CPSA CPSA MCQ 4 — Questions and Answers
Question 1: Which metric is commonly used to measure the rate of hospital-acquired conditions (HACs)?
- Case mix index
- Incidents per 1,000 patient-days (Correct answer)
- Average length of stay
- Staff-to-patient ratio
Correct answer: Incidents per 1,000 patient-days
HAC rates are standardly expressed as events per 1,000 patient-days to allow comparison across units and facilities with different census volumes.
Question 2: In TeamSTEPPS, what does the acronym 'CUS' stand for?
- Check, Update, Summarize
- Concerned, Uncomfortable, Safety issue (Correct answer)
- Communicate, Understand, Support
- Critical, Urgent, Stabilize
Correct answer: Concerned, Uncomfortable, Safety issue
CUS (Concerned, Uncomfortable, Safety issue) is a TeamSTEPPS assertive statement tool used to escalate patient safety concerns when normal communication fails.
Question 3: Which of the following is an example of a 'forcing function' in patient safety system design?
- Staff education on correct medication dosing
- A computer alert warning of a drug interaction
- IV tubing that cannot be connected to an enteral port (Correct answer)
- A policy requiring double-checks for high-alert medications
Correct answer: IV tubing that cannot be connected to an enteral port
A forcing function is a physical design constraint that makes it impossible to proceed incorrectly, such as incompatible connectors that prevent wrong-route medication errors.
Question 4: The AHRQ Hospital Survey on Patient Safety Culture (HSOPSC) is PRIMARILY used to:
- Report adverse events to regulatory agencies
- Measure staff perceptions of patient safety climate (Correct answer)
- Calculate a hospital's overall patient safety score for public reporting
- Identify individual staff members responsible for errors
Correct answer: Measure staff perceptions of patient safety climate
The HSOPSC measures staff perceptions about patient safety culture dimensions such as teamwork, communication openness, and management support for safety.
Question 5: A patient receives a 10-fold overdose of a medication due to a decimal point error. This is BEST classified as:
- A near miss
- A sentinel event (Correct answer)
- An adverse drug reaction
- A latent error
Correct answer: A sentinel event
A 10-fold overdose causing patient harm meets the definition of a sentinel event—an unexpected occurrence involving death or serious physical or psychological injury.
Question 6: Which of the following BEST supports a culture of safety rather than a blame culture?
- Disciplining all staff involved in adverse events
- Requiring staff to sign acknowledgment of error reports
- Encouraging anonymous voluntary incident reporting (Correct answer)
- Publishing staff names in safety event summaries
Correct answer: Encouraging anonymous voluntary incident reporting
Anonymous voluntary reporting systems reduce fear of punishment, encouraging staff to report near misses and errors so systemic issues can be identified and corrected.
Question 7: During an RCA, the team identifies that the event was caused by fatigue from excessive on-call shifts. This is BEST categorized as:
- An active error
- A patient-related factor
- A contributory factor at the staff level
- A latent organizational factor (Correct answer)
Correct answer: A latent organizational factor
Excessive on-call scheduling is an organizational/management decision that creates latent conditions (fatigue) predisposing staff to active errors.
CPSA CPSA MCQ 4
Which metric is commonly used to measure the rate of hospital-acquired conditions (HACs)?