What happens when outcomes are not clearly linked to structure and process? (Select all that apply.)
a. There is no clear justification for mandating changes to either structure or process.
b. Structure will not change without evidence as to outcomes.
c. Processes will be altered according to whim and guesswork.
d. Without evidence of clear links, general "bundle" or "package" changes are enacted, and these are less likely to gain staff support than are single changes.
e. Outcomes may be assumed to be reflective of structures and processes that actually are associated with different outcomes.
ANS: A, C, D, E
Donabedian proposed a theory of quality health care and the process of evaluating it.
Its three dimensions are health, subjects of care, and providers of care, and its three objects of evaluation in appraising quality are structure, process, and outcome. Donabedian's theory requires that identified outcomes be clearly linked with the process that caused the outcome.
You might also like to view...
The nurse has four clients that come to the clinic for healthcare. Which one of these clients has the highest risk factor for HIV infection?
A) A 46-year-old female who has been in a monogamous relationship for 9 years B) A 22-year-old heterosexual male who has had one relationship for 2 years C) A 34-year-old female who has donated blood on several occasion D) A 26-year-old inmate who receives tattoos in prison
A nurse is developing a bowel-training program for a client after a stroke. Which interventions are appropriate for inclusion in the plan?
A. Providing privacy and time for defecation B. Assisting the client into a sitting position C. Limiting the amount of fiber in the client's diet D. Providing a cool drink before defecation time E. Initiating defecation measures every day at the same time F. Administering a cathartic suppository a half-hour before defecation time
A nurse teaches a client who is at risk for mild hypernatremia. Which statement should the nurse include in this client's teaching?
a. "Weigh yourself every morning and every night." b. "Check your radial pulse twice a day." c. "Read food labels to determine sodium content." d. "Bake or grill the meat rather than frying it."
When seeking advice involving the patient's right to refuse medication, the nurse should most appropriately consult:
a. a minister or priest. b. the hospital ethics committee. c. the nursing supervisor. d. a more experienced nurse.