CHAPTER 2
QSEN: Building Competency in Patient-Centered Care
Answer: Nathan knows that meeting patient expectations is part of
delivering patient-centered care. He first asks the patient about his
expectations for his hospitalization but also for discharge. He also
discusses to what extent the patient wants to be involved in decision
making. Nathan can talk with the case manager/discharge planner
regarding the patient concerns related to discharge. Nathan can work
with the case manager/discharge planner to ensure that the patient has
the resources and equipment needed for home care.
Answers and Rationales for Review Questions
1.
Answer: 4. Maintaining ongoing competency is a nurse’s
responsibility. Earning certification in a specialty area is
one mechanism that demonstrates competency. Specialty
certification has been shown to be positively related to
patient safety.
2.
Answer: 1, 2, 5. Primary care activities are focused on
health promotion. Health promotion programs contribute
to quality health care by helping patients acquire healthier lifestyles. Health promotion activities help keep people
healthy through exercise, good nutrition, rest, and adopting positive health attitudes and practices.
3.
Answer: 4. Magnet® status is a process and review that hospitals go through that shows achievement of excellence in
nursing practice. The designation is given by the American
Nurses Credentialing Center and focuses on demonstration of quality patient care, nursing excellence, and innovations in professional practice.
4.
Answer: 3. In secondary care the diagnosis and treatment
of illnesses are traditionally the most common services.
Secondary services are usually provided in an acute care
setting. Inpatient medical-surgical units provide secondary
care. Critical care units provide tertiary care.
5.
Answer: 1. Restorative interventions focus on returning
patients to their previous level of function or on reaching
a new level of function limited by their illness or disability. The goal of restorative care is to help individuals regain
maximal functional status and to enhance quality of life
through promotion of independence.
6.
Answer: 1, 3, 5. Integrated health care systems are shifting
to more holistic approaches to health care. At the core of
this shift is provision of a coordinated continuum of services for enhancing the health status of defined populations.
There is no single model for an integrated health care system. Two types of integrated health care delivery systems
are common: an organizational structure that follows economic imperatives and a system that supports an organized
care delivery approach. Patient-centered medical home
care is an example; members of the care team are linked by
information technology, electronic health records, and system-best practices to ensure that patients receive care when
and where they need it, and how they want it.
7.
Answer: 2, 3, 5. Social determinants include social support, exposure to crime and violence, and culture. The
nurse should learn the child’s age at which behavioral problems appeared, but this is not a social determinant. Seating
placement is not a social determinant but could be a factor
if the child has visual or other physical problems.
8.
Answer: 2. The nurse must make the referral as soon as
possible. The other elements of discharge planning, including knowing the discharge date, involving the patient and
family in decision-making, and incorporating the referral
discipline’s recommendations for the patient’s care are part
of discharge planning.
9.
Answer: 1, 2. Barriers to effective discharge planning
include ineffective communication, lack of role clarity
among health care team members, and lack of resources.
The presence of long-term disability is not a barrier but a
characteristic of some patients who need greater discharge
planning. A patient’s cultural background is not a barrier
unless you do not consider cultural factors in planning for
discharge.
10.Answer: 2, 3, 5. Intentional rounding is an evidence-based
practice used in an increasing number of hospitals today.
Studies have shown that intentional rounding can reduce
patient falls and call light use and improve patient satisfaction scores. Proactive problem solving can occur when
using intentional rounding. Education for patients helps
them understand the importance of this practice.
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