A nurse is contributing to the plan of care for a client who has had HIV for 10 years and is at the end of life. Which of the following interventions should the nurse recommend?

Explanation:

A. Improve communication among staff members:

This is an important goal related to patient safety as effective communication is crucial for providing safe and coordinated care. Improving communication helps prevent errors and ensures that critical information is shared among healthcare team members.

B. Correctly identify clients prior to administering medications:

This is a key patient safety goal as medication errors can have serious consequences for patients. Ensuring the correct identification of clients before medication administration helps prevent medication errors and enhances patient safety.

C. Increase job satisfaction for staff members:

While job satisfaction is important for staff well-being, it is not directly related to the National Patient Safety Goals. The NPSGs primarily focus on specific actions and protocols aimed at improving patient safety outcomes.

D. Educate clients about health promotion and prevention:

While patient education is valuable, it is not a specific National Patient Safety Goal. The NPSGs are typically focused on systematic changes and protocols within healthcare organizations to enhance patient safety.

E. Prevent catheter-associated urinary tract infections in clients:

This is a relevant National Patient Safety Goal as healthcare-associated infections, including catheter-associated urinary tract infections (CAUTIs), are a significant patient safety concern. Implementing strategies to prevent CAUTIs aligns with the NPSGs' goal of reducing healthcare-associated infections.

Explanation:

A. Administer the Hamilton depression scale:

The Hamilton Depression Rating Scale is a tool used to assess the severity of depression symptoms in individuals. While assessing the client's depression level is an important aspect of mental health assessment, it is not the immediate priority in this scenario. The client has been admitted following a suicide attempt, indicating an acute risk to their safety. Therefore, the priority at this stage is to ensure the client's safety and prevent any further harm or attempts at self-harm.

B. Make a contract with the client for weight gain:

Making a contract with the client for weight gain, especially in the context of anorexia nervosa, may be an important aspect of the client's overall treatment plan. However, in this scenario, the client's immediate safety takes precedence. The client has a history of depression, substance abuse, and anorexia nervosa, and the primary concern at admission is to prevent any further self-harm or suicide attempts.

C. Review the client's toxicology laboratory report:

Reviewing the client's toxicology laboratory report is important for understanding any recent substance abuse and its potential impact on the client's physical and mental health. However, while this information is relevant to the client's overall care, it is not the first action to take upon admission. The immediate priority is to ensure the client's safety and provide appropriate monitoring and intervention to prevent further harm.

D. Initiate one-to-one nursing observation:

This is the correct answer. Initiating one-to-one nursing observation means assigning a dedicated nurse to continuously monitor and supervise the client closely. This level of observation is crucial in a situation where there is a history of suicide attempt and ongoing risk of self-harm. One-to-one observation allows for immediate intervention if the client shows signs of distress or attempts to harm themselves, ensuring their safety while they are in the acute mental health unit.