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PS 102: From Error to Harm Questions
and Answers Rated A
Which of the following is a latent unsafe condition in the system that contributes to the resident's error? ✔✔Long work schedule
To prevent this problem from happening again, which of the following would be the best course of action? ✔✔Develop a system that prevents messy handwriting from causing miscommunication that leads to error.
"Latent errors" are best defined as: ✔✔Defects in the design and organization of processes and systems
What is the active error in this scenario? ✔✔The nurse administers an antibiotic to Ms. Tyler and a sedative to Ms. Taylor.
What is one of the latent errors in this scenario? ✔✔The forms are completed by hand at the same time for different patients
According to James Reason, by definition an "unsafe act" always includes: ✔✔A potential hazard
This is an example of what type of error? ✔✔Lapse
This is an example of what type of unsafe act? ✔✔Violation
Which of the following is the most significant advantage of shifting to a systems view of safety within health care? ✔✔It allows us to change the conditions under which humans work
What type of error is this intervention best designed to address? ✔✔Lapse
What intervention helped prove that catheter-associated bloodstream infections (CLABSIs) were preventable consequences of care? ✔✔A checklist of evidence-based practices applied consistently and collectively every time a catheter is used
What is one reason that patient safety has shifted to work on reducing harm in addition to preventing errors? ✔✔Harm is more preventable than providers once thought.
