Chapter 12: Quality of Care: From Quality Assurance and Improvement to Cultures of Patient Safety -

Correct Answer: D

Rationale: The foundation of quality assurance programs- achieving predetermined standards in the clinical setting- was seen as somewhat arbitrary. Administrators and program directors established the level to which each standard was to be achieved. Critical standards were expected to be achieved $100\%$ of the time, while less critical standards, perhaps $80\%$ to $90\%$ of the time.

Correct Answer: B

Rationale: The goal of continuous quality improvement is prevention, not detection, of errors. Quality improvement is a continuous cycle of improving processes before errors are made or complaints are reviewed. Doing the right thing the first time and all the time is considered much more cost-effective than redoing work.

Correct Answer: C

Rationale: An associated domain of outcomes measurement is the use of evidence-informed best practice guidelines as a support to nurse decision making in the delivery of quality nursing care.

Correct Answer: C

Rationale: In the early 1990s, the CCHSA Survey Standards included clinical outcomes to support evidence-informed nursing care that are now reflected in the C-HOBIC standardized clinical outcomes.

Correct Answer: C

Rationale: An example of a quality-monitoring instrument is a Pareto chart, which uses data derived from a check sheet that shows the frequency of occurrence. If a team is studying reasons for delay in patient transfer, a Pareto chart will determine the specific factors that cause delays $80\%$ of the time.