# A unit finds that unlabeled specimens reached the laboratory on 7 of the last 600 collections. Leaders want to mandate a hospital-wide workflow change tomorrow. Complete the performance-improvement statement. > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=525983&lang=en > language: en > subject: Performance Improvement > category: MOC ## Question A unit finds that unlabeled specimens reached the laboratory on 7 of the last 600 collections. Leaders want to mandate a hospital-wide workflow change tomorrow. Complete the performance-improvement statement. The team should first ::선택::identify the staff member involved in the most recent eventstop collecting incident reports until the workflow changesannounce that the intervention has already succeededdefine a measurable aim and establish the baseline process and outcome data, then ::선택::test the defined change on one unit through a small PDSA cyclerequire every hospital unit to change simultaneouslywait until an unlabeled specimen causes permanent harmreplace measurement with informal staff impressions, and before broader spread ::선택::use only one post-change data pointremove balancing measures that could slow adoptionstudy run-chart, process, outcome, and balancing data and adapt the next cycleassume that no new report means the problem is solved. ## Explanation Performance improvement begins with a specific aim and a clear baseline measure. The team should test a defined change on a small scale, collect process and balancing data, and study results over time before adapting, adopting, or spreading the intervention. Immediate system-wide implementation without a test can create unintended workflow problems and makes it harder to learn which component produced the result. ## In-depth explanation Correct Answer Define the aim and baseline, test the change on one unit through a PDSA cycle, and review run-chart and balancing data before spread. Why It Fits Small tests create usable learning while limiting the reach of unintended consequences. Clinical Picture The outcome count identifies a problem, but the team also needs a process measure and a balancing measure such as collection delays or relabeling workload. Memory Link Aim, small test, study, spread: improvement grows from measured learning. NCLEX Rule Do not confuse immediate broad implementation with a completed improvement cycle. Why the Alternatives Fail Blaming one staff member ignores system contributors. Eliminating event reporting hides the signal. A single post-change count cannot show whether an effect is sustained or whether a balancing harm increased. Source 1AHRQ Plan-Do-Study-Act Improvement Cycle 2AHRQ Applying the PDSA Cycle 32026 NCLEX-RN Test Plan ## Clinical scenario The team has identified a measurable safety problem but has not yet tested the proposed change. A small PDSA cycle can reveal workflow effects before broader adoption. ## Key concepts - **PDSA Cycle** — An iterative Plan-Do-Study-Act method used to test, learn from, and refine a change. - **Process Measure** — A measure of whether the steps expected to produce improvement are being performed. - **Balancing Measure** — A measure used to detect whether a change creates an unintended problem elsewhere in the system. ## Related questions - [A nurse manager is discussing patient safety culture with the unit team after a medication…](https://mymerci.kr/pages/nclex_q.php?qn_id=364797&lang=en) - [An RN realizes at 0900 that a pain assessment performed yesterday at 1700 was never docume…](https://mymerci.kr/pages/nclex_q.php?qn_id=372702&lang=en) - [An RN has just completed venipuncture for blood specimens on four assigned patients during…](https://mymerci.kr/pages/nclex_q.php?qn_id=372703&lang=en) - [Review the unit's Plan-Do-Study-Act timeline for reducing specimen-labeling errors and det…](https://mymerci.kr/pages/nclex_q.php?qn_id=394839&lang=en) - [A quality-improvement team is evaluating a central-line infection-prevention project. 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