QSEN EXAM LATEST UPDATE
Major barrier to making progress in safety and quality - Answer failure to appreciate
work complexity
complex work environments - Answer time pressure, high stakes, inadequate info, ill
defined goals, poor procedures, dynamic conditions, people working in teams, stress
recognition primed decision process - Answer cues expectancies goals actions +
situation
adjust actions to fit
more experience deal with situations with more confidence
environments prone to - Answer distraction
slips - Answer break in routine when attention is diverted
capture- more frequently used routine takes over
description- right action on wrong object
associative activation- go to phone when doorbell rings
loss of activation- forget what you are doing when you rise to get up
mistakes - Answer rule based- wrong rule chosen
knowledge based- lack of knowledge or misinterpretation of problem (pattern matching,
confirmation bias, overconfidence, deminimus)
factors that divert attention - Answer physiologic- sleep, drugs, illness, etc
psychological- anxiety, emotion
environmental
characteristic of complex adaptive systems - Answer embeddedness, distributed
control, nonlinear, adaptable elements, emergence, diversity, order/disorder, self
organization
coordinating knowledge mindset goals - Answer goals, conflict, obstacles, hazards,
data, behavior
adapt, anticipate, accommodate, react, cope
3 aspects of rn work in context - Answer factors that make actual care delivery complex
cognitive factors leading to care delivery decisions
, strategies used to manage complexity in care delivery
work complexity patterns - Answer interruptions, missing supplies, waiting on systems,
inconsistency in communication, lack of time, early learning curve for new process and
lack of fit with other work
knowledge patterns - Answer knowing patient information, typical patient profiles, unit
routine and workflow
care management strategy patterns - Answer stacking
anticipating
proactive monitoring
strategic delegation
memory aids
workarounds
challenges to cognitive work of nursing - Answer frequent cognitive shifts, interruption,
cognitive load prone to disrupting attention
5 major categories of nursing obstacles - Answer med, order, supplies, staffing,
equipment,
average nurse time at one task is 3.1 sec and nurses interrupted mid-task 8 times per
shift
missed nursing care - Answer ambulation, turn, feedings, education, discharge
planning, emotional support, hygeine, i/o documentation, surveillance
reasons for missed care - Answer too few staff, time, poor use of existing staff
resources, its not my job syndrome, ineffective delegation, habit, denial
complexity compression - Answer personal, environmental, practice, systems and
technology, administration and management, and autonomy and control. In particular,
system, practice, and autonomy and control factors lead to complexity compression.
limitation of content knowledge - Answer work isnt linear, equal goals need attention at
same time, unreliable support and resources, RNs have human limitation, managing
work flow requires org and prior skills specific to situation
nursing care requires - Answer engaged reasoning, relationship, and context to make
qualitative distinctions that lead to effective nursing practice
what nurses bring to a caring situation and the context surrounding the situation
influences clinical judgement more than objective information
nursing education - Answer although scientific evidence is essential to good practice,
Major barrier to making progress in safety and quality - Answer failure to appreciate
work complexity
complex work environments - Answer time pressure, high stakes, inadequate info, ill
defined goals, poor procedures, dynamic conditions, people working in teams, stress
recognition primed decision process - Answer cues expectancies goals actions +
situation
adjust actions to fit
more experience deal with situations with more confidence
environments prone to - Answer distraction
slips - Answer break in routine when attention is diverted
capture- more frequently used routine takes over
description- right action on wrong object
associative activation- go to phone when doorbell rings
loss of activation- forget what you are doing when you rise to get up
mistakes - Answer rule based- wrong rule chosen
knowledge based- lack of knowledge or misinterpretation of problem (pattern matching,
confirmation bias, overconfidence, deminimus)
factors that divert attention - Answer physiologic- sleep, drugs, illness, etc
psychological- anxiety, emotion
environmental
characteristic of complex adaptive systems - Answer embeddedness, distributed
control, nonlinear, adaptable elements, emergence, diversity, order/disorder, self
organization
coordinating knowledge mindset goals - Answer goals, conflict, obstacles, hazards,
data, behavior
adapt, anticipate, accommodate, react, cope
3 aspects of rn work in context - Answer factors that make actual care delivery complex
cognitive factors leading to care delivery decisions
, strategies used to manage complexity in care delivery
work complexity patterns - Answer interruptions, missing supplies, waiting on systems,
inconsistency in communication, lack of time, early learning curve for new process and
lack of fit with other work
knowledge patterns - Answer knowing patient information, typical patient profiles, unit
routine and workflow
care management strategy patterns - Answer stacking
anticipating
proactive monitoring
strategic delegation
memory aids
workarounds
challenges to cognitive work of nursing - Answer frequent cognitive shifts, interruption,
cognitive load prone to disrupting attention
5 major categories of nursing obstacles - Answer med, order, supplies, staffing,
equipment,
average nurse time at one task is 3.1 sec and nurses interrupted mid-task 8 times per
shift
missed nursing care - Answer ambulation, turn, feedings, education, discharge
planning, emotional support, hygeine, i/o documentation, surveillance
reasons for missed care - Answer too few staff, time, poor use of existing staff
resources, its not my job syndrome, ineffective delegation, habit, denial
complexity compression - Answer personal, environmental, practice, systems and
technology, administration and management, and autonomy and control. In particular,
system, practice, and autonomy and control factors lead to complexity compression.
limitation of content knowledge - Answer work isnt linear, equal goals need attention at
same time, unreliable support and resources, RNs have human limitation, managing
work flow requires org and prior skills specific to situation
nursing care requires - Answer engaged reasoning, relationship, and context to make
qualitative distinctions that lead to effective nursing practice
what nurses bring to a caring situation and the context surrounding the situation
influences clinical judgement more than objective information
nursing education - Answer although scientific evidence is essential to good practice,
