A quality committee is investigating repeated delays in giving urgent medicines. Which information is most useful for identifying a system cause?
Correct answer: A. The medication ordering, dispensing and administration steps
- A. The medication ordering, dispensing and administration steps
- B. The name of the nurse who made the most recent delay
- C. The number of nurses who received a warning last year
- D. The personal opinion of one staff member about the incident
Explanation
Reviewing the full medication process can reveal workload, communication, storage or workflow failures. Focusing only on one nurse encourages blame and may fail to correct conditions that affect many staff members.
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About Quality and Patient Safety
Quality and patient safety include standards of care, quality assurance, continuous quality improvement, audits, indicators and patient feedback. The subject also covers medication errors, falls, infections, communication failures, incident reporting, root cause analysis and preventive actions, distinguishing system improvement from assigning blame to an individual.
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