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A risk professional receives a call from a nurse manager seeking help with a patient’s family
member. The nurse manager states she has tried everything to please this family. She indicated the
family threatened a lawsuit. The nurses are now afraid to go in the room. Upon hearing this, the risk
An organization recently adopted Just Culture principles in their approach to handling employee
errors. The organization’s risk manager is asked by a unit director how to handle an employee
involved in an error where there was no harm to the patient, but a workaround was used which
resulted in an error. Which of the following is the risk manager’s best response?
An unknown child is carried into a plastic surgeon’s office by a witness after a hit and run. The
child has sustained notable trauma and is unconscious. The child has significant bleeding from a
laceration, the office calls 911 and the risk professional because the surgeon wants to suture the
wound. If the surgeon sutures the wound, is consent needed?
Which of the following reasons for under-reporting of incidents should be of greatest concern to
a risk manager?
Which of the following is most likely to occur if a health system punishes an individual for an unintended error that was the result of a system design issue?
In the Just Culture model, which of the following types of behavior should result in the coaching of an employee?
In disclosing a medical error to a patient, it is important the care provider
According to The Joint Commission, an environment that enhances patient safety encourages
1. recognition and acknowledgement of risks to patient safety.
2. initiation of actions to reduce risks to patient safety.
3. involvement of legal counsel to promote individual accountability.
4. focus on processes and systems.
A risk professional became aware of a medication error that reached the patient. Upon review of
the medical record, the risk professional notes the error was not documented. When contacting the
nurse who made the error, the risk professional should
An organization’s development of a non-punitive approach to reporting of adverse events may result in an increase in the
Which of the following is the most appropriate information to share with the family during an
initial disclosure process?
A wrong-site surgery was discovered in the recovery room. The staff immediately reported the
event and identified a deviation in not completing a “time out” prior to the surgery. In review of the
event, the organization’s risk manager can confirm that Just Culture principles are being followed as
evidenced by which of the following behaviors?
1. acknowledging that even professionals will take short cuts
2. supporting blameless reporting of events
3. admitting that a mistake has been made
4. protecting confidentiality of event details to reduce liability
A specific, fair, non-arbitrary method for determining system versus individual accountability in
cases of medical error is known as which of the following?
The emergency exception to the informed consent rule allows physicians to assume an unconscious patient, about whom there is no information, would have given his consent to a procedure in an emergency situation when
Under which of the following conditions can a relative consent to a minor’s health care treatment?
Which of the following are a risk manager’s best strategies to drive organizational leaders and other staff to commit to a medication safety program?
1. Include medication safety as part of a Safety Week.
2. Promote open communication regarding medication errors.
3. Quantify the benefits for reducing patient harm from errors.
4. Implement a physical environment that promotes safe medication use processes.
A physician contacted the risk professional to report a wrong site surgery. The physician stated
disclosure of the event to the patient has occurred. The risk professional should be aware that
The most effective human factors design strategy to reduce risk is to
In preparation of working with disruptive patients, families, or visitors, it is important for organizations to
A patient undergoes a laparotomy and does not do well postoperatively. The patient is taken
back to surgery and a retained towel is extracted. The physician refuses to inform the patient and
instructs staff to advise the patient a previously undiagnosed condition is the cause. The risk
manager should FIRST
Informed consent is based upon the principle of
A premature neonate in the NICU is receiving intravenous vancomycin for a severe infection.
During the routine blood test to monitor the amount of medication in the blood at peak potency,
levels were determined to be toxic. Due to the risk of the baby developing hearing loss as a result of
the toxicity, a disclosure to the family is warranted. The initial disclosure discussion should include
which of the following statements?
A risk professional conducted a root cause analysis on a medical error. The root cause analysis
revealed that the nurse acted with reckless behavior. Using the just culture model, which of the
following is the best way to manage the nurse’s behavior?
When debriefing after an adverse event that caused harm to a patient, which of the following are
1. Individual team members should not feel personally responsible for the adverse event.
2. The focus is on individual team members’ strengths and weaknesses.
3. Teams learn practical applications to assist in dealing with difficult situations in the future.
4. Teams can develop new communication methods to use during subsequent events.
Which of the following are four commonly accepted principles of biomedical ethics?
Which of the following are examples of disruptive behavior by a clinician?
1. insulting another clinician during a multi-disciplinary team meeting
2. refusing to follow established reporting protocols
3. throwing objects at the wall in an empty staff-only room
4. arriving late for a scheduled patient procedure due to a flat tire
Which of the following represents an appropriate disclosure of an adverse event?
The daughter of an elderly patient has been noted to take pictures of the staff while they are
providing care to her father. She became verbally abusive to the staff when informed of the facility’s
ban on picture taking during the provision of care. Which of the following is the risk manager’s
best course of action at this time?
Following an untoward event, the principal purpose of disclosure is to
Which of the following elements should be included in a policy on disclosure of unanticipated outcomes?
1. who is responsible for the disclosure
2. documentation of the disclosure
3. how to disclose deliberations from the peer review process
4. follow-up discussions with patient and family