A nurse is attending a quality improvement meeting. Which of the following actions should the nurse take first when initiating a quality improvement program to address health care-associated infections?

Incorporate the process change into daily practice within the facility.

Determine if the implemented change has lowered the current infection rate.

Select a potential intervention to lower the current infection rate.

Identify current infection rates from facility data.

Answer and Explanation

The Correct Answer is D

A) Incorporate the process change into daily practice within the facility: While incorporating process changes is an essential step in quality improvement, it should not be the first action taken. Before implementing changes, it is crucial to gather data and identify areas for improvement to ensure that interventions are targeted and effective.

B) Determine if the implemented change has lowered the current infection rate: Assessing the effectiveness of interventions is an important aspect of quality improvement, but it should occur after identifying baseline data and implementing interventions. Without baseline data, it is challenging to determine the impact of changes accurately.

C) Select a potential intervention to lower the current infection rate: While selecting interventions is a necessary step in quality improvement, it should follow the identification of current infection rates and areas for improvement. Without data on current infection rates, it is difficult to select appropriate interventions.

D) Identify current infection rates from facility data: This is the correct first action when initiating a quality improvement program to address healthcare-associated infections. Gathering data on current infection rates provides a baseline for assessing the problem's magnitude and identifying areas for improvement. It allows healthcare providers to target interventions effectively and evaluate their impact over time.

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Correct Answer is C

Explanation

A) Tying the restraint to the bed frame: This action is appropriate and ensures that the restraint is anchored securely to the bed frame, preventing the client from removing it independently. Tying the restraint to the bed frame is a standard practice to maintain the client's safety.

B) Applying the restraint over the client's gown: While it's generally preferable to apply restraints directly to the client's skin to minimize movement and ensure effectiveness, applying the restraint over the gown is acceptable in some situations. However, it's essential to ensure that the restraint is snug and properly secured to prevent the client from slipping out of it.

C) Placing the restraint across the client's chest: Placing the restraint across the client's chest is not recommended because it can restrict chest expansion and interfere with breathing, potentially leading to respiratory compromise. Restraints should be applied to minimize movement while allowing the client to breathe comfortably.

D) Using a quick-release knot to secure the restraint: Using a quick-release knot is essential when applying restraints to ensure that they can be quickly removed in case of an emergency or if the client experiences distress. This promotes client safety and allows for rapid intervention if needed.

A. "My attorney will need to notarize the document." B. "I have to choose a member of my family to be my health care surrogate." C. "Once the form is notarized, it cannot be changed." D. "My health care surrogate can decide my treatment if I am unable to."

Correct Answer is D

Explanation

A. "My attorney will need to notarize the document."

This statement indicates a misunderstanding of advance directives. Notarization by an attorney is not a requirement for advance directives. While legal advice may be helpful in completing advance directive documents, notarization by an attorney is not necessary for their validity.

B. "I have to choose a member of my family to be my health care surrogate."

This statement is incorrect. While a family member can serve as a health care surrogate if chosen by the individual, there is no requirement to select a family member. The individual can choose any competent adult to act as their health care surrogate, regardless of familial relationship.

C. "Once the form is notarized, it cannot be changed."

This statement is incorrect. Advance directive documents can be changed or revoked at any time by the individual as long as they are of sound mind and able to make decisions. Notarization does not prevent changes or revisions to the document.

D. "My health care surrogate can decide my treatment if I am unable to."

Correct. This statement demonstrates an understanding of advance directives. A health care surrogate, also known as a health care proxy or durable power of attorney for health care, is a person chosen by an individual to make medical decisions on their behalf if they become unable to do so. This includes decisions about medical treatment, procedures, and end-of-life care.

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A nurse is attending a quality improvement meeting. Which of the following actions should the nurse take first when initiating a quality improvement program to address health care-associated infections?

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