Nursing Challenges and Clinical Competency Quiz
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Questions and Answers

According to the Nursing Executive Center, what is a significant challenge observed among many nursing school graduates?

  • An academic-practice gap (correct)
  • Proficiency in specialized medical procedures
  • Exceptional leadership skills
  • Advanced research capabilities

    • Acute care agencies report that new registered nurses are achieving clinical competency faster due to increased resources for onboarding and training.

    False (B)

    What are two specific concerns identified by administrators regarding new graduate nurses that may lead to negative patient outcomes?

    Failure to notice changes in patient condition and failure to act.

    Two of the most common reasons that new graduate nurses are disciplined are failure to notice changes in patient status and failure to ______ when a patient is deteriorating.

    <p>act</p> Signup and view all the answers

    Match the following domains with the correct definition:

    <p>Patient/Care Management = Comprehensive oversight of patient care activities. Holistic Patient Care = Addressing the patient’s physical, emotional, and psychological needs. Elements of Interprofessional Care = Collaboration among different healthcare professionals for comprehensive patient care. Professional Concepts = Understanding ethical and legal aspects of nursing practice. Nursing Teamwork and Collaboration = Working together with other nurses to deliver coordinated care.</p> Signup and view all the answers

    Which of the following is NOT listed as a domain of Medical-Surgical Nursing Practice?

    <p>Advanced Surgical Techniques (B)</p> Signup and view all the answers

    What is the primary purpose of conducting a literature review after defining a research question?

    <p>To assess the current state of scientific knowledge regarding the research question (B)</p> Signup and view all the answers

    The study mentioned about readiness for practice of new graduate nurses was completed in 2018.

    <p>False (B)</p> Signup and view all the answers

    Randomized controlled studies are considered the 'gold standard' of research due to their ability to minimize bias through random assignment.

    <p>True (A)</p> Signup and view all the answers

    Which of the following is suggested as a strategy to better prepare the nurse graduate for the realities of practice?

    <p>Increased use of simulation in nursing education programs (B)</p> Signup and view all the answers

    What two groups are included in a case-control study?

    <p>Those with a specific disorder and those without</p> Signup and view all the answers

    __________ studies follow a group of people initially free of disease over time to examine the development of new cases.

    <p>Cohort</p> Signup and view all the answers

    Match the level of evidence with the corresponding study type:

    <p>Level I = Systematic reviews of randomized controlled studies Level II = Single randomized controlled study Level III = Quasi-experimental studies Level VII = Expert opinions</p> Signup and view all the answers

    Which type of study does NOT use control and experimental groups but instead relies on observations of populations and phenomena?

    <p>Descriptive and qualitative studies (C)</p> Signup and view all the answers

    In the given evidence hierarchy, a lower numerical rating correlates with a lower level of evidence.

    <p>False (B)</p> Signup and view all the answers

    What is the typical setting where case-control and cohort studies are often conducted?

    <p>Epidemiological research (C)</p> Signup and view all the answers

    Which of the following is a key focus of patient-centered care?

    <p>Treating patients and families with dignity and respect (C)</p> Signup and view all the answers

    According to the content, clinical competency and knowledge base are not relevant to patient-centered care provided by registered nurses.

    <p>False (B)</p> Signup and view all the answers

    What is the name of the survey that provides a standardized approach to collecting data from patients about their experiences in hospitals?

    <p>Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)</p> Signup and view all the answers

    The Joint Commission accredits and certifies approximately 80% of ______ in the United States.

    <p>hospitals</p> Signup and view all the answers

    What is the primary focus of The Joint Commission's mission statement?

    <p>Continuously improving healthcare for the public (C)</p> Signup and view all the answers

    The Beryl Institute promotes patient-centered care through the concept of the 'patient experience'.

    <p>True (A)</p> Signup and view all the answers

    List one aspect of patient-centered care that is incorporated into The Joint Commission (TJC) accreditation?

    <p>Data related to patient participation in the plan of care OR visitation rights</p> Signup and view all the answers

    Match the organization with its role in healthcare:

    <p>The Joint Commission (TJC) = Accredits and certifies hospitals, focusing on patient care, effectiveness, and safety The Beryl Institute = Fosters patient-centered care through the patient experience HCAHPS = Provides a standardized survey for collecting patient feedback on hospital experiences</p> Signup and view all the answers

    What does the 'A' in SBAR stand for?

    <p>Assessment (B)</p> Signup and view all the answers

    The SBAR method is primarily useful in low-risk situations.

    <p>False (B)</p> Signup and view all the answers

    According to the SBAR example, what surgery did Ms. Sandra Williams undergo?

    <p>Lumbar laminectomy</p> Signup and view all the answers

    In preparing a patient for surgery, it is important to mark the correct ______ on the patient's body.

    <p>place</p> Signup and view all the answers

    Which of the following is a key component of the 'Recommendation' section of SBAR?

    <p>A definitive approach to addressing the clinical problem (C)</p> Signup and view all the answers

    Preventing interruptions during medication preparation is not a safety measure in medical-surgical settings

    <p>False (B)</p> Signup and view all the answers

    What is the role of medical-surgical nurses in preventing infection and surgical errors?

    <p>Integral</p> Signup and view all the answers

    Match the SBAR component with its description:

    <p>Situation = Brief statement of the problem or issue being addressed Background = Data related to the current situation Assessment = Summary of causes, significance, and severity of situation Recommendation = Specific actions needed to address the situation</p> Signup and view all the answers

    What is the primary focus of the Quality and Safety Education for Nurses (QSEN) initiative?

    <p>Preparing nurses to improve quality and safety in healthcare. (D)</p> Signup and view all the answers

    Surgical 'time-outs' involve verifying the patient's identity, the correct anatomical site, and ensuring all equipment is in working order.

    <p>True (A)</p> Signup and view all the answers

    What should a nurse ensure regarding alarm parameters on patient monitoring equipment?

    <p>Individualization to the patient</p> Signup and view all the answers

    Many acute care facilities have implemented increased surveillance and evidence-based guidelines to prevent hospital-acquired __________.

    <p>infections</p> Signup and view all the answers

    Match the following actions with their purpose in improving patient safety:

    <p>Implementing surgical 'time-outs' = Preventing surgical errors Individualizing alarm parameters = Ensuring timely response to patient changes Effective communication and collaboration = Improving patient outcomes Increased surveillance of infections = Reducing hospital-acquired infections</p> Signup and view all the answers

    According to the information presented, what was identified as a root cause of medical errors in the U.S. hospitals?

    <p>Ineffective communication among the interprofessional healthcare team (A)</p> Signup and view all the answers

    Medical-surgical nurses in acute care settings are rarely involved in interprofessional rounds.

    <p>False (B)</p> Signup and view all the answers

    In acute care settings, what role do nurses often assume within the interprofessional healthcare team?

    <p>Care coordinator</p> Signup and view all the answers

    The Joint Commission includes an accreditation standard that addresses the importance of effective ______.

    <p>communication</p> Signup and view all the answers

    Match the following competencies with the organization that endorses them:

    <p>Provide patient-centered care = Institute of Medicine (IOM) Teamwork and Collaboration = Quality and Safety Education for Nursing (QSEN) Utilize informatics = Institute of Medicine (IOM) Safety = Quality and Safety Education for Nursing (QSEN)</p> Signup and view all the answers

    Which of the following is NOT explicitly listed as one of QSEN's competencies?

    <p>Cost-Effectiveness (D)</p> Signup and view all the answers

    According to the content, the IOM report 'To Err Is Human' stated that preventable medical errors never lead to patient deaths in U.S. hospitals.

    <p>False (B)</p> Signup and view all the answers

    What specific skills are crucial for medical-surgical nurses to effectively function as care coordinators?

    <p>Clinical reasoning and communication skills</p> Signup and view all the answers

    Flashcards

    Academic-Practice Gap

    The disparity between nursing education and practical skills needed in clinical settings.

    Clinical Competency

    The ability to perform nursing skills effectively in patient care.

    Nursing Executive Center

    A body that supports nursing administrators with data and best practices.

    Patient Management

    Administering holistic and interprofessional patient care effectively.

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    Failure to Notice

    The inability of nurses to recognize changes in a patient's condition.

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    Failure to Act

    The inability to take necessary actions when patient conditions deteriorate.

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    Simulation in Education

    Using realistic scenarios to enhance nursing students' practical skills.

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    Academic-Service Partnerships

    Collaborations between educational institutions and healthcare services to improve nursing readiness.

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    Patient-centered care

    Care that respects patients' preferences and involves them in decision making.

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    HCAHPS

    A survey measuring patient perceptions of hospital care.

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    TJC Standards for Hospitals

    Regulations by The Joint Commission for hospital accreditation.

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    Effective communication skills

    The ability to convey information clearly and empathetically.

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    Empathy in nursing

    Understanding and sharing the feelings of patients.

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    Components of patient-centered care

    Includes dignity, respect, and patient engagement in care decisions.

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    Patient experience

    The sum of all interactions a patient has with healthcare providers.

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    Beryl Institute

    An organization that promotes patient-centered care and experiences.

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    Literature Review

    A comprehensive assessment of existing research related to a specific question.

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    Evidence Quality Evaluation

    Assessing the quality, validity, and reliability of collected data.

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    Level I Evidence

    The highest level of evidence, found in systematic reviews of randomized controlled studies.

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    Level II Evidence

    Evidence based on a single randomized controlled study.

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    Quasi-Experimental Studies

    Level III evidence that uses control and experimental groups but lacks random assignment.

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    Case-Control Study

    Research comparing two groups: those with a disorder and those without.

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    Cohort Studies

    Studies following a group over time to observe disease development related to exposures.

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    Expert Opinion (Level VII Evidence)

    The lowest level of evidence, derived from the views of individuals or committees.

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    Hospital-Acquired Infections

    Infections that patients get during their hospital stay, often prolonging recovery.

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    Time-Out Procedure

    A safety check before surgery to confirm patient identity and site of surgery.

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    Quality and Safety Education for Nurses (QSEN)

    An initiative to educate nursing students on quality and safety measures in healthcare.

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    SBAR Communication

    A structured communication method in healthcare to enhance patient safety.

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    Alarm Settings in Patient Monitoring

    Adjusting alarms on monitoring equipment to suit individual patient needs.

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    SBAR

    A structured communication method used in healthcare to ensure clear information exchange.

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    Situation

    The initial brief statement of the problem or issue in SBAR.

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    Background

    Relevant data or information related to the current situation in SBAR.

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    Assessment

    A summary of the causes, significance, and severity of the situation in SBAR.

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    Recommendation

    Specific suggestions for actions to address the situation in SBAR.

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    Medication Safety

    Practices that prevent interruptions during the preparation and administration of medications.

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    Surgical Preparation

    The process of ensuring the correct surgical site is marked on the patient’s body.

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    Nurse's Role in Surgery

    Nurses help prevent infection and surgical errors in the operating room.

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    Interprofessional Teams

    Groups composed of members from different healthcare professions working towards patient care.

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    Evidence-Based Practice

    Healthcare practices based on the best available evidence, clinical expertise, and patient preferences.

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    Quality Improvement

    Ongoing efforts to improve services or processes within healthcare settings.

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    Safety

    The prevention of errors and adverse effects associated with healthcare.

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    Informatics

    The use of information technology and data management in healthcare improvements.

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    Communication in Healthcare

    The exchange of information between healthcare team members to ensure coordinated care.

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    Care Coordinator

    A healthcare professional who organizes patient care activities and facilitates communication across teams.

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    Study Notes

    Medical-Surgical Nursing Competencies

    • Entry-level nursing programs prepare nurses to practice competently in various medical-surgical settings
    • Competency in adult medical-surgical patients requires a strong background in anatomy, physiology, chemistry, microbiology, pathophysiology, and pharmacology
    • Emphasis on correlating nursing care rationales with physiological and pathophysiological bases of selected diseases for better interpretation of data, critical thinking, and clinical decision-making
    • The Academy of Medical-Surgical Nurses (AMSN) is the recognized leader in medical-surgical nursing
    • AMSN's mission is a dynamic community of medical-surgical nurses committed to quality patient care through professional development, certification, scholarship, and advocacy
    • AMSN values dedication to the well-being of nurses and their patients
    • AMSN promotes innovation and collaboration with interdisciplinary teams and external stakeholders to achieve common goals
    • AMSN advocates for medical-surgical nurses and patients from the point of care to the boardroom and from the payer to the legislative arena

    Strategic Plan

    • AMSN's strategic plan focuses on achieving the mission of commitment to quality patient care through professional development, certification, scholarship, and advocacy
    • This plan guides the work of AMSN

    Competency Gaps

    • New graduate nurses sometimes demonstrate an academic-practice gap
    • Acute care agencies report new graduates take longer to achieve clinical competency despite increased onboarding and training resources
    • New graduates lack expected knowledge and competency in patient/care management, holistic patient care, interprofessional care, professional concepts, and nursing teamwork and collaboration

    Clinical Judgment

    • Clinical judgment is the observed outcome of critical thinking, and decision-making based on nursing knowledge
    • Nurses use clinical judgment to observe and assess presenting situations, identify concerns, and generate evidence-based solutions
    • Clinical judgment is a required competency in the increasingly complex environment of nursing practice
    • The American Association of Colleges of Nursing (AACN) emphasizes clinical judgment as an important attribute of professional nursing
    • Clinical judgment directly influences patient care outcomes and is often based on nursing knowledge, critical thinking, and clinical reasoning

    Clinical Judgment Measurement Model (CJMM)

    • NCSBN developed the CJMM to measure clinical judgment in new graduate nurses
    • The CJMM measures a registered nurse's ability to recognize cues, analyze cues, prioritize hypotheses, generate solutions, take actions, and evaluate outcomes

    Evidence-Based Nursing Care

    • Evidence-based practice is the foundation of professional nursing practice
    • Medical-surgical nursing uses evidence-based practice principles to provide high-quality, cost-effective care to patients and families
    • Evidence-based care considers the best available evidence, clinical expertise, and patient preferences
    • Steps in the evidence-based process include developing the question, searching and collating evidence, evaluating evidence quality, integrating evidence into practice, evaluating outcomes, and disseminating evidence

    Medication Administration Errors

    • Medication administration errors are a critical patient safety issue
    • Qualitative research suggests medication knowledge, fatigue, workload, and interruptions are primary causes of medication administration errors
    • Nurses perceive multifactorial and system-related causes of medication errors

    Patient-Centered Care

    • Patient-centered care is a benchmark for acute care facilities; the IOM report highlighted its importance
    • Patient-centered care focuses on providing respectful and dignified care for patients and involves patient participation in decision-making
    • The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey measures patient experiences regarding care
    • The Joint Commission (TJC) includes patient-centered care concepts in accreditation standards
    • The Beryl Institute emphasizes patient-centered culture in healthcare settings

    Patient Safety

    • Joint Commission's National Patient Safety Goals focus on areas to improve patient safety; identifying patients correctly and improving staff communication are core goals
    • Nurses must use accurate patient identification throughout the patient experience, especially during assessments, procedures, and medication administration

    Interprofessional Collaboration and Communication

    • Interprofessional collaboration is crucial in medical-surgical settings, especially with high-acuity patients
    • Effective communication, including SBAR, among interprofessional teams is important in acute care settings; this includes healthcare providers, pharmacists, and social workers
    • Educational programs are focused on educating the future healthcare workforce collaboratively and in interprofessional medical settings

    Quality Improvement and Informatics

    • Quality improvement and safety in healthcare are essential for safe, effective care
    • Technology plays a crucial role in quality and safety improvement and patient centered care

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    Competencies In Medical-Surgical Nursing PDF

    Description

    This quiz explores significant challenges faced by new nursing graduates, particularly relating to clinical competencies and concerns raised by administrators. It also covers key domains in Medical-Surgical Nursing Practice and the importance of literature reviews in nursing research. Test your knowledge on these critical issues affecting patient outcomes and nursing education.

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