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Self-Assessment Answers for Section 1: Preventing Medical Errors: Quality Chasm Series

  1. According to IOM study a hospital patient is subject to medical error at what rate?

    1. At least once every three days.
    2. At least once every two days.
    3. At least once a day.
    4. At least twice a day.

  1. What percentage of medication-related injuries are preventable?

    1. 10%
    2. 15%
    3. 20%
    4. 25%

  1. In hospitals, at which step in the medication-use process is an error most likely to occur

    1. Prescribing
    2. Dispensing
    3. Monitoring the patient
    4. Equally likey at all steps

  1. The IOM report calls for a more patientcentered model of health care which has led to patient rights laws. Which of the following is not specifically addressed in these laws?

    1. The option to accept or reject medication.
    2. The right to be told when an adverse event has occurred.
    3. The right to designate someone to assist with their management.
    4. The right to be informed about alternatives.

  1. Internet-based health information has proliferated in the last decade. Which of the following is correct regarding that resource?

    1. Health information does not figure prominently during online searches.
    2. Most consumers are familiar with how to access health information.
    3. The information is adequately designed for accessing health information.
    4. It provides consistent information for consumers.

  1. Which of the following is correct regarding risk / benefit information about prescription drugs?

    1. Over the past decade, drug evaluation studies have been comprehensive.
    2. There is a need to redesign clinical studies for risk / benefit information.
    3. The majority of prescriptions are based on empirical data.
    4. Clinical studies currently provide transparency in clinical studies.

  1. The Institute of Medicine’s (IOM) report To Err is Human concludes that the most significant causes of medical errors are all of the following EXCEPT:

    1. Incompetent health professionals.
    2. Problems with the health care delivery system.
    3. Failure to prescribe potentially beneficial medications.
    4. Prescribed medications harmful effects with other medications.

  1. The IOM report has led to marked improvements in all of the following areas EXCEPT:

    1. Acceptance in the health care community that medical errors is a serious problem.
    2. Improved clinical information systems.
    3. Expanded patient safety.
    4. Accountability.

  1. The most common cause of adverse medical effects is:

    1. Drug related.
    2. Procedure related.
    3. Inadequate staffing.
    4. Physician impairment.

  1. Researchers found that the chance of receiving high quality health care in the United States is:

    1. 35%
    2. 55%
    3. 75%
    4. 90%

  1. Which of the following is correct regarding efforts in health care cost containment?

    1. Costs are increasing at a lower rate than the rate of inflation.
    2. Medicare prescription drug benefit will likely reduce costs.
    3. An aging population is leading to increased costs.
    4. Prescription drug sales are decreasing.

  1. The Medicare Modernization Act mandated that the Center for Medicare and Medicaid Services sponsor a study by the IOM with the primary focus of:

    1. Safety of biologic products (e.g.,vaccines, blood products).
    2. Use and safety of herbal/natural supplements.
    3. Determining barriers to electronicrecords.
    4. Avoiding medication errors.

  1. The Institute of Medicine Committee study of medication error rates found that there was no data for which setting?

    1. Ambulatory care
    2. Psychiatric care
    3. Pediatric care
    4. Schools

  1. Which of the following is correct regarding the study’s assessment of medication errors?

    1. Assessment is established based on consistent results from numerous studies.
    2. There is little or no data about medication selection and procurement procedures.
    3. A standardized definition of errors allowed for accurate estimates of error.
    4. Reliable methods are in place to measure the extent of errors in most settings.

  1. According to a study at the LDS hospital, the largest number of preventable drug erros arose from

    1. Excessive dosage
    2. Drug interactions
    3. Computer error
    4. Drug allergies

  1. The committee concluded that the estimate of 400,000 preventable adverse drug effects per year is likely to be the lower bounds of the actual number.

    2.  True False

  1. It is estimated that the total number of medication errors in the United States per year is:

    1. 500,000
    2. 800,000
    3. 1 million
    4. 1.5 million

  1. Extrapolating the figures gathered in the Classen, et al., 1997 study of Adverse Drug Event incidence during hospitalization, the authors concluded that what number of hospital patients in America would experience an ADE annually?

    1. 127,000
    2. 490,000
    3. 770,000
    4. 1,000,000

  1. In the cited retrospective review by Shaughnessy and Nickel of prescriptions written by family medicine residents, 21% of the prescriptions contained at least one prescription writing error. The most common error was that of:

    1. Omission.
    2. Prescriptions written for nonprescription products.
    3. Indecipherable quantity to be dispensed.
    4. Incorrect doses or directions.

  1. According to a study conducted in 2000 involving dispensing of samples, what percentage of evaluated labels provided dosage, route, frequency and duration?

    1. 5%
    2. 9%
    3. 17%
    4. 62%
Self-Assessment Answers for Section 2: Prevention of Wrong-Site Surgery

  1. All of the following describe self-directed learning (SDL) EXCEPT:

    1. Learning is always done alone.
    2. Includes a wide variety of formats.
    3. Learner defines educational objectives.
    4. Learner selects the educational activity.

  1. Many states are adding the requirement that CME include which of the following components?

    1. Attendance at least one professional meeting per year.
    2. Specific focus in the physician’s area of practice.
    3. Patient satisfaction data.
    4. Independent learning.

  1. All of the following are characteristics of PoC EXCEPT:

    1. Practice based.
    2. Reflective process.
    3. Individual directed.
    4. Specifically structured.

  1. Directus serves as a CME tool for Internet searches by doing which of the following?

    1. Providing a form for the learner to cut and paste URL sites visited.
    2. Tracking and documenting the search process.
    3. ICreating a post-test for searches.
    4. Blocking commercial sites.

  1. Which of the following results in the greatest number of wrong-site errors in surgery?

    1. Incorrect information in documents relating to the surgery.
    2. Misinterpretation such as left/right confusion.
    3. Ambiguity in surgery documents.
    4. Combination of the above.

  1. The member of the surgical team most commonly associated with wrong-site surgery is the:

    1. Nurse
    2. Anesthesia Provider
    3. Surgeon
    4. Technician

  1. Two-thirds of near-miss events result from errors communicated from the:

    1. Patient
    2. Nurse
    3. Consent Form
    4. Surgeon’s Office
        Indicate whether each of the following plays a major role in avoiding wrong-site surgeries

  1. Members of the surgery team voicing concern.

    2.  Yes No

  1. Surgeon conducting time-out.

    2.  Yes No

  1. Use of a Checklist.

    2.  Yes No

  1. Verification from patient before anesthesia.

    2.  Yes No

  1. According to the PA Patient Safety Reporting System (PA-PSRS) data, on average in a 300-bed hospital, the frequency of wrong-site surgery per year is:

    1. .05/yr.
    2. 1/yr.
    3. 1.5/yr.
    4. 2/yr.

  1. Which of the following describes the change in wrong-site surgery reports in Pennsylvania since the implementation of the Joint Commission Universal Protocol?

    1. 5% decrease
    2. 8% decrease
    3. 2% increase
    4. No change

  1. Which is the most common site of wrongsite surgeries?

    1. Head
    2. Lower extremities
    3. Upper extremities
    4. No change

  1. The specialty most commonly involved in a reported wrong-site surgery is:

    1. General Surgery
    2. Neurosurgery
    3. Orthopedic
    4. Urology

  1. The root cause of more than 70% of wrong-site surgeries is:

    1. Communication breakdowns.
    2. Incomplete preoperative assessment.
    3. Inadequate procedures for site verification.
    4. Family involvement.

  1. Which of the following decreases the likelihood of surgical error?

    1. Complete reliance on surgeon to verify site.
    2. More than one primary system.
    3. All team members permitted to question other members.
    4. Marking wrong side with “NO.”
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