metric used to evaluate the real-world effectiveness of fall prevention interventions.
Question 6: A Failure Mode and Effects Analysis (FMEA) is conducted before implementing a new anticoagulation protocol. What is the PRIMARY purpose of FMEA?
- Retroactively investigate a medication error that already occurred
- Proactively identify potential failure points before a process goes live (Correct answer)
- Document staff competencies for annual review
- Compare the new protocol to national benchmarks
Correct answer: Proactively identify potential failure points before a process goes live
FMEA is a proactive risk assessment tool used to identify and mitigate potential failures before a new process is implemented.
Question 7: An orthopaedic unit's quality dashboard shows a sudden spike in unplanned readmissions. What should be the nurse manager's FIRST action?
- Immediately suspend the discharge planning nurse
- Conduct a detailed review of readmission cases to identify common contributing factors (Correct answer)
- Report the data to the Joint Commission
- Reduce the number of patients discharged per day
Correct answer: Conduct a detailed review of readmission cases to identify common contributing factors
Reviewing cases to identify patterns is the first step in understanding the root causes before implementing any corrective action.
Orthopaedic Nurse Test Quality Control & Assurance 3
An orthopaedic nurse notices that post-op pain reassessment is frequently skipped after analgesic administration.
Which quality improvement model would BEST guide corrective action?