Process Improvement to Enhance Quality in a Large Volume Labor and Birth Unit

TEST INSTRUCTIONS

* Read the article. The test for this CE activity can only be taken online at http://www.nursingcenter.com/ce/MCN. Tests can no longer be mailed or faxed.

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* There is only one correct answer for each question. A passing score for this test is 12 correct answers. If you pass, you can print your certificate of earned contact hours and access the answer key. If you fail, you have the option of taking the test again at no additional cost.

* For questions, contact Lippincott Williams & Wilkins: 1-800-787-8985.

* Registration Deadline: December 31, 2018.

DISCLOSURE STATEMENT:

The author and planners have disclosed no potential conflicts of interest, financial or otherwise.

PROVIDER ACCREDIDATION:

Lippincott Williams & Wilkins, publisher of MCN, The American Journal of Maternal/Child Nursing, will award 2.5 contact hours for this continuing nursing education activity.

Lippincott Williams & Wilkins is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 2.5 contact hours. Lippincott Williams & Wilkins is also an approved provider of continuing nursing education by the District of Columbia, Georgia, and Florida, CE Broker #50-1223. Your certificate is valid in all states.

PAYMENT:

The registration fee for this test is $24.95.

CE TEST QUESTIONS

General Purpose:

To present the results of a study done to evaluate the use of the LEAN process to plan and implement changes that would improve the patients' experience during labor and birth.

Learning Objectives/Outcomes:

After reading this article and taking this test, you will be able to

1. Identify the methods and goals of this process improvement project.

2. Outline the authors' findings and any implications for practice.

1. The LEAN process is based on the premise that which of the following could achieve rapid improvement in multiple care processes?

a. leadership

b. experience

c. teamwork

2. Value in health care is based on the perspective of the

a. managers.

b. customers.

c. nurses.

3. In a LEAN leadership environment, the experts are those who

a. perform the work.

b. direct the work.

c. evaluate the work.

4. The quality improvement team set a goal for labor induction to start within how many minutes of the patient's arrival?

a. 30

b. 60

c. 90

5. One of the barriers to on-time scheduled cesarean cases was identified as

a. missing required laboratory data and results.

b. waiting for physicians to return pages.

c. lacking a standard process for the admission in the electronic medical record (EMR).

6. For the purposes of this study, start time for the induction was defined as the time

a. the woman arrived in the OR.

b. the induction agent was started.

c. the physician arrived in the OR.

7. Medical aliases are used in this facility

a. for women unable to communicate.

b. to prevent identity theft from the EMR.

c. to safeguard victims of domestic violence.

8. To help minimize the time spent waiting for food trays to be delivered and patients eating, the team proposed

a. stocking food on the OB triage unit.

b. having patient' families provide or obtain food.

c. discouraging patients from eating until after disposition.

9. The solution implemented to solve the problem of time spent looking for wheelchairs for patients was

a. labeling wheelchairs brightly with "property of triage" signage.

b. initiating a budget increase for procuring additional wheelchairs.

c. having nurses from the labor and birth unit bring wheelchairs when picking up patients.

10. Which of the following changes saved the most LOS time per patient?

a. not offering patients a meal from the hospital menu

b. making appointments for patients in the perinatal testing center

c. not looking for wheelchairs to transfer patients to the labor and birth units

11. The authors found that the main reason scheduled cesareans did not start on time was

a. physician's unavailability.

b. patients' late arrivals.

c. inadequate epidural blocks.

12. After full implementation of the changes, OR cases started on time what percentage of the time?

a. 52%

b. 63%

c. 74%

13. The newly created "Add On Team" was made up of

a. nurses that were already staffed to help in the OR.

b. nurse managers who took turns relieving labor unit nurses.

c. patient care assistants to transport patients from triage to the labor and birth units.

14. The hardest part of a project like cleaning and organizing the entire labor and birth unit is

a. sorting.

b. standardization.

c. sustainment.

15. The group work for the process implemented in this study requires

a. collaboration.

b. complex data analysis.

c. sophisticated research methodology.

16. Key aspects of the role of the facilitator include

a. owning the entire process.

b. defining the non-negotiables of the project.

c. supporting all team members during the stages of the process.