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Bonus Chapter 1: Introduction to QSEN Multiple Choice Identify the choice that best completes the statement or answers the question. ____
1. Which is the priority when providing nursing care? 1) Implementing evidence-based practice 2) Providing patient-centered care 3) Implementing safe practice 4) Providing advocacy
____
2. Which is a result of the Institute of Medicine’s (IOM’s) report addressing quality and safety issues in
health care? 1) The Quality and Safety Education for Nurses (QSEN) initiative 2) The American Nurses Association (ANA) Code of Nursing Ethics 3) The National League for Nurses (NLN) Centers of Excellence in Nursing Education 4) The American Association of Colleges of Nursing (AACN) Essentials in Nursing Practice ____
3. Which term is used when implementing patient-centered care in the maternal-newborn and pediatric
settings? 1) Culturally sensitive care 2) Evidence-based practice 3) Family-centered care 4) Age-appropriate care ____
4. Which is a core concept in providing patient-centered care? 1) Advocacy 2) Safety 3) Collaboration 4) Teamwork
____
5. Which should the nurse evaluate in himself/herself when implementing patient-centered care? 1) Personal values 2) Level of education 3) Use of research 4) Family dynamics
____
6. Which is an essential skill for a nurse who is a member of a health-care team? 1) Advocacy 2) Assessment 3) Spirituality 4) Communication
____
7. The maternal-newborn nurse works with a registered nurse and a nurse’s aide. Which type of team is
this nurse a member of according to current data? 1) Intraprofessional
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2) Interprofessional 3) Multidisciplinary 4) Allied health ____
8. The nurse is a member of an interprofessional team. Which observed behavior by another member of
the team could adversely affect collaboration? 1) A physician who reviews the nurse’s documentation prior to prescribing a new medication 2) A registered nurse who updates the physical therapist on a patient’s progress with ambulation 3) A licensed practical nurse who neglects to notify the charge nurse regarding abnormal vital signs 4) An unlicensed assistive personnel who asks for assistance with a delegated task ____
9. Which action should the nurse implement to remain up-to-date regarding best patient practices? 1) Reviewing a skill in a textbook on the unit 2) Completing annually required competencies 3) Attending a conference offering continuing education credits 4) Asking a seasoned nurse to act as a professional mentor
____ 10. The nurse is asked to participate on a quality improvement (QI) committee related to
hospital-acquired infections. Which initial action should the nurse take in preparation for the meeting? 1) Review current data on the subject 2) Conduct a review of the literature to determine best practices 3) Edit unit policies related to infection control and prevention 4) Plan an in-service to educate staff on the current issue ____ 11. Which electronic health record (EHR) tool should the nurse use to include evidence-based
interventions in the patient’s plan of care? 1) Alerts related to abnormal test results 2) Clinical decision support tool 3) Multiuser access in real time 4) Storage of collected data ____ 12. The nurse is asked during a job interview to state a prerequisite skill in the QSEN competency
related to informatics. Which response by the nurse reflects correct understanding? 1) “An advanced practice degree is considered a prerequisite skill in the QSEN competencies.” 2) “Licensure as a practical nurse is a prerequisite skill in the QSEN competencies.” 3) “Basic computer literacy is considered a prerequisite skill in the QSEN competencies.” 4) “Licensure as a registered nurse is a prerequisite skill in the QSEN competencies.” ____ 13. Which health-care provider is the last line of defense between a patient and a medication error? 1) Nurse 2) Surgeon 3) Physician
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4) Pharmacist ____ 14. The nurse makes a medication error during a busy shift on the unit. Which response by the nurse
manager reflects “just culture”? 1) Placing the nurse on administrative leave 2) Recommending that the nurse’s job be terminated 3) Encouraging the nurse to complete an incident report 4) Making a public announcement about the error during shift report
____ 15. Which nursing action enhances patient safety while making it harder to do the wrong thing? 1) Creating independent checks 2) Learning from defects 3) Using evidence-based practice 4) Standardizing work when possible ____ 16. Which nursing action reflects the simple rules of a 21st century health-care system? 1) Controlling the delivery of patient care 2) Including the patient in the delivery of care 3) Basing patient care on the current visit only 4) Basing patient interventions on clinical experience Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 17. Which QSEN competencies should be evaluated during performances reviews? (Select all that
apply.) 1) Communication 2) Infection control 3) Patient-centered care 4) Evidence-based practice 5) Teamwork and collaboration ____ 18. Which are core concepts related to the implementation of patient-centered nursing care? (Select all
that apply.) Respect Dignity Advocacy Participation Collaboration
1) 2) 3) 4) 5)
____ 19. Which patient characteristics should the nurse consider when planning patient-centered care? (Select
all that apply.) Knowledge Values Experiences Diagnoses Surgeries
1) 2) 3) 4) 5)
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____ 20. Which are core concepts the nurse should exhibit in order to meet the QSEN competency of
teamwork and collaboration? (Select all that apply.) Calculation Cooperation Coordination Classification Communication
1) 2) 3) 4) 5)
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Bonus Chapter 1: Introduction to QSEN Answer Section MULTIPLE CHOICE 1. ANS: 3
Chapter number and title: Bonus Chapter 1: Introduction to QSEN Chapter learning objective: Explain the core tenets of safety science. Chapter page reference: 2 Heading: Conceptual Cornerstone – Safety Integrated processes: Clinical Problem-Solving Process Client need: Safe and Effective Care Environment/Safety and Infection Control Cognitive level: Knowledge [Remembering] Concept: Safety Difficulty: Easy 1 2 3 4
Feedback Although the implementation of evidence-based practice is important, this is not the priority when providing nursing care. Although the implementation of patient-centered care is important, this is not the priority when providing nursing care. The priority when providing nursing care is safety. Although the implementation of advocacy is important, this is not the priority when providing nursing care.
PTS: 1 2. ANS: 1
CON: Safety
Chapter number and title: Bonus Chapter 1: Introduction to QSEN Chapter learning objective: Discuss the role of the Institute of Medicine’s To Err Is Human report and other historical drivers of the QSEN initiative. Chapter page reference: 2 Heading: Team Works Integrated processes: Clinical Problem-Solving Process Client need: Safe and Effective Care Environment/Safety and Infection Control Cognitive level: Comprehension [Understanding] Concept: Safety Difficulty: Easy 1
2 3
Feedback As a result of the IOM’s report addressing quality and safety issues in health care, nurse leaders responded with the QSEN initiative, which outlines the skill set required of nurses in the 21st-century workforce. The ANA Code of Nursing Ethics is not a result of the IOM’s report addressing quality and safety issues in health care. The NLN Centers of Excellence in Nursing Education is not a result of the IOM’s report addressing quality and safety issues in health care.
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The AACN Essentials in Nursing Practice is not a result of the IOM’s report addressing quality and safety issues in health care.
PTS: 1 3. ANS: 3
CON: Safety
Chapter number and title: Bonus Chapter 1: Introduction to QSEN Chapter learning objective: Discuss patient-centered care and the conflicts between patient-centered care and other QSEN competencies. Chapter page reference: 3 Heading: QSEN Competency for Patient-Centered Care Integrated processes: Caring Client need: Health Promotion and Maintenance Cognitive level: Comprehension [Understanding] Concept: Nursing Difficulty: Easy 1 2 3 4
Feedback Culturally sensitive care is not the term used when implementing patient-centered care in the maternal-newborn and pediatric settings. Evidence-based care is not the term used when implementing patient-centered care in the maternal-newborn and pediatric settings. Family-centered care is the term used when implementing patient-centered care in the maternal-newborn and pediatric settings. Age-appropriate care is not the term used when implementing patient-centered care in the maternal-newborn and pediatric settings.
PTS: 1 4. ANS: 3
CON: Nursing
Chapter number and title: Bonus Chapter 1: Introduction to QSEN Chapter learning objective: Discuss patient-centered care and the conflicts between patient-centered care and other QSEN competencies. Chapter page reference: 3 Heading: Team Works Integrated processes: Caring Client need: Safe and Effective Care Environment/Coordinated Care Cognitive level: Knowledge [Remembering] Concept: Nursing Difficulty: Easy 1 2 3 4
Feedback Advocacy is not a core concept in providing patient-centered care. Safety is not a core concept in providing patient-centered care. Collaboration is one of the core concepts in providing patient-centered care. Teamwork is not a core concept in providing patient-centered care.
PTS: 1
CON: Nursing
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5. ANS: 1
Chapter number and title: Bonus Chapter 1: Introduction to QSEN Chapter learning objective: Discuss patient-centered care and the conflicts between patient-centered care and other QSEN competencies. Chapter page reference: 3 Heading: Team Works Integrated processes: Caring Client need: Psychosocial Integrity Cognitive level: Application [Applying] Concept: Nursing Roles Difficulty: Moderate 1 2 3 4
Feedback In order to successfully implement patient-centered care, the nurse must evaluate his or her own personal values. The nurse does not need to evaluate his or her level of education to successfully implement patient-centered care. The nurse does not need to evaluate his or her use of research to successfully implement patient-centered care. The nurse does not need to evaluate his or her family dynamics to successfully implement patient-centered care.
PTS: 1 6. ANS: 4
CON: Nursing Roles
Chapter number and title: Bonus Chapter 1: Introduction to QSEN Chapter learning objective: Explain the role of teamwork and collaboration in improving patient safety. Chapter page reference: 3 Heading: QSEN Competency for Teamwork and Collaboration Integrated processes: Communication and Documentation Client need: Safe and Effective Care Environment/Coordinated Care Cognitive level: Comprehension [Understanding] Concept: Collaboration Difficulty: Easy 1 2 3 4
Feedback Advocacy is not an essential skill for being a member of a health-care team. Assessment is not an essential skill for being a member of a health-care team. Spirituality is not an essential skill for being a member of a health-care team. Effective communication is an essential skill for a nurse who is a member of a health-care team.
PTS: 1 7. ANS: 1
CON: Collaboration
Chapter number and title: Bonus Chapter 1: Introduction to QSEN Chapter learning objective: Define the key terms.
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Chapter page reference: 4 Heading: QSEN Competency for Teamwork and Collaboration Integrated processes: Clinical Problem-Solving Process Client need: Safe and Effective Care Environment/Coordinated Care Cognitive level: Comprehension [Understanding] Concept: Collaboration Difficulty: Easy 1 2
3 4
Feedback An intraprofessional team is teamwork that occurs within the profession, such as nurses working with other nurses. An interprofessional team is teamwork that occurs with other members of the health-care team, such as nurses working with physicians and physical therapists. A multidisciplinary team is an outdated term for an interprofessional team. Allied health is not a type of team.
PTS: 1 8. ANS: 3
CON: Collaboration
Chapter number and title: Bonus Chapter 1: Introduction to QSEN Chapter learning objective: Explain the role of informatics in patient-centered care, teamwork, collaboration, evidence-based practice, quality, and safety. Chapter page reference: 4 Heading: QSEN Competency for Teamwork and Collaboration Integrated processes: Communication and Documentation Client need: Safe and Effective Care Environment/Coordinated Care Cognitive level: Comprehension [Understanding] Concept: Collaboration Difficulty: Easy 1 2 3
4
Feedback A physician who reviews the nurse’s documentation prior to prescribing a new drug for the patient exemplifies collaboration. A registered nurse who updates the physical therapist on a patient’s progress with ambulation exemplifies collaboration through effective communication. A licensed practical nurse who neglects to report abnormal vital signs to the charge nurse is adversely affecting the collaborative process through poor communication. An unlicensed assistive personnel who asks for assistance with a delegated task exemplifies collaboration through effective communication.
PTS: 1 9. ANS: 3
CON: Collaboration
Chapter number and title: Bonus Chapter 1: Introduction to QSEN Chapter learning objective: Describe the roles national health-care agencies and public policy play in driving quality improvement.
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Chapter page reference: 4 Heading: Evidence-Based Practice Integrated processes: Clinical Problem-Solving Process Client need: Safe and Effective Care Environment/Coordinated Care Cognitive level: Application [Applying] Concept: Evidence-Based Practice Difficulty: Moderate 1 2 3 4
Feedback Reviewing a skill in a textbook on the unit is not a nursing action that allows the nurse to remain up-to-date regarding best patient practices. Completing annually required competencies is not a nursing action that allows the nurse to remain up-to-date regarding best practices. Attending a conference that offers continuing education credits is an action that allows the nurse to remain up-to-date regarding best practices. Asking a seasoned nurse to act as a professional mentor is not a nursing action that allows the nurse to remain up-to-date regarding best patient practices.
PTS: 1 10. ANS: 1
CON: Evidence-Based Practice
Chapter number and title: Bonus Chapter 1: Introduction to QSEN Chapter learning objective: Describe the roles national health-care agencies and public policy play in driving quality improvement. Chapter page reference: 5 Heading: QSEN Competency for Quality Improvement Integrated processes: Clinical Problem-Solving Process Client need: Safe and Effective Care Environment/Safety and Infection Control Cognitive level: Analysis [Analyzing] Concept: Quality Improvement Difficulty: Difficult 1
2
3
4
Feedback QI is the act of working to improve care. In order to know if care is improving, one must measure past care to compare with current care. Thus, QI is data driven. Although a review of the literature regarding best practices is a necessary step in the QI process, it is not the initial step the nurse should take to prepare for the committee meeting. Although editing unit infection control and prevention policies may be a necessary step in the QI process, it is not the initial step the nurse should take to prepare for the committee meeting. Although an in-service may be necessary in order to educate staff on the most recent evidence and practices, it is not the initial step the nurse should take to prepare for the committee meeting.
PTS: 1
CON: Quality Improvement
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11. ANS: 2
Chapter number and title: Bonus Chapter 1: Introduction to QSEN Chapter learning objective: Explain the role of informatics in patient-centered care, teamwork, collaboration, evidence-based practice, quality, and safety. Chapter page reference: 5 Heading: QSEN Competency Definition for Informatics Integrated processes: Communication and Documentation Client need: Safe and Effective Care Environment/Coordinated Care Cognitive level: Application [Applying] Concept: Evidence-Based Practice, Informatics Difficulty: Moderate 1
2
3
4
Feedback Alerts related to abnormal test results are not the EHR tool the nurse should use when updating the patient’s plan of care to include evidence-based interventions. This tool is meant to enhance communication among members of an interprofessional team. The clinical decision support tool should be used by the nurse when planning care because it links current practitioner prescriptions to evidence-based practice protocols. Multiuser access in real time is not the EHR tool the nurse should use when updating the patient’s plan of care to include evidence-based interventions. This tool should be used to enhance collaboration among members of an interprofessional team. Storage of collected data is not the EHR tool the nurse should use when updating the patient’s plan of care to include evidence-based interventions. This tool is used when reviewing data for the purpose of QI.
PTS: 1 12. ANS: 3
CON: Evidence-Based Practice | Informatics
Chapter number and title: Bonus Chapter 1: Introduction to QSEN Chapter learning objective: Explain the role of informatics in patient-centered care, teamwork, collaboration, evidence-based practice, quality, and safety. Chapter page reference: 5 Heading: QSEN Competency Definition for Informatics Integrated processes: Communication and Documentation Client need: Safe and Effective Care Environment/Coordinated Care Cognitive level: Application [Applying] Concept: Informatics Difficulty: Moderate 1 2
Feedback An advanced practice degree is not considered a prerequisite skill in the QSEN competency related to informatics. Licensure as a practical nurse is not considered a prerequisite skill in the QSEN competency related to informatics.
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Basic computer literacy is a prerequisite skill in the QSEN competency related to informatics. Licensure as a registered nurse is not considered a prerequisite skill in the QSEN competency related to informatics.
PTS: 1 13. ANS: 1
CON: Informatics
Chapter number and title: Bonus Chapter 1: Introduction to QSEN Chapter learning objective: Discuss the key principles of human factors engineering and their role in improving patient safety. Chapter page reference: 5 Heading: QSEN Competency for Safety Integrated processes: Clinical Problem-Solving Process Client need: Safe and Effective Care Environment/Management of Care Cognitive level: Comprehension [Understanding] Concept: Safety Difficulty: Easy 1
2
3
4
Feedback The nurse is the last line of defense between a patient and a medication error. The nurse must always implement the rights of medication administration to safeguard the patient from a drug error. Although a surgeon may prescribe medications for a patient, this member of the interprofessional team is not the last line of defense between the patient and a medication error. Although a physician may prescribe medications for a patient, this member of the interprofessional team is not the last line of defense between the patient and a medication error. Although a pharmacist is an interprofessional team member who is in the line of defense between the patient and a medication error, he or she is not the last line of defense.
PTS: 1 14. ANS: 3
CON: Safety
Chapter number and title: Bonus Chapter 1: Introduction to QSEN Chapter learning objective: Explain the role of a just culture in improving patient safety. Chapter page reference: 5 Heading: QSEN Competency for Safety Integrated processes: Communication and Documentation Client need: Safe and Effective Care Environment/Coordinated Care Cognitive level: Application [Applying] Concept: Quality Improvement Difficulty: Moderate 1
Feedback Placing the nurse on administrative leave does not reflect just culture; this action
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reflects blame. Recommending that the nurse’s job be terminated does not reflect just culture; this action reflects blame. Encouraging the nurse to complete an incident report is a response that reflects just culture. This action allows individuals, teams, and systems to identify the cause of the error and the circumstances surrounding the error in hopes of implementing safer practices. Making a public announcement regarding the nurse’s error does not reflect just culture. This action reflects blame.
PTS: 1 15. ANS: 4
CON: Quality Improvement
Chapter number and title: Bonus Chapter 1: Introduction to QSEN Chapter learning objective: Discuss the key principles of human factors engineering and their role in improving patient safety. Chapter page reference: 6 Heading: Human Factors Integrated processes: Clinical Problem-Solving Process Client need: Safe and Effective Care Environment/Safety and Infection Control Cognitive level: Comprehension [Understanding] Concept: Safety Difficulty: Easy 1 2 3 4
Feedback Creating independent checks enhances patient safety by decreasing reliance on memory, not by making it harder to do the wrong thing. Learning from defects enhances patient safety by making it easier to do the right thing in the future, not by making it harder to do the wrong thing. Using evidence-based practice enhances patient safety; however, safety is not enhanced by making it harder to do the right thing. Standardizing work when possible is a nursing action that enhances patient safety while making it harder to do the wrong thing.
PTS: 1 16. ANS: 2
CON: Safety
Chapter number and title: Bonus Chapter 1: Introduction to QSEN Chapter learning objective: Discuss patient-centered care and the conflicts between patient-centered care and other QSEN competencies. Chapter page reference: 4 Heading: Box B1-1 Core Competencies for Interprofessional Collaborative Practice Integrated processes: Clinical Problem-Solving Process Client need: Safe and Effective Care Environment/Coordinated Care Cognitive level: Application [Applying] Concept: Collaboration Difficulty: Moderate
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Feedback Controlling the delivery of care does not reflect the simple rules of a 21st century health-care system. The patient should be included in all aspects of care. This action reflects the simple rules of a 21st century health-care system. Basing care only on the current visit does not reflect the simple rules of a 21st century health-care system. Care should be based on continuous relationships that focus on healing. Basing patient interventions on clinical experience is not best practice, nor does it reflect the simple rules of a 21st century health-care system. Interventions should be based on evidence.
PTS: 1
CON: Collaboration
MULTIPLE RESPONSE 17. ANS: 3, 4, 5
Chapter number and title: Bonus Chapter 1: Introduction to QSEN Chapter learning objective: Discuss the role of the Institute of Medicine’s To Err Is Human report and other historical drivers of the QSEN initiative. Chapter page reference: 2 Heading: Conceptual Cornerstone – Safety Integrated processes: Clinical Problem-Solving Process Client need: Safe and Effective Care Environment/Coordinated Care Cognitive level: Comprehension [Understanding] Concept: Quality Improvement Difficulty: Easy
1. 2. 3. 4. 5.
Feedback This is incorrect. Communication is a skill included in the QSEN competency of patient-centered care and not a separate competency that should be evaluated. This is incorrect. Infection control is a skill included in the QSEN competency of safety and not a separate competency that should be evaluated. This is correct. Patient-centered care is a QSEN competency that should be evaluated during performance reviews. This is correct. Evidence-based practice is a QSEN competency that should be evaluated during performance reviews. This is correct. Teamwork and collaboration is a QSEN competency that should be evaluated during performance reviews.
PTS: 1 18. ANS: 1, 2, 4, 5
CON: Quality Improvement
Chapter number and title: Bonus Chapter 1: Introduction to QSEN Chapter learning objective: Discuss patient-centered care and the conflicts between patient-centered care and other QSEN competencies. Chapter page reference: 3
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