D026 Quality Outcomes in a Culture of Value-Based Nursing Care

Correct answer:

B. 2009

Explanation:

The review on medication safety by Davis and Tzeng was published in 2009. In their work, they explored various factors contributing to medication errors and proposed strategies to enhance medication safety within healthcare settings. Their research has been influential in guiding policies and practices aimed at reducing medication-related errors and improving patient outcomes.

Why other options are wrong:

A. 2012

This date is incorrect, as the review was published earlier, in 2009. Citing 2012 would misrepresent the timeline of their contributions to medication safety literature.

C. 2015

The review was not published in 2015. Referring to this year would inaccurately reflect the publication date and could lead to confusion regarding the evolution of medication safety practices influenced by their work.

D. 2007

While close, 2007 is not the correct publication year. The review was published two years later, in 2009, marking a significant point in medication safety research during that period.

Correct Answer:

D. Safety, care, and timely intervention

Explanation:

The Agency for Healthcare Research and Quality (AHRQ) emphasizes that effective healthcare should prioritize safety, ensuring that patients receive care without harm; care, which includes delivering appropriate, patient-centered services; and timely intervention, ensuring that patients receive necessary treatments without unnecessary delays. These three components work together to improve patient outcomes and healthcare effectiveness.

Why other options are wrong:

A. Prevention, comfort, and urgency

While prevention and comfort are important aspects of healthcare, they do not fully capture the AHRQ's framework, which emphasizes a broader focus on patient safety and timely intervention.

B. Accuracy, empathy, and speed

Although these factors contribute to quality care, they do not represent the AHRQ’s fundamental components, which emphasize patient safety, care delivery, and timely response to medical needs.

C. Quality, efficiency, and compassion

While these aspects are critical in healthcare, the AHRQ specifically focuses on safety, care, and timely intervention as key components in ensuring effective healthcare delivery.

Correct answer:

D. Every seven days

Explanation:

Peripheral Intravenous Catheter (PIVC) and Central Venous Catheter (CVC) dressings should be changed every seven days unless they become soiled, loose, or non-adherent. Regular dressing changes are crucial to preventing infections and ensuring catheter site integrity. Transparent dressings allow for continuous monitoring, but scheduled replacements help maintain sterility and minimize complications such as catheter-associated bloodstream infections (CLABSI).

Why other options are wrong:

A. Every two weeks

Waiting two weeks to change dressings significantly increases the risk of infection. Guidelines recommend a maximum of seven days to ensure that the dressing remains clean, dry, and intact while reducing microbial growth at the catheter insertion site.

B. Every day

Daily dressing changes are unnecessary unless the dressing is visibly soiled or dislodged. Frequent changes can increase the risk of contamination and skin irritation, making the recommended seven-day interval more effective in maintaining sterility and patient comfort.

C. Every three days

Three-day dressing changes may be required in specific situations, such as gauze dressings or compromised dressings, but standard practice for transparent dressings is to replace them every seven days. Changing them too frequently without clinical justification can be unnecessary and waste healthcare resources.

Correct answer:

D. It fosters trust and improves patient engagement

Explanation:

Compassionate care is a crucial component of CQI because it strengthens the patient-provider relationship, leading to better patient experiences and improved health outcomes. By demonstrating empathy, active listening, and respect, healthcare providers foster trust, which encourages patients to actively engage in their care. This engagement leads to better adherence to treatment plans, reduced anxiety, and higher patient satisfaction, all of which align with CQI's goal of continuous improvement in healthcare delivery.

Why other options are wrong:

A. It reduces the need for communication

Compassionate care enhances, rather than reduces, communication between healthcare providers and patients. Effective communication is vital for understanding patient needs, addressing concerns, and ensuring informed decision-making.

B. It prioritizes financial outcomes over patient care

While financial sustainability is important in healthcare, compassionate care is centered on patient well-being. CQI focuses on improving patient experiences and outcomes rather than simply maximizing financial gains.

C. It focuses solely on the healthcare provider's needs

Compassionate care is patient-centered, emphasizing the emotional and psychological well-being of patients rather than the convenience or preferences of healthcare providers. The goal is to create a supportive and healing environment for patients.

Correct answer:

D. Increased staff engagement and satisfaction

Explanation:

Grol and Grimshaw (2003) highlight that engaging healthcare staff in quality improvement efforts leads to greater job satisfaction and motivation. When employees are actively involved in decision-making and process enhancements, they feel valued and empowered. This participation fosters a culture of continuous learning, professional growth, and commitment to delivering better patient outcomes. Additionally, staff engagement in quality initiatives improves teamwork, communication, and adherence to best practices.

Why other options are wrong:

A. Higher patient fees

Quality improvement efforts are not focused on increasing costs for patients. Instead, they aim to enhance patient care, reduce errors, and improve efficiency, which can sometimes lead to cost savings rather than higher fees.

B. Less need for teamwork

Quality improvement initiatives often require stronger collaboration among healthcare professionals. Teamwork is essential to identify problems, implement solutions, and ensure that improvements are sustained across departments. Reducing the need for teamwork contradicts the fundamental principles of quality improvement.

C. Reduced training requirements

Engaging staff in quality improvement efforts often increases the need for ongoing training and professional development. Healthcare professionals must stay updated on best practices, new technologies, and evolving standards to ensure continuous improvement and patient safety.

Correct answer:

C. By fostering a culture of continuous professional development

Explanation:

Ongoing training and development equip employees with the skills and knowledge needed to maintain high-quality standards. A culture of continuous learning helps organizations adapt to changes, enhance efficiency, and uphold best practices in quality management.

Why other options are wrong:

A. By reducing employee training

Reducing training would weaken employees' ability to perform tasks effectively, leading to errors, inefficiencies, and a decline in quality standards.

B. By limiting employee growth opportunities

Restricting growth opportunities hinders employee motivation and development, which can negatively impact engagement and overall work performance. Encouraging professional development enhances workforce capability and quality outcomes.

D. By ignoring employee feedback

Employee feedback is essential for identifying challenges and areas for improvement. Ignoring feedback limits opportunities for process enhancements and quality improvements.

Correct answer:

C. Clients trust in the role and skills of the nurse in the healing process

Explanation:

Relationship-centered nursing care prioritizes building trust between nurses and clients, recognizing the importance of meaningful interactions in the healing process. Trust fosters open communication, adherence to treatment, and emotional support, all of which contribute to better health outcomes. This approach emphasizes empathy, respect, and partnership between healthcare providers and patients, creating a more personalized and effective care experience.

Why other options are wrong:

A. Focus on care as it is given in the community setting

While community-based care is an important aspect of nursing, relationship-centered care applies to all healthcare settings, not just those in the community. The key focus is on the relationship between the nurse and the patient, regardless of where care is delivered. Community health nursing is a broader concept that includes public health initiatives and outreach programs beyond direct patient relationships.

B. Use of high-level advanced nursing skills in the care of the client

Advanced nursing skills are essential for clinical expertise, but they are not the core element of relationship-centered care. The emphasis is on the human connection and the trust established between nurse and patient. Technical skills play a role in delivering safe and effective care, but relationship-centered nursing highlights the interpersonal and emotional aspects of healing.

D. Responsiveness to societal changes in a consumer-driven economy

While adapting to societal changes is necessary in healthcare, relationship-centered care is not primarily about responding to economic shifts. Instead, it focuses on fostering strong, therapeutic relationships between nurses and patients. Consumer-driven healthcare may influence service delivery models, but the essence of relationship-centered care lies in trust and meaningful patient-provider interactions rather than economic trends.

Correct Answer:

A. To improve outcomes and increase care value

Explanation:

According to Teisburg et al. (2020), expanding partnerships in improvement projects aims to enhance healthcare outcomes by leveraging collaborative efforts, shared expertise, and integrated solutions. By working with various stakeholders, healthcare organizations can implement more effective strategies, reduce inefficiencies, and ultimately improve the value of care delivered to patients.

Why other options are wrong:

B. To enhance staff safety

While partnerships may contribute to staff safety indirectly, the primary focus of expanding partnerships is on improving healthcare outcomes and increasing the value of care.

C. To increase patient satisfaction

Although improved care value and outcomes often lead to higher patient satisfaction, the core objective of expanding partnerships is broader—ensuring quality improvements in care delivery and effectiveness.

D. To reduce costs

Cost reduction may be a secondary benefit, but the main goal of expanding partnerships is to optimize healthcare outcomes and value, rather than focusing solely on financial savings.

Correct answer:

D. Defining and upholding quality standards

Explanation:

Quality assurance policies establish clear guidelines for maintaining product and service quality within an organization. These policies ensure consistency, compliance with industry regulations, and continuous improvement, ultimately enhancing customer satisfaction and operational efficiency.

Why other options are wrong:

A. Expanding market reach

While maintaining high quality may help a company grow, the primary goal of quality assurance policies is to set and uphold standards rather than directly expanding market presence.

B. Reducing employee turnover

Although a well-structured quality assurance system may create a better work environment, its primary purpose is not to address employee retention but to maintain product and service quality.

C. Increasing production speed

Quality assurance focuses on ensuring standards are met, which may sometimes require thorough checks that do not necessarily prioritize speed. Increasing production speed without maintaining quality could lead to defects and inefficiencies.