Chapter 13: Organizing Patient Care and Staffing for Patient Safety

MULTIPLE CHOICE

1. Which statement is accurate in describing care delivery models?

1. Total patient care is an example of a contemporary care delivery model.

2. Functional nursing model and team nursing are equivalent models.

3. Lateral communication exists in primary nursing model.

4. Integrated models utilize registered nurses to provide primary care to patients.

ANS:

2. A group of nursing students are discussing how staffing affects patient safety. Which nursing student comment, if observed by the nursing instructor, would warrant intervention?

1. Research has indicated that if staffing is adequate then patients are less likely to develop nosocomial infections.

2. If staffing is adequate with registered nurses (RNs), then patient mortality is decreased.

3. There is little evidence to support that adequate staffing leads to improved patient outcomes.

4. Adequate staffing helps to prevent nursing fatigue leading to better clinical decision making.

ANS:

3. A charge nurse is preparing staffing for the upcoming shift on a medical-surgical unit. Which factor would take priority in planning?

1. Productive time

2. Adequate staffing mix

3. Average daily census

4. High patient acuity

ANS:

4. According to clinical research findings, what is a higher registered nurse (RN) skill mix associated with?

1. Increased missed care

2. Increased patient complications

3. Increased assessment time

4. Better time management

ANS:

5. Which factors are seen as being critical to evaluating staffing patterns based on nurse-sensitive quality indicators (National Database of Nursing Quality Indicators [NDNQI])?

1. Only the skill mix of nurses in the clinical setting

2. Skill mix and amount of nursing hours per patient per day

3. Acuity of patients and number of physicians

4. Skill mix and nurse job satisfaction

ANS:

6. Inspection of a medical-surgical nursing unit reveals that the unit is understaffed, with several of the nurses asked to continually sign up for overtime to fulfill staffing needs. Before this staffing pattern request, nurses were called off due to low patient census. The present situation has now been occurring for several months, and the nurse manager has just received a 2-week notice from one of the staff nurses assigned to the unit. What would one suspect to be occurring based on this observed situation?

1. Teamwork and solidarity on the part of the nursing staff

2. Consistent patient outcomes

3. Poor morale of nursing staff

4. Decrease in nosocomial infections

ANS:

MULTIPLE RESPONSE

7. Which description best illustrates a type of care delivery model? Select all that apply.

1. Primary nursing focused on the registered nurse being responsible for total patient care at the bedside.

2. A team nursing approach consisted of all registered nurses providing complex care to a group of high acuity patients.

3. Nontraditional models of patient care incorporate nonnursing personnel to deliver patient care.

4. Partnership models focused on decreasing health-care costs while providing patient care.

5. Functional care model focused on the use of registered nurses as the basis for providing total care.

ANS:

8. Which characteristics are included in the Clinical Nurse Leader (CNL) model? Select all that apply.

1. The CNL assumes an administrative role in the clinical setting.

2. The aim of the CNL model is to improve outcomes for the patient across the health-care continuum.

3. Evidence-based practice (EBP) is not incorporated into the CNL model.

4. The functioning CNL in the clinical setting obtains certification on graduation from a master’s program by passing a certification examination.

5. The entry level of practice requires a doctoral degree.

ANS:

9. Which factors contribute to the present nursing shortage in the United States? Select all that apply.

1. Increased access to health care

2. Decreased clinical sites

3. Staffing patterns within hospital settings

4. Newer nurses less likely to remain employed in clinical practice settings compared to more experienced nurses

5. Shortage of nurses that exists only in specialty areas of practice

ANS:

10. A charge nurse is preparing staffing for the upcoming shift on a medical-surgical unit. Which statements about the scope of practice for various types of staff are true? Select all that apply.

1. RN scope of practice includes all aspects of the nursing process.

2. RN scope of practice includes supervising LPNs/LVNs and UAP.

3. LPN/LVN scope of practice includes all aspects of the nursing process plus medication administration.

4. LPN/LVN scope of practice includes physical care, taking vital signs, and administering medication.

5. UAP scope of practice includes any activity that has been assigned by an RN.

6. UAP scope of practice includes activities of daily living, hygiene, and physical care.

ANS: