Question 1

The ambulatory care nurse has noticed a decrease in individuals visiting the clinic and has been hearing reports that some individuals have stopped coming due to the actions of a couple of staff members. Which action would be most appropriate in this situation?

A)Assess care provided via a survey from the individuals requesting care.
B)Question the staff about the rumors.
C)Consider changing hours of operation to better fit the population.
D)Research data from other local agencies and compare numbers.

Assess care provided via a survey from the individuals requesting care.

Accepted Answer

Requesting that individuals who come for care complete a survey will help provide information about the experiences of these individuals. The survey can include information concerning communication, coordination of care, and customer service. This will also allow the individuals the option to remain anonymous, especially if they fear retaliation for reporting what happened. Questioning the staff concerning the rumors may not reveal the incidents due to fear of punishment. Changing the hours and comparing numbers to other agencies will also not address this situation.

Question 2

The ambulatory care nurse is utilizing Donabedian's methods to analyze the quality results of the clinic's care. Which categories should the nurse ensure are included in this analysis? Select all that apply.

A)Structure
B)Process
C)Outcome
D)Population
E)Staff involved

Structure
Process
Outcome

Accepted Answer

In 1996, Avedis Donabedian introduced the medical community to a framework to evaluate healthcare using a foundational conceptual model that segments quality into structure, process, and outcomes of care. The framework does not include segments on population or staff considerations.

Question 3

A family member is asking the ambulatory care nurse for assistance in finding a home healthcare agency for an older family member who needs assistance. Which option should the nurse prioritize for this individual?

A)Visit CMS website for comparison data on local agencies.
B)Invite local agencies to the older adult's home to see which responds the best.
C)Ask friends and neighbors for recommendations for local agencies.
D)Check the Better Business Bureau for information about the local agencies.

Visit CMS website for comparison data on local agencies.

Accepted Answer

The CMS maintains information on its website concerning the quality of care provided by home health agencies. These publicly reported measures include outcome measures that indicate how well home health agencies assist their patients in regaining and/or maintaining their function, and process measures to evaluate the home health agency's use of evidence-based processes of care. The other choices will provide the family with additional information that can be added to the information gleaned from the website to assist in making the ultimate decision.

Question 4

An APRN, concerned about the lack of adequate healthcare in the surrounding remote areas, has started a company that will operate urgent care centers in several small, medically underserved towns. Which step should this APRN prioritize to ensure each individual receives the best care possible?

A)Compare the facilities' performance to other similar facilities.
B)Closely follow CMS guidelines and policies.
C)Allow an independent audit of statistical data.
D)Compile responses from consumer surveys following each treatment or visit.

Accepted Answer

By comparing the facilities' performance with other similar facilities using established benchmarks, the APRN will be able to determine if these facilities are meeting the established standards. These facilities will be compared using their setting type, unit type, and structural features. This will allow the APRN to monitor trends and compare performance to other similar participating units. This company will need to follow CMS guidelines to receive Medicare and Medicaid reimbursement. Conducting an independent audit and collecting surveys would be secondary options to evaluate the success of the facility. This information can also be used to evaluate the effectiveness of the care provided.

Question 5

A group of ambulatory care nurses at a day-surgery facility are advocating with other colleagues to improve the care being provided to individuals. Which option should the nurses present as the best goal for this group?

A)Magnet Recognition
B)The Joint Commission certification
C)CMS registration
D)AAACN membership

Accepted Answer

The American Nurses Credentialing Center (ANCC) Magnet Recognition Program was started in the acute care setting and sets high standards to achieve this status. Hospitals that have achieved Magnet Recognition are known for excellence in outcomes relative to nursing staff satisfaction, patient care quality, and excellent interprofessional collaboration. To maintain this recognition, the facility must show improvement. This is now available for ambulatory practices and has been a catalyst for positive change with performance. The standards are high, making this a difficult achievement and one that requires all members of the organization to become involved with the ultimate goal of improving healthcare for the entire local population. The other choices are also possible. The Joint Commission certification has a slightly different focus but also helps ensure quality care. CMS registration is necessary to qualify for Medicare and Medicaid reimbursement. The American Academy of Ambulatory Care Nursing (AAACN) is responsible for a more comprehensive inclusion of ambulatory nursing practice in the Magnet Recognition program.

Deck 4: Measurement and Value