CPPS IHI Practice Exam2023 Questions and Answers (Graded A)

In preparation for new antimicrobial stewardship regulatory requirements, a hospital is creating an antimicrobial stewardship committee. What should be the first step in supporting this new patient safety initiative? A. Reach out to subject matter experts to gain insight on different compliance issues. B. Work with information technology (IT) to build antibiotic indication and time-out screens. C. Partner with key stakeholders to perform a gap analysis of current state to ideal state. D. Review the past year's data to identify the most commonly grown pathogens. - ANSWER-C. Partner with key stakeholders to perform a gap analysis of current state to ideal state. After implementing a new product recall system, a hospital was alerted to a high-risk medication recall. This medication is in stock in the emergency department and oncology unit. To ensure the effectiveness of the new system, a patient safety professional should: A. require individual departments to verify that a search for the recalled medication was performed. B. ensure an on-site visit verifies that the recalled medication was sequestered. C. reconcile the number of doses administered to the number of doses purchased. D. notify the affected units via fax to remove recalled meds and to post recall notices in the units - ANSWER-B. ensure an on-site visit verifies that the recalled medication was sequestered. An organization is implementing a standardized surgical safety checklist and encounters resistance from the perioperative staff. To improve staff engagement, a patient safety professional should: A. prepare a business case for the implementation of the checklist. B. present evidence that checklist use reduces practice variability. C. assure staff that anesthesia is responsible for the checklist. D. delegate checklist enforcement to nursing. - ANSWER-B. present evidence that checklist use reduces practice variability. An organization has achieved 92% compliance with a process measure. The patient safety professional believes that the processes in place are not reliable or that the results are attributable to luck. Which of the following best describes this characteristic? A. appreciative inquiry B. commitment to resilience C. deference to expertise D. preoccupation with failure - ANSWER-D. preoccupation with failure A just culture framework provides a means to address behaviors that undermine a culture of safety because A. single outbursts are differentiated from consciously chosen acts. B. preservation of highly valued team members is a primary goal. C. the evaluative process does not consider personal performance-shaping factors. D. the organizational response to investigated events is independent of patient outcome. - ANSWER-D. the organizational response to investigated events is independent of patient outcome. In process improvement, reducing variation improves A. predictability of outcomes. B. patient care processes. C. frequency of poor results. D. reluctance to simplify. - ANSWER-A. predictability of outcomes. When creating action plans, which of the following solutions would be considered the weakest? A. visible involvement and action by leadership B. standardizing processes as much as possible C. creating access barriers to high-risk medications D. use of color-coded labels that are readily seen by staff - ANSWER-D. use of color-coded labels that are readily seen by staff Which of the following is emphasized in crew resource management? A. care standards B. team leadership C. caregiver burnout D. health literacy - ANSWER-B. team leadership 10. As a result of an adverse drug event, a patient required renal dialysis. A patient safety professional and other leaders are discussing what to disclose to the patient. In addition to an apology, critical components of disclosure include A. a commitment to investigate what happened and how future errors will be prevented. B. who was involved, when it happened, and how often medication errors occur. C. plans for staff disciplinary action, physician disciplinary action, and a plan for education. D. history of pharmacy transcription errors, and the plan to implement an electronic health record. - ANSWER-A. a commitment to investigate what happened and how future errors will be prevented. Results from recent tests were not included in a patient transfer from one facility to another, resulting in an adverse event. Which of the following is the most common cause of this type of harm? A. inadequate information flow B. inattentional blindness C. normalized deviance D. insufficient staffing - ANSWER-A. inadequate information flow A healthcare organization is introducing a new medication administration barcoding system. Which of the following is the most significant indicator of successful implementation? A. order accuracy for high-risk medications B. bar code scanning compliance C. nursing bar coding knowledge D. bar coding performance goal setting - ANSWER-B. bar code scanning compliance A manager demonstrates adherence to the principles of a just culture by applying which of the following types of decision-making frameworks? A. harm-based B. outcome-focused C. equity-focused D. risk-based - ANSWER-D. risk-based When interpreting data after a safety event, which of the following is true? A. Identifying human error results in a deep understanding of the event and its causes. B. Comparing actions taken to procedures and rules will explain the behaviors during the event. C. The outcome of the event has no influence on the interpretation or conclusions. D. Causes are constructed from the investigation and analysis. - ANSWER-D. Causes are constructed from the investigation and analysis. As a member of an improvement team focused on standardizing surgical protocols, the patient safety professional recognizes that one concern clinicians may raise is: A. improved supply chain management. B. increased amount of waste. C. depersonalized care. D. increased length of stay. - ANSWER-C. depersonalized care. When healthcare providers are involved in an adverse event, it is important to first A. conduct an objective root cause analysis. B. offer guidance and emotional support. C. involve crisis counselors in the investigation. D. consult providers who experienced a similar event. - ANSWER-B. offer guidance and emotional support. Which of the following is an example of a syndrome characterized by emotional exhaustion and a decrease in personal accomplishments that is directly associated with employment? A. burnout B. grit C. resilience D. failure to thrive - ANSWER-A. burnout When processing an order for diagnostic imaging of a patient's left foot, the nurse remembered changing the dressing on the right foot. The nurse called the provider to confirm the laterality, and the order was corrected. Which critical feature of the culture of safety did the nurse practice? A. measurement of patient safety B. ensuring all orders are carried out C. awareness of health education D. detection of a near miss - ANSWER-D. detection of a near miss Which of the following is an example of a high reliability principle? A. individual accountability B. sensitivity to operations C. executive patient safety rounds D. adoption of cutting edge technology - ANSWER-B. sensitivity to operations Despite pre-procedure screening for scheduled MRIs, patients with implanted devices presented for scheduled MRI procedures. Technicians identified the hazards and prevented patients from entering the suite. The most effective action for the patient safety professional is to recommend A. using track and trend reports for repeat occurrences. B. suspending provider MRI ordering privileges for repetitive noncompliance. C. requiring providers and staff to complete a safety training program. D. collaborating with providers and staff to strengthen the screening process. - ANSWER-D. collaborating with providers and staff to strengthen the screening process. Which of the following statements about root cause analysis (RCA) is accurate? A. The goal of performing an RCA is to find the one underlying root cause. B. RCAs are not subject to outcome or hindsight biases. C. RCAs may be subject to political highjack, resulting in poor risk controls. D. RCAs are as effective in healthcare as they are in other high-risk industries. - ANSWER-C. RCAs may be subject to political highjack, resulting in poor risk controls. Which of the following is accurate when a patient has back-to-back procedures, and the person performing each procedure changes? A. No staff changes may occur between procedures. B. One time-out at the beginning of the first surgery is sufficient for each procedure. C. Another time-out needs to be performed before starting each procedure. D. No additional sponge count is needed between surgeries. - ANSWER-C. Another time-out needs to be performed before starting each procedure. Which of the following is most useful in illustrating inefficiency and waste in a process? A. fishbone diagram B. control chart C. spaghetti chart D. Pareto diagram - ANSWER-C. spaghetti chart Measurement of hospital-acquired pressure injuries would be an example of A. an outcome measure. B. a process measure. C. a balance measure. D. an evidence-based measure. - ANSWER-A. an outcome measure. What type of organization recognizes and respects that information can come from any source within the organization and that each reporter has a valuable perspective? A. highly reliable B. diverse C. patient-centered D. interdisciplinary - ANSWER-A. highly reliable From a human factors engineering perspective, which of the following should beknown about identifying and eliminating diagnostic errors? A. Diagnostic errors are the result of cognitive biases and failures by clinicians. B. Partnership with scientists in cognition, perception, and decision making is needed. C. An effective strategy to reduce diagnostic errors is the use of checklists. D. Attribution of diagnostic errors is not subject to either hindsight or outcome biases. - ANSWER-B. Partnership with scientists in cognition, perception, and decision making is needed. Which of the following would best demonstrate non-random process variation over time? A. histogram B. control chart C. run chart D. pie chart - ANSWER-B. control chart A patient safety professional is leading a process improvement team to enhance communication hand-offs between hospital units. Which of the following is the best question to ask at the first team meeting? A. "What process change should be the focus?" B. "When should direct observations begin?" C. "What are we trying to accomplish?" D. "When should we spread best practices?" - ANSWER-C. "What are we trying to accomplish?" Which of the following is most important in building a culture of safety? A. measuring safety outcomes B. addressing burnout C. establishing shared values D. utilizing electronic health records - ANSWER-C. establishing shared values A practitioner reads a groundbreaking study on a condition seen frequently in their practice. Coincidentally, the next patient that the practitioner sees has symptoms commonly seen with that condition. Which of the following biases or heuristics best describes this phenomena? A. anchoring B. availability C. premature closure D. risk aversion - ANSWER-B. availability While investigating a near miss medication event, a manager identifies a pattern of work arounds by a clinician that violates policies and procedures. To determine accountability, the manager's next step should be to A. conduct a focus group with work area staff. B. perform a substitution test. C. escalate the workarounds to leadership. D. amend procedures to support the workarounds. - ANSWER-B. perform a substitution test. A physician is planning to discharge a patient. The nurse knew that the patient needed additional equipment at home. Together they reached out to the social worker and discharge planner for a safe care transition. Which feature of the culture of safety did they practice? A. activation of transfer protocols B. utilization of open communication C. measurement of patient safety D. ensuring health literacy - ANSWER-B. utilization of open communication From a human factors standpoint, which of the following is true about harmduring healthcare? A. It is either due to system errors or intentional human choice. B. It would not occur if healthcare workers followed rules. C. It is prevented by healthcare workers adapting to changes. D. It is always preventable; the goal is zero harm. - ANSWER-C. It is prevented by healthcare workers adapting to changes. A patient safety professional notes an increase in safety events involving insulin. Which of the following strategies is most likely to result in improvement? A. The quality committee requires monthly progress reports on departmental insulin safety plans. B. The pharmacy and therapeutics committee introduces two insulin products to the formulary. C. The pharmacy educates on insulin safety by distributing a tip sheet to nursing and providers. D. The medication safety committee monitors reports on insulin administration errors. - ANSWER-A. The quality committee requires monthly progress reports on departmental insulin safety plans. Of the following steps, which should be done first when conducting an FMEA? A. Identify a high-risk process to evaluate. B. Formulate solutions for a high-risk process. C. Develop a ranking method to prioritize actions. D. Facilitate error management strategies. - ANSWER-A. Identify a high-risk process to evaluate. When evaluating the conduct of a healthcare worker in the aftermath of a harm event, which of the following considerations demonstrate consistency with the principles of a fair and just culture? A. the severity of the injury that occurred B. alignment with state health department regulations C. the impact to the organization's reputation D. the practice of similarly qualified individuals - ANSWER-D. the practice of similarly qualified individuals A patient safety professional receives an event report stating that a physician ordered anticoagulation medication to be discontinued through the physician order entry system. The pharmacy computer system did not receive the order, and the patient received four extra doses of the medication before the order was identified to be discontinued. The patient safety professional's investigation should focus on A. software interfaces. B. decision support. C. patient identification. D. business intelligence. - ANSWER-A. software interfaces. Which of the following concepts describes a situation where violations of safe practices become regarded as acceptable and are generally tolerated by the group? A. standards of practice B. inattentional blindness C. normalized deviance D. situational bias - ANSWER-C. normalized deviance Which of the following types of errors is due to a previous management decision that impacted design, resulting in patient harm? A. active error B. commission error C. latent error D. omission error - ANSWER-C. latent error An incident report relates that a nurse who completed a 12-hour shift on a newly opened ward forgot to document a skin assessment in the patient's medical record. This is an example of A. human error. B. careless action. C. at-risk behavior. D. recklessness. - ANSWER-A. human error. Which of the following actions provides evidence that a healthcare organization considers patients' experiences to improve the safety of patientcare? A. Consumers, payors, and administrators are represented on committees. B. Patients receive experience surveys after reviewing charges. C. Patient feedback is used to redesign care processes. D. Patient involvement is publicly recognized. - ANSWER-C. Patient feedback is used to redesign care processes. A new long-term care facility is being planned. Recognizing that resident injuries related to falls are a significant concern, a team has been convened to plan, implement, and evaluate potential solutions. Which of the following interventions will have the largest impact on the rate of injuries related to falls? A. Position grab bars in bathrooms. B. Attach egress alarms to residents. C. Locate floor pads next to beds. D. Install impact-absorbing flooring. - ANSWER-D. Install impact-absorbing flooring. The patient safety professional disseminated a patient safety culture survey to all employees at a 100-bed hospital. The total response rate was 32%. Which of the following should the patient safety professional do next? A. Re-survey the staff to obtain a higher response rate. B. Form a task force to address the questions on the safety survey. C. Interpret the results with caution due to the response rate. D. Contact the managers of the units to identify non-responders. - ANSWER-C. Interpret the results with caution due to the response rate. On studying the results of a root cause analysis, it is recognized that an RN missed steps in a protocol. The RN is regarded as highly competent by colleagues and unit leaders. The patient safety professional should determine the RN's behavior in this error to be considered A. workaround. B. reckless. C. high risk. D. drift. - ANSWER-D. drift. Patient safety is considered a subset of quality, but it is more difficult to measure in part because A. identification of incidents often depends on self-reporting. B. caregivers are not held accountable to report incidents. C. incident reporting systems are always anonymous. D. of dependence on trigger tools to identify safety events. - ANSWER-A. identification of incidents often depends on self-reporting. Leadership addressed an unrecognized latent threat in an existing workflow that was brought to their attention by frontline workers. This is an example of: A. preoccupation with failure. B. decentralized decision making. C. sensitivity to operations. D. commitment to resilience. - ANSWER-C. sensitivity to operations. Leadership has been promoting fair and just culture concepts including non-punitive response to reporting and the value of near miss reporting. The plan is not universally supported, and some argue it is a waste of the facility's resources. To support this leadership initiative, a patient safety professional should explain that the plan is intended to result in A. a decrease in event reporting volume due to fewer actual adverse events. B. a decrease in event reporting due to fewer near misses. C. an increase in event reporting that will decrease malpractice insurance premiums. D. an increase in event reporting that will help the hospital identify areas of risk. - ANSWER-D. an increase in event reporting that will help the hospital identify areas of risk. Which of the following is the most appropriate method to determine if a root cause analysis (RCA) should be conducted on an adverse event? A. Consider only the outcome severity. B. Consider only blameworthy events. C. Utilize a risk-based prioritization system. D. Assess only the probability of recurrence. - ANSWER-C. Utilize a risk-based prioritization system. Which of the following strategies is best for facilitating the acceptance of changer elated to specific performance improvement initiatives? A. Provide a quarterly statistical report. B. Utilize storytelling tools. C. Recognize leadership participation. D. Distribute weekly newsletters via e-mail. - ANSWER-B. Utilize storytelling tools. A patient who is a heroin addict and frequent visitor to the emergency department presented to the hospital with abdominal pain, nausea, and vomiting. He was admitted for dehydration and potential opioid withdrawal. The patient's abdominal pain worsened at night, prompting the nurse to call the physician on call. The physician assumed that the patient was drug-seeking, and increased the patient's methadone. Early the next morning, the patient experienced severe abdominal pain, showed signs of sepsis, and was found to have an abdominal perforation. Which cognitive process best describes the on-call physician's response? A. hindsight bias B. implicit bias C. normalization of the deviant D. recall bias - ANSWER-B. implicit bias A hospital is using the AHRQ Hospital Survey on Patient Safety Culture. There were 80 employees who responded. Responses to the survey item that states "we have patient safety problems in this unit" were as follows: · Strongly Agree: 16 · Agree: 32 · Neither Agree nor Disagree: 12 · Disagree: 17 · Strongly Disagree: 3 What is the Percent Positive Score that should be reported for this item? - ANSWER-Correct Answer: 25% The AHRQ Hospital Survey on Patient Safety Culture User Guide scoring guidance says to use the "Strongly Agree/Agree" response sum, or, for negatively worded items—such as this one—use the "Strongly Disagree/Disagree" sum. In this example, 17+3 gives us the response sum (i.e., 20), which we divide by total number of respondents (i.e., 80): 20/80 = 25%. A staff member discovered a medication with an incorrect label. The staff immediately notified the pharmacist and the correct label was sent prior to medication administration. Then, the staff completed an event report through the organization's reporting tool. Which of the following actions should the unit manager take in response to this event?