CNE Quality Control & Process Improvement 3 — Questions and Answers
Question 1: Which quality framework emphasizes 'structure, process, and outcome' as three domains for evaluating healthcare quality?
- Baldrige Excellence Framework
- Donabedian Model (Correct answer)
- IHI Triple Aim
- PDCA Cycle
Correct answer: Donabedian Model
Avedis Donabedian proposed evaluating quality through structure (resources), process (care delivery), and outcome (results).
Question 2: A CNE wants to determine if a new clinical simulation protocol improved student competency scores. Which statistical test is most appropriate for comparing pre- and post-scores from the same group?
- Independent samples t-test
- Chi-square test
- Paired t-test (Correct answer)
- ANOVA
Correct answer: Paired t-test
A paired t-test compares means from the same participants before and after an intervention, controlling for individual variability.
Question 3: In Six Sigma quality improvement, what does 'DMAIC' stand for?
- Define, Measure, Analyze, Improve, Control (Correct answer)
- Design, Monitor, Assess, Implement, Check
- Develop, Manage, Analyze, Integrate, Calibrate
- Define, Map, Adjust, Innovate, Confirm
Correct answer: Define, Measure, Analyze, Improve, Control
DMAIC is the Six Sigma structured problem-solving approach: Define, Measure, Analyze, Improve, Control.
Question 4: A nursing faculty team uses a control chart and notices a data point beyond 3 standard deviations from the mean. This is called:
- Common cause variation
- A sentinel event
- Special cause variation (Correct answer)
- An outlier bias
Correct answer: Special cause variation
A data point beyond 3 standard deviations on a control chart signals special cause variation, indicating an unusual event requiring investigation.
Question 5: When a nursing educator applies failure mode and effects analysis (FMEA), the primary goal is to:
- Investigate errors that have already occurred and caused harm
- Proactively identify potential failure points before they occur (Correct answer)
- Measure cost savings from quality improvement initiatives
- Compare adverse event rates between two clinical units
Correct answer: Proactively identify potential failure points before they occur
FMEA is a prospective tool used to identify and prioritize potential failure modes in a process before harm occurs.
Question 6: The Institute for Healthcare Improvement (IHI) Triple Aim framework targets which three dimensions simultaneously?
- Safety, efficiency, and equity
- Population health, patient experience, and per capita cost (Correct answer)
- Access, quality, and workforce satisfaction
- Timeliness, effectiveness, and patient-centeredness
Correct answer: Population health, patient experience, and per capita cost
The IHI Triple Aim focuses on improving population health, enhancing patient experience of care, and reducing per capita cost.
Question 7: A Pareto chart used in nursing quality improvement is based on which principle?
- All causes of a problem contribute equally to outcomes
- Approximately 80% of problems stem from 20% of causes (Correct answer)
- Statistical control requires normal distribution of data
- Process improvement requires eliminating all identified causes
Correct answer: Approximately 80% of problems stem from 20% of causes
The Pareto Principle holds that roughly 80% of effects come from 20% of causes, helping prioritize improvement efforts.
CNE Quality Control & Process Improvement 3
Which quality framework emphasizes 'structure, process, and outcome' as three domains for evaluating healthcare quality?