Author Question: The quality assurance (QA) committee determines the standards of care for the hospital. An opening ... (Read 106 times)

Tazate · **on:** Jul 17, 2018

The quality assurance (QA) committee determines the standards of care for the hospital. An opening exists on the committee. Which applicant should be accepted based upon the principles of quality assurance?

A) A new graduate registered nurse from a Bachelor's in Science of Nursing (BSN) program has just completed orientation and an internship for 3 months and is working in the emergency unit caring for clients across the lifespan.
B) A licensed practical/vocational nurse with gerontology certification is newly hired to the hospital with 6 years of experience working in a nursing home and is currently enrolled into a BSN program.
C) A registered nurse (RN) with an Associate's Degree in Nursing, certified in critical care with 3 years' experience in critical care nursing and 4 years' experience in medicalsurgical nursing, is currently enrolled in a RN to Master's Science of Nursing (MSN) program.
D) A registered nurse with an advanced degree and certification in medicalsurgical nursing has 5 years of experience floating to multiple medicalsurgical nursing units and 2 years of experience working in a maternity unit, recently passed the Health Care Quality Management certification.

Question 2

There was an increase in incidence of client falls on the unit where the licensed practical/vocational nurse serves on the continuous quality improvement (CQI) committee.

Several of the incident reports noted that clients fell during the change of shift and other reports noted multiple causes. The unit practiced reporting to the oncoming nurses at the nursing station. Which activity should the CQI committee perform next?
A) Search for the best evidence-based fall prevention protocol that meets the unit's needs and will help to decrease the incidence of falls in the future.
B) Continue to track the number of falls and review the incident reports to determine actions to take in the future.
C) Place signs by the room of a client who is at risk for falls to help all health care personnel to provide added observation when rounding.
D) Change the policy for change of shift reporting to be carried out at the client's bedside to help decrease the number of falls.

k2629 · **Reply #1 on:** Jul 17, 2018

Answer to Question 1

Ans: D
Feedback:
The quality assurance committee establishes standards of care based upon best evidence, recommendations from accreditation and regulatory agencies, and expert advice arising from educational preparation, and experiences in nursing and working with the hospital system being served. The standards of care set the minimum expectation for practice. When provided a group of applicants, the most qualified nurse will be chosen. The new graduate registered nurse (RN) has limited experience in nursing and working in the hospital, so the committee would not choose this candidate as their first choice. The licensed practical/vocational nurse offers experience, commitment to lifelong learning, and certification in gerontology, but does not have any experience working at the hospital. The last two RNs have 7 years of experience working at the hospital and offer two areas of nursing and certification. The last candidate offers the most because of already completing an advanced degree, providing two certifications, with the one in Health Care Quality Management, which prepares the nurse to have a working knowledge to decrease medical errors, decrease client days, improve the quality of client care, and improve client safetyall aspects of QA programs.

Answer to Question 2

Ans: A
Feedback:
The next step the CQI committee needs to take is to search for the best evidence-based fall prevention protocol that meets the unit's needs in helping to decrease the incidence of falls. Not only are the falls a result of no one rounding during change of shift report, but there are other reasons for the falls. If the committee simply tracks the number of falls and reviews the incidence reports, then the committee is ignoring the problem and not addressing it, which goes against the principles of CQI. Placing a sign by the door of clients at risk for falls may help increase rounding, but does not address end-of-shift coverage when all nursing staff are at the nursing station giving and receiving report. Simply changing the policy for change of shift reporting to be at the bedside addresses decreasing some of the falls, but it does not address all of the reasons for the increased incidence of falls.