Interprofessional Collaboration

Question 1

standard of care

Answer 1

what a reasonable and prudent nurse would do in the same or similar circumstances

an objective standard

provides consistency within the profession

often the standard of care is established at a national level; states and local areas may establish their own standard

includes keeping up to date with current developments in the medical profession

Question 2

evidence of standard of care

Answer 2

hospital policies and procedures

standards of a certifying body (ANA code of ethics for nurses); nursing organizations

nursing guidelines and specialty guidelines

expert testimony (must be appropriately qualified to provide opinions)

Question 3

negligence

Answer 3

failure to use such care as a reasonably prudent and careful person would use under similar circumstances

Question 4

negligence is when the patient/plaintiff must establish:

Answer 4

the defendant owed a duty
the defendant breached the duty
defendant’s breach cause harm to the patient
harm/injury/damages were a direct cause of the breach

Question 5

malpractice

Answer 5

professional misconduct or unreasonable lack of skill; professional’s improper or immoral conduct in the performance of duties either through carelessness or ignorance

Question 6

risk management recommendations

Answer 6

utilize patient physical restraint pursuant to practitioner orders, when clinically indicated to protect a patient from injury to themselves or others

apply and monitor physical patient restraint

conduct contraband search

maintain restrained patients in a controlled environment

perform frequent monitoring and clinical assessment of restrained patients

document all patient monitoring, assessment, and clinical findings

document any variation in patient monitoring and assessment protocol

Question 7

incident

Answer 7

any event not consistent with routine hospital operation or patient care; an event that is unexpected or unplanned; example - fall without injury

Question 8

incident involves:

Answer 8

patient clinical care in a healthcare facility

potential injury to the patient

did not cause an unanticipated injury OR require additional health care services to the patient

Question 9

near miss

Answer 9

event that almost happened but was caught in time by change or active intervention by the people involved

Question 10

examples of near miss

Answer 10

wrong drug in Pyxis drawer
wrong patient asked to consent to a procedure
wrong drug concentration in IV
instrumentation opened and wet
wrong patient taken to the OR holding area

Question 11

serious event

Answer 11

causes harm to the patient; occurrence that involves:

• clinical care of a patient that results in death or
• compromises patient safety and results in an unanticipated injury that requires the delivery of additional health services to the patient

Question 12

examples of serious event

Answer 12

a fall resulting in a fractured hip requiring surgery

fall requiring suturing of laceration

stage 3 or 4 pressure ulcer

Question 13

sentinel event

Answer 13

resulting in an unanticipated death or major permanent loss of function

Question 14

examples of sentinel event

Answer 14

patient suicide in hospital within 72 hours of d/c
infant discharge wrong family/pt abduction
unanticipated death of full-term infant
HAI causing death or loss of function
severe neonatal hyperbilirubinemia 
rape
hemolytic transfusion 
surgery on wrong body part

Question 15

root cause analysis

Answer 15

process of identifying basis or causal factors that underline variation in performance

involved multidisciplinary peer review

focuses primarily on systems and processes, not on individual performance

non-punitive process (non-disciplinary)

can be done for any event

Question 16

root cause analysis basics

Answer 16

symptoms of the problem (the weed) above the surface – obvious

the underlying causes (root) below the surface - not obvious

product is an action plan which identifies strategies that the organization intends to implement to reduce the risk of similar events occurring again

Question 17

role of risk management

Answer 17

identify areas of potential liability (proactive risk assessment) - falls in radiology

manage incidents/events as they occur (investigate the incident ASAP with statements from those involved)

reduce patient injuries by learning from mistakes (removing ability of IV pump to infuse certain meds)

Question 18

professional liability

Answer 18

legal consequence due to negligence on the part of a professional

Question 19

deposition

Answer 19

question and answer session that is recorded by a court reporter, and may be taken of a party, or a fact witness

Question 20

preparation for deposition

Answer 20

up-to-date curriculum vitae
review records
review complaint
meet with attorney
depositions of other parties

Question 21

Good Samaritan law

Answer 21

no duty/obligation
know your state
you will not be held liable unless you are grossly negligent or intentionally harm the person

Question 22

nurse’s role in obtaining informed consent

Answer 22

assessing patient’s ability to understand the discussion (competency and language)

alerting physician to question the patient has regarding the procedure, risks or alternatives

ensuring a completed consent form is in the chart prior to start of procedure

patient may feel more comfortable asking a nurse questions because the nurse may have more interaction with the patient

acting as a witness for consent over the phone

witness for consent for autopsy

Question 23

why nurses are sued

Answer 23

patients do not feel they were heard when complaints were made

patients perceive healthcare providers as rude, callous, unsympathetic

patients sustain injury or feel that they have experienced a less than perfect result

patients feel they have been wronged

patients are dissatisfied with quality of cost of care

Question 24

common complaints against nursing staff

Answer 24

failure to properly and timely administer meds
failure to administer appropriate meds
failure to monitor equipment
failure to monitor and assess the patient
failure to provide for the patient’s safety
failure to warn the patients/protect from dangers
failure to correctly report assessment and observations
failure to communicate
failure to document
failure to follow physician’s orders

Question 25

medical records

Answer 25

tell a story of the care and treatment that was rendered to a patient

can provide that the standard of care was met

Question 26

medical documentation

Answer 26

never alter the medical record
do not use the record for jousting or accusatory remarks 
do not erase or obliterate an entry (add late addendum)
document discussions with care team
document objectively 
document descriptively
date and time each entry
write legibly
record instructions given to a patient
document patient refusals

Question 27

patient-centered care

Answer 27

Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient’s preferences, values, and needs.

Question 28

teamwork and collaboration

Answer 28

Function effectively within nursing and inter-professional teams, fostering open communication, mutual respect, and shared decision-making to achieve quality patient care.

Question 29

evidence based practice

Answer 29

Integrate best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care.

Question 30

quality improvement

Answer 30

Use data to monitor the outcomes of care processes and use improvement methods to design and test changes to continuously improve the quality and safety of health care systems.

Question 31

safety

Answer 31

Minimizes risk of harm to patients and providers through both system effectiveness and individual performance.

Question 32

informatics

Answer 32

Use information and technology to communicate, manage knowledge, mitigate error, and support decision making.