Improving Patient Safety in Long-Term Care Facilities

Part 1. Pre/Post-Test Questions

1. What is the best environment that allows you to pick up on a change in a resident's condition?
   1. An environment where providers are 'tuned in' to the residents.
   2. One where staff are punished for reporting safety concerns.
   3. One where people only feel comfortable to report anonymously.
   4. One in which only supervisors/leadership may address concerns about residents.
2. Mr. L has been in the [LTC facility] for a month. He has a pressure ulcer that developed weeks ago and measurements are about the same as last week. The nurse should:
   1. Make no mention of it at report.
   2. Mention it at report, noting that it is unchanged, and when the nurse/doctor will next review the situation.
   3. Tell Mr. L to 'eat more and fatten up a bit!'
   4. Talk critically about the resident's care privately to coworkers.
3. Which of the following are part of gauging a resident's normal patterns:
   1. Talking with the resident about things that are important to the resident.
   2. Assessment of consciousness and function.
   3. Reviewing the resident's health record.
   4. All of above.
4. You notice that another nurse's resident, who is in the room near where you are to see to your resident, is angrily demanding his lunch. You are surprised because he is usually quiet and patient. Which of the following is the best next step?
   1. You ask the licensed nurse if she has noticed any change in his mood or behavior, and if she has asked him how he is feeling.
   2. You go to the resident and ask how he is feeling.
   3. You ask the resident what is wrong, telling him you will check on his lunch, and then notify the licensed nurse responsible for the resident about the possible change in condition.
   4. You do nothing, as this is the first time it has occurred.
5. The Early Warning tool reminds you to do the following things, except?
   1. Notice whether the resident seems different than usual.
   2. Check whether the resident ate less than usual.
   3. Assess the resident's capacity to make a decision.
   4. Notice whether the resident seems more agitated or nervous than usual.
6. What protocol does the SBAR tool ask you to follow?
   1. Situation-Blame-Argue-Resolve.
   2. Situation-Background-Assessment-Recommendation.
   3. Situation-Background-Alleviate-Resolve.
   4. Solve-No Blame-Assessment-Resolve.
7. If you notice a sudden change in a resident's condition, what should the nursing assistant do?
   1. Notify a supervisor.
   2. Document it in the resident's record.
   3. Check with a co-worker about any previous history of similar events.
   4. All of the above.

Part 2. Pre/Post-Test Questions with Answers

1. What is the best environment that allows you to pick up on a change in a resident's condition?
   1. An environment where providers are "tuned in" to the residents.
   2. One where staff are punished for reporting safety concerns.
   3. One where people only feel comfortable to report anonymously.
   4. One in which only supervisors/leadership may address concerns about residents.

   Answer: a

2. Mr. L has been in the [LTC facility] for a month. He has a pressure ulcer that developed weeks ago and measurements are about the same as last week. The nurse should:
   1. Make no mention of it at report.
   2. Mention it at report, noting that it is unchanged, and when the nurse/ doctor will next review the situation.
   3. Tell Mr. L to 'eat more and fatten up a bit!'
   4. Talk critically about the resident's care privately to coworkers.

   Answer: b

3. Which of the following are part of gauging a resident's normal patterns:
   1. Talking with the resident about things that are important to the resident.
   2. Assessment of consciousness and function.
   3. Reviewing the resident's health record.
   4. All of above.

   Answer: d

4. You notice that another nurse's resident, who is in the room near where you are to see to your resident, is angrily demanding his lunch. You are surprised because he is usually quiet and patient. Which of the following is the best next step?
   1. You ask the licensed nurse if she has noticed any change in his mood or behavior, and if she has asked him how he is feeling.
   2. You go to the resident and ask how he is feeling.
   3. You ask the resident what is wrong, telling him you will check on his lunch, and then notify the licensed nurse responsible for the resident about the possible change in condition.
   4. You do nothing, as this is the first time it has occurred.

   Answer: c

5. The Early Warning tool reminds you to do the following things except?
   1. Notice whether the resident seems different than usual.
   2. Check whether the resident ate less than usual.
   3. Assess the resident's capacity to make a decision.
   4. Notice whether the resident seems more agitated or nervous than usual.

   Answer: c

6. What protocol does the SBAR tool ask you to follow?
   1. Situation-Blame-Argue-Resolve.
   2. Situation-Background-Assessment-Recommendation.
   3. Situation-Background-Alleviate-Resolve.
   4. Solve-No Blame-Assessment-Resolve.

   Answer: b

7. If you notice a sudden change in a resident's condition, what should the nursing assistant do?
   1. Notify a supervisor.
   2. Document it in the resident's record.
   3. Check with a co-worker about any previous history of similar events.
   4. All of the above.

   Answer: d