A nurse is caring for a client at risk for atelectasis. Which independent nursing measure should the nurse prioritize to prevent atelectasis development?

A. The number of medication errors committed by another nurse. Quality improvement focuses on systemic issues rather than individual performance. Addressing medication errors should involve evaluating factors such as workflow inefficiencies, high workloads, or unclear protocols rather than singling out a specific nurse. Identifying system-wide improvements enhances patient safety more effectively.
B. Systems that make it difficult for the nurses to do their job. Quality improvement initiatives aim to identify and correct systemic barriers that hinder nursing efficiency and patient care. Issues such as inadequate staffing, poor communication, or outdated technology can lead to errors and inefficiencies. Addressing these barriers can improve workflow, reduce mistakes, and enhance patient outcomes.
C. Collective bargaining activity at a nearby hospital. Discussions about union activities or labor disputes are not directly related to quality improvement. While working conditions can impact patient care, this topic is more relevant to human resources or labor relations than a quality improvement committee focused on systemic patient safety issues.
D. How unhappy the nurses are with their current pay. While job satisfaction is important, a quality improvement committee focuses on patient safety, workflow efficiency, and care outcomes. Salary concerns are best addressed through administration or labor negotiations rather than a committee designed to implement clinical and operational improvements.

A. An adverse event. An adverse event is an unintended injury or complication resulting from medical care rather than the patient’s underlying condition. In this case, the surgical site infection (SSI) developed as a complication of surgery, requiring additional treatment. While adverse events may prolong recovery, they do not always indicate negligence or preventability.
B. A never event. Never events are serious, preventable medical errors that should not occur under proper care, such as surgery on the wrong site, retained surgical instruments, or administering the wrong medication. While SSIs are concerning, they are not classified as never events because they can occur even when proper precautions are taken.
C. A near miss. A near miss refers to an event that could have caused harm but was prevented before reaching the patient. Since the infection did occur and required intervention, it does not qualify as a near miss. A near miss example would be identifying and correcting a medication error before administration.
D. A sentinel event. Sentinel events involve unexpected occurrences that result in serious injury, permanent harm, or death, such as patient suicide, wrong-site surgery, or a fatal medication error. Although the infection required prolonged treatment, it did not lead to severe harm or death, making it an adverse event rather than a sentinel event.