A nurse is caring for a client who is disoriented and has removed their IV catheter. After observing the RN reinsert the IV catheter, which of the following actions should the nurse take first?

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.

A) The surgeon should delay surgery until he can obtain informed consent from a parent:

This option is not feasible in emergencies where immediate surgical intervention is required to save the client's life or prevent further harm. Delaying surgery could jeopardize the client's health and violate the principle of beneficence, which prioritizes the client's well-being.

B) The client's pediatrician can obtain implied consent:

While pediatricians often play a role in providing medical care to minors, implied consent typically pertains to emergency situations where immediate intervention is necessary, and obtaining consent from a parent or legal guardian is not possible. In this scenario, the surgeon, rather than the pediatrician, would be responsible for obtaining consent.

C) The surgeon can proceed with the surgery by invoking implied consent:

In emergency situations where immediate surgical intervention is required to prevent harm or save a client's life, healthcare providers may proceed with treatment under the doctrine of implied consent. Implied consent assumes that a reasonable person would consent to necessary medical treatment if they were able to do so. However, the specific legal requirements for invoking implied consent may vary depending on jurisdiction and institutional policies.

D) The surgeon can obtain informed consent from the client's adult cousin:

While obtaining consent from a close family member may be necessary in certain situations, such as when a parent is unavailable, it may not be legally sufficient in emergency situations where immediate action is required. Additionally, the legal authority to provide consent may vary depending on the jurisdiction and the client's age. In this scenario, relying on informed consent from the client's adult cousin could delay necessary surgical intervention and may not be appropriate without further legal clarification.