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A nurse is a member of a quality-improvement committee seeking to reduce the risk of adverse events in a health care facility. When reviewing recently submitted incident reports, which of the following incidents should the nurse identify as a sentinel event?
- A. Surgery to the wrong site was stopped prior to a procedure.
- B. Paralysis of a client's lower extremities occurred following epidural anesthesia.
- C. A client fall during ambulation did not result in client injury.
- D. A complaint that a nurse was culturally insensitive was made by a client's family member.
Correct Answer: B
Rationale: The correct answer is B: Paralysis of a client's lower extremities occurred following epidural anesthesia. This incident should be identified as a sentinel event because it resulted in a serious harm or death to the patient. Sentinel events are defined as unexpected occurrences involving death or serious physical or psychological injury. In this case, the paralysis of the client's lower extremities following epidural anesthesia qualifies as a serious physical injury. The other choices do not meet the criteria for a sentinel event: A did not result in harm, C did not result in client injury, and D involves a complaint of cultural insensitivity which, while important, does not meet the criteria of a sentinel event.
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A charge nurse notes that a staff nurse delegates an unfair share of tasks to the assistive personnel (AP) and the nurses on next shift report the staff nurse frequently leaves tasks uncompleted. Which of the following statements should the charge nurse make to resolve this conflict?
- A. I need to speak with you about unit expectations regarding delegating and completing tasks.
- B. You have been very inconsiderate of others by not completing your share of the work.
- C. If you don't do your share of the work, I will have to inform the nurse manager.
- D. Several staff members have commented that you don't do your fair share of the work.
Correct Answer: A
Rationale: The correct answer is A: "I need to speak with you about unit expectations regarding delegating and completing tasks." This statement addresses the issue directly and professionally, focusing on establishing clear communication and setting expectations. By having a conversation about unit expectations, it allows for clarification on roles and responsibilities, promoting accountability and teamwork.
Incorrect Choices:
B: This statement uses accusatory language and does not address the issue constructively.
C: Threatening to inform the nurse manager may escalate the conflict instead of resolving it through open communication.
D: This choice involves hearsay and gossip, which is not an effective way to address the issue professionally.
A nurse manager has recently become aware of a conflict between the pharmacy and the staff nurses regarding sending and receiving medications. Which of the following actions should the nurse take first to resolve the conflict?
- A. Evaluate the results.
- B. Identify the problem.
- C. Brainstorm solutions.
- D. Implement a resolution.
Correct Answer: B
Rationale: The correct answer is B: Identify the problem. The first step in resolving any conflict is to understand the root cause. By identifying the problem between the pharmacy and staff nurses, the nurse manager can gain insight into the specific issues causing the conflict. This step allows for a targeted and strategic approach to finding solutions. Evaluating results (A) comes after implementing a resolution, brainstorming solutions (C) is premature without a clear understanding of the problem, and implementing a resolution (D) should only occur once the problem has been fully identified and a plan developed.
A nurse in an acute care setting is serving on a committee whose charge is to use the auditing process to client care. Which of the following aspects of client care is measured by an outcome audit?
- A. Incidence of catheter-induced urinary tract infections.
- B. Nursing staff ratios.
- C. Availability of resources, such as fire extinguishers.
- D. Quality of nursing care provided.
Correct Answer: A
Rationale: The correct answer is A because an outcome audit measures the results or outcomes of client care, such as the incidence of catheter-induced urinary tract infections. This type of audit evaluates the effectiveness of the care provided and focuses on patient outcomes. Choices B and C are incorrect as they pertain to process audits, which assess how care is delivered and the availability of resources, respectively. Choice D is incorrect because it is too broad and does not specifically address a measurable outcome. Choices E, F, and G are not provided, but they would likely be incorrect unless they specifically relate to measurable outcomes of client care.
The Rehabilitation Unit at Pleasant Valley Hospital has a high number of falls. What interventions might assist to reduce the number of falls on the unit?
- A. Restrain patients at risk for falls.
- B. Recognize that errors are solely the result of the actions of individual people.
- C. Provide an in-service that informs nurses of the current, best practices of fall prevention.
- D. Punish the staff who are caring for the patients who fall.
Correct Answer: C
Rationale: The correct answer is C: Provide an in-service that informs nurses of the current, best practices of fall prevention. This intervention is effective because education and training on fall prevention strategies empower staff to implement evidence-based practices to reduce falls. Restraint (Choice A) is not recommended as it can lead to physical and psychological harm. Blaming individuals (Choice B) does not address systemic issues. Punishing staff (Choice D) creates a culture of fear and does not promote learning or improvement.
A manager notes that the incidence of medication errors has increased since the implementation of staffing changes. What strategy should the manager consider to reduce errors?
- A. Deter mistakes by emphasizing the consequences of committing a medication error.
- B. Include the bedside nurses in the decision-making process involving their practice.
- C. Encourage nurses who commit medication errors to file incident reports, placing them in the patient's chart.
- D. Relinquish responsibility by asking a separate department to oversee quality improvement.
Correct Answer: B
Rationale: The correct answer is B: Include the bedside nurses in the decision-making process involving their practice. By involving the nurses in decision-making, the manager can gain valuable insights into the root causes of the medication errors and collaboratively develop solutions to address them. This participatory approach fosters ownership, accountability, and engagement among the nurses, leading to a sense of empowerment and motivation to improve patient care.
A: Deter mistakes by emphasizing the consequences of committing a medication error - This approach may create a culture of fear and discourage open communication about errors, hindering the identification and resolution of underlying issues.
C: Encourage nurses who commit medication errors to file incident reports, placing them in the patient's chart - While incident reporting is important for learning from errors, placing them in the patient's chart may not address the systemic issues contributing to the errors.
D: Relinquish responsibility by asking a separate department to oversee quality improvement - This approach shifts accountability away from the nursing staff and may not effectively address