CPPS: Certified Professional in Patient Safety Exam Practice Questions With Correct Answers 2023/2024

CPPS: Certified Professional in Patient Safety Exam Practice Questions With Correct Answers 2023/2024. availability heuristic - Correct Answer-dx of current pt biased by experience with past cases (crushing chest pain=MI) anchoring heuristic - Correct Answer-relying on initial dx impression despite subsequent info to the contrary (BC with corynebacterium txed as contaminant when endocarditis) framing effects - Correct Answer-dx decision making unduly biased by subtle cues and collateral information (addicted pt with abd pain tx for withdrawal but had bowel perf) blind obedience - Correct Answer-undue reliance on test results or expert opinion (false neg rapid Strept test) prominent reason for malpractice claims - Correct Answer-missed or delayed dx predisposing factors for dx error in ES and surgery - Correct Answer-poor teamwork communication gold standard for diagnosis - Correct Answer-autopsy goals is to have 25% inpt deaths autopsied prevent dx errors - Correct Answer-1. info technology hoen triage 3. teamwork & communication training 4. increased supervision of trainees mega-cognition - Correct Answer-cognitive psychology reflect on own thinking with the hope to catch own misuse of heuristics before cause harm components of disclosure that matter most to pts - Correct Answer-1. disclosure of all harmful errors 2. explanation why occurred 3. how error's effects will be minimized 4. steps taken to proven recurrences Full Disclosure Principle - Correct Answer-disclose all circumstances and events, acknowledgement of responsibility, and apology fewer malpractice lawsuits and lower litigation cost CANDOR - Correct Answer-Communication and Optimal Resolution used with disclosure of events % who reported witnessing physicians engage in disruptive behavior vs. nurses - Correct Answer-77% 65% physician disruptive and disrespectful behavior impact on nursing - Correct Answerdissatisfaction and likelihood of leaving nursing profession adverse events in OR % of healthcare professionals at any level engage in disruptive behavior - Correct Answer-2-4% disruptive behavior - Correct Answer-disrespect for others interpersonal interaction that impedes the delivery of pt care subverts the org ability to develop a culture of safety (impacts teamwork and blame-free environment) unprofessional behavior in medical school is linked to subsequent disciplinary action by licensing board founder of patient safety movement - Correct Answer-Dr. Lucian Leape prevent disruptive behavior - Correct Answer-code of conduct defines and managing behaviors leadership in ensuring culture of safety prevent behavior Bell Commission - Correct Answer-1987 mandating residents at New Your hospitals should work no more than 80 hours per week and no more than 24 consecutive hours due to Libby Zion's death due to med prescribing error Accreditation Council for Graduate Medical Education rules for work hours in 2003 - Correct Answer-1. no more than 80 hours per week 2. no more than 24 consecutive hours on duty 3. not be on call more than every 3rd night 4. must have 1 day off per week 2003 work hours regs impact on pt safety - Correct Answer-no clear effect on pt safety or clinical outcomes may be due to the number of pt handoffs burnout and fatigue are still common Accreditation Council for Graduate Medical Education rules for work hours in 2017 - Correct Answer-based on Flexibility in Duty Hours Requirements for Surgical Trainees (FIRST) same other than no 16 hour shift limit for first-year residents problems with EHR - Correct A info display 2. complicated screen sequences and navigation 3. mismatch between user workflow safety hazards with data entry errors can be created by - Correct Answer-1. use of copy-forward or copy and paste 2. electronic signatures 3. lack of clarity in sources and date of information presented 4. alert fatigue 5. usability problems 6. altered workflow 7. altered communication Med errors not impacted by EHR - Correct Answer-1. wrong pt (bar coding decreases error) 2. wrong med at time of selection 3. wrong time SAFER guides - Correct Answer-assessment checklists and structure for team to assess and improve their systems 1. high-priority practices 2. org responsibilities 3. contingency planning 4. system configuration 5. system interfaces 6. pt identification 7 CPOE with decision support 8. test result reporting and f/u 9. clinician communication suitability safety risk for EHR - Correct Answer-1. lack support of workflow 2. lack data coding, std, and structure 3. lack duplicate record detection 4. inaccurate, incomplete, or outdated decision support rules 5. bugs in software 6. content import features usability safety risk for EHR - Correct Answer-1. default values 2. problematic alerts 3. simultaneous task performance 4. inadequate info displays 5. unclear current state of user actio9ns in order processing 6. difficult interfaces 7. error-prone intervaces Human Factors Engineering - Correct Answer-interaction between workers, the equipment, and their environment takes into account human strengths and limitations in the design of interactive systems HFE accesses - Correct Answer-1. physical demand 2. skill demands 3. mental workload 4. team dynamics 5. aspects of work environment 6. device design goal is to compete the task optimally usability testing - Correct Answer-test in real-world conditions in order to id potential problems and unintended consequences of new technology will id workarounds forcing functions - Correct Answer-prevents unintended or undesirable action from being performed or allows it performance only if another specific action is performed first (shift into reverse unless brake is pushed) does not always involve device design (removing potassium from med rooms) standardization - Correct Answer-standardizing equipment and processes whenever possible to increase reliability, improve info flow, and minimize cross-training needs (checklists) resiliency efforts - Correct Answer-attention to detection and mitigation before events occur dynamic aspects of risk mgmt. to anticipate and adapt to changing conditions and recover from system anomalies HRO characteristic way of thinking - Correct Answer-1. preoccupation with failure 2. reluctance to simplify explanations for operations, successes, and failures 3. sensitivity to operations (situational awareness) 4. deference to frontline expertise 5. commitment to resilience Health literacy - Correct Answer-individual's ability to find, process, and comprehend the basic health info necessary to act on medical instructions and make decisions about one's health Institute of Medicine definition of health literacy - Correct Answer-function of systems within and beyond health care, and it involves interaction between the individual patient and health care system, as well as other social, cultural, and ed factors 2003 health literacy results - Correct Answer-over a third had basic or below basic levels 53% had intermediate level 12% proficient why is health literacy not static - Correct Answer-vary with mental or emotional state, illness, and life stressors individual skills complexity of info and tasks universal precautions for health literacy - Correct Answer-1. create shame-free environment 2. simplifying info (3 to 5 pts, 4-6th grade level) 3. listen carefully 4. confirm comprehension (teach back or show me) 5. improving support for navigation healthcare contexts (signage, forms, apps) 6. support in health mgmt efforts CUSP - Correct Answer-comprehensive unit-based safety program combines culture of safety, teamwork, and communications together with checklists that incorporate evidence-based measure to prevent HAI after how many hours does the drive for sleep become increasingly powerful - Correct Answer-12 to 16 hours fatigue - Correct Answer-latent hazard and unsafe condition which leads to increased medical errors prefrontal cortex functions - Correct Answer-memory and tracking capacity sensitive to sleep deprivation cumulative deficits related to sleep deprivations - Correct Answer-dynamic, naturalistic decision-making executive function mode heightened irritability impaired communication and coordination cognitive performance less sensitive to sleep deprivation - Correct Answer-complex tasks that are rule based & interesting require critical reasoning in logical well-practiced tasks mitigate the impact of extended work hours - Correct Answer-conducting a risk assessment robust handoff practices involving staff design of work schedules fatigue mgmt plan with strategic use of caffeine and planned naps educate about sleep hygiene adequate environment for sleep breaks falls rates - Correct Answer-3-5 per 1000 bed-days up to 1 million hospitalized pt fall each year 1.6 million NH residents each year 10% of Medicare SNC resident experience a significate injury with a fall falls occur in elderly with - Correct Answer-1. delirium 2. psychoactive meds (benzodiazepines) 3. baseline difficulties with strength, mobility, or balance Considerations in fall prevention program - Correct Answer-1. individualized 2. combine environmental measures (nonslip floors, within line sight) 3. clinical interventions (minimize deliriogenic meds) 4. care process interventions (std risk assessment tool) 5. cultural interventions (multidisciplinary) 6. tech/logistical interventions (lower bed) 2011 components of fall prevention interventions - Correct Answer-1. multidisciplinary 2. staff and pt ed 3. individualized POC 4. safe footware 5. focus on prevent, detect, and tx delirium 6. culprit meds 7. continence mgmt 8. device, mobility aids, and exercise 9. post fall review falls reportable to TJC - Correct Answer-falls with injury are serious reportable event and a "never event" by CMS failure to rescue - Correct Answer-not able to rapidly id and tx complications when they occur inability to prevent death after the development of a complication reflect resources and preparedness of system how can a hospital have a low complication rate but high failure to rescue rate or vise versa - Correct Answer-higher complications have more experience recognizing and responding to complications Needleman and Buerhaus - Correct Answer-developed a measure o failure to rescue derived from adm data, used outcomes sensitive to nursing care, and integrated exclusion rules aimed to eliminate cases whicht he complication was POD "failure to rescue-nursing" death rate among surgical inpatients with serious txable conditions - Correct Answer13.9% national rate associated with higher failure to rescue rates - Correct Answer-1. hospital volume 2. communication failures 3. lower nurse staffing The single greatest impediment to error prevention in the medical industry - Correct Answer-we punish people for making mistakes individual performance rates - Correct Answer-3% physicians accounted for 49% of pt complaints 1% of physicians accounted for 32% of all malpractice complaints technically proficient but can provide unsafe care including - Correct Answer-1. poor communication skills 2. lack professionalism 3. medical or mental health conditions safe, high-quality care - Correct Answer-well designed systems of care that are supported by individuals with a full range of competencies % of physicians who develop a substance use disorder - Correct Answer-10-12% 2015 Annual Perspective on balance systems approach with accountability - Correct Answer-just culture at risk vs. reckless improve performance - Correct Answer-simulation individualized coaching CME mandate to report suspected impaired or unable to perform pt care duties leadership roles - Correct Answer-1. prioritizing safety 2. est culture of safety 3. responding to pt or staff concerns 4. supporting efforts to improve safety 5. monitor progress Board of Directors Responsibilities - Correct Answer-1. formatting mission & key goals 2. ensuring financial viability 3. monitoring and eval performance of high-level executives 4. meets the needs of the community it serves 5. ensuring quality and safety of care discontinuity creates - Correct Answer-opportunities for error when clinical information in not accurately transferred between providers "kids playing telephone" "handoffs" - Correct Answer-transferring responsibility for a patient from one caregiver to another with the goal of providing timely, accurate information about a patient's plan of care, treatment, current condition and anticipated changes "signout" - Correct Answer-act of transmitting information about a patient leading cause of preventable error in ED physicians and trainees - Correct Answercommunication failures I-PASS - Correct Answer-gold std for standardized handoff bundle - illness severity - pt summary - action list - situational awareness and contingency plans - synthesis by receiver (ask questions and confirm POC) TJC handoff process - Correct Answer-1. interactive communications 2. up to date and accurate info 3. limited interruptions 4. process for verification 5. opportunity to review any relevant hx data Office of the Inspector General study on SNF resident that required hospitalization each year - Correct Answer-25% % of Medicare beneficiaries that are d/c to some form of LTC facilities after hospital stay - Correct Answer-40% % of Medicare beneficiaries in SNF experience an adverse event during their stay and how many were preventable - Correct Answer-22% half 1999 institute of Medicine Report - Correct Answer-"To err is human: building a safer health system " toll of medical errors at the national level - 98,000 deaths every year due to preventable harm no single validated method for measuring eh overall safety of care Donabedian Triad - Correct Answer-quality is viewed : 1. structure, 2. process, 3. outcome measurement is sued to - Correct Answer-1. eval effectiveness of intervention 2. id new or emerging safety threats 3. compare safety across setting 4. determine if safety is improving methods of measuring pt safety - Correct Answer-1. retrospective chart review - gold std 2. voluntary error reporting 3. automated surveillance 4. adm or claims data (AHRQ pt safety indicators) 5. pt reports 2015 Free From Harm by the National Patient Safety Foundation - Correct Answer-call for creation of common set of safety metrics that reflect meaningful outcomes 1. est std set of process and outcome measures for use on a national basis 2. creating measures of pt safety for settings outside the hospital 3. improve the quality of safety reporting systems 4. develop ways of measuring safety in real time most common medication errors - Correct Answer-1. wrong time of administration 2. omission 3. wrong dose 4. wrong prep 5. wrong adm rate (IV meds) most common self and caregiver medication errors - Correct Answer-1. low health literacy 2. poor provider-pt communication 3. absence of health literacy universal precautions prevention of medication errors - Correct Answer-1. barcoding 2. smart infusion pumps 3. single-use med packages 4. package design features 5. minimizing interruptions medication error - Correct Answer-an error of commission or omission at any step between prescribing and receiving the med adverse drug event - Correct Answer-harm experienced by a pt as a result of exposure to a medication does not necessarily indicate an error or poor quality care Preventable ADE - Correct Answer-med error that reaches pt and causes any degree of harm about half are preventable potential ADE - Correct Answer-med errors that do not cause any harm either because they are intercepted or luck (incorrect dose given but no clinical consequences) Ameliorable ADE - Correct Answer-pt experienced harm from a med that, while not completely preventable, could have been mitigated (earlier detection could have reduced the level of harm the pt experienced) nonpreventable ADE - Correct Answer-side effects event when prescribed and adm properly strongest risk factor for ADE - Correct Answer-polypharmacy Beers Criteria - Correct Answer-Identifies High Risk Meds to Generate Wide List of Meds That Should be Avoided