Patient Safety Indicators & Complications of Care Self-Evaluation

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1) The AHRQ Patient Safety Indicators (PSIs) are all of the following EXCEPT:

a) Avoidable safety events

b) Potential in-hospital complications following surgeries, procedures, and childbirth

c) Help identify opportunities to improve delivery of care

d) Complications of care that penalize physicians if reported

2) Which of the following PSIs is not included in PSI 90?

a) Death following hip fracture

b) Pressure ulcer

c) Postoperative respiratory failure

d) Iatrogenic pneumothorax

3) Which of the following would exclude an inpatient discharge from PSI 06, Iatrogenic Pneumothorax?

a) Admission type is elective

b) Patient > 18 years of age

c) Rib fractures

d) Principal diagnosis of pneumonia

4) PSI-90 is included as a quality measure in which of the following CMS pay for performance programs

a) Hospital Acquired Condition Reduction Program

b) Hospital Readmissions Reduction Program

c) Hospital Value Based Purchasing Program

5) PSI-90 is one of six measures included in the HAC Reduction Program and accounts for what percentage of the total score:

a) 17%

b) 25%

c) 83%

d) PSI-90 has no impact on the score

6) The AHRQ was established in 2003 to develop patient safety measures for CMS.

a) True

b) False

7) A patient is admitted for a bowel obstruction which required a colon resection. Following surgery, the patient developed severe AKI which required temporary dialysis. Which of the following would exclude this from being counted as a complication under PSI 10, Postoperative Acute Kidney Injury Requiring Dialysis?

a) Admission type is emergency

b) Patient > 18 years of age

c) Dialysis occurred two days after surgery

d) Principal diagnosis of colon cancer

8) A patient is admitted with lung cancer for a lobectomy. Following surgery, the patient developed pneumonia and sepsis. Which of the following would result in sepsis being counted as a complication under PSI 13, Postoperative Sepsis?

a) Admission type is elective

b) Secondary diagnosis of sepsis not POA

c) Secondary diagnosis of pneumonia not POA

d) All of the above

e) None of the above

9) A patient is admitted for an elective right hepatic lobectomy for liver mass. Surgery included extensive lysis of adhesions and control of liver hemorrhage with complex sutures. Would assignment of code K91.61, Intraoperative hemorrhage and hematoma of digestive system organ complicating a digestive system procedure result in PSI 09, Postoperative Hemorrhage or Hematoma?

a) Yes, hemorrhage or hematoma that occurs during surgery will result in PSI 09

b) No, this was an elective surgery

c) No, the hemorrhage and control of the hemorrhage occurred during the surgery

d) No, the patient has a bleeding disorder which is a PSI 09 exclusion

10)Guidance for coding complications of care from the Official Coding Guidelines include all of the following EXCEPT:

a) Code assignment is based on the provider’s documentation of the relationship between the condition and the care or procedure unless otherwise instructed by the ICD-10 classification.

b) The provider must document the term “complication” or state that the condition is “due to” or “resulting from” the procedure or care to code a condition as a complication of care.

c) Query the provider for clarification when the documentation is not clear as to the relationship between the condition and the care or procedure.

d) The medical record documentation must support that the complication of care is clinically significant.

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