A nurse is part of a Continuous Quality Improvement (CQI) committee tasked with developing a program to decrease medication administration errors following a sentinel event.
Which strategy should the committee consider implementing first?
Require nurses to demonstrate competency by passing a medication administration test.
Review the circumstances leading up to each medication error.
Develop a quality improvement program for nurses involved in medication errors.
Conduct an in-service training on medication administration for all nurses.
The Correct Answer is B
Choice A rationale
While ensuring that nurses demonstrate competency by passing a medication administration test is important, it is not the first step in developing a program to decrease medication administration errors. This strategy focuses on the individual skills of the nurses, but does not address the systemic issues that may have contributed to the errors.
Choice B rationale
Reviewing the circumstances leading up to each medication error is the first step in understanding why the errors occurred. This process allows the committee to identify patterns and common factors that contribute to errors. It is a crucial step in the development of effective strategies to prevent future errors.
Choice C rationale
Developing a quality improvement program for nurses involved in medication errors is a strategy that could be implemented after understanding the root causes of the errors. This approach ensures that the program addresses the specific issues that led to the errors.
Choice D rationale
Conducting an in-service training on medication administration for all nurses is a valuable strategy for preventing medication errors. However, it should be based on the findings from the review of the circumstances leading up to each error. Therefore, it is not the first strategy to consider.
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Related Questions
Correct Answer is B
Explanation
Choice A rationale
Collective bargaining activity at a nearby hospital may be of interest, but it is not directly related to the quality improvement of the unit.
Choice B rationale
Systems that make it difficult for the nurses to do their job directly impact the quality of care provided in the unit. Addressing these issues can lead to improvements in workflow, patient care, and nurse satisfaction.
Choice C rationale
While nurse pay is an important issue, it is typically addressed through human resources or union negotiations, not a unit-based quality improvement project.
Choice D rationale
The number of medication errors committed by another nurse is a serious concern, but it is a specific personnel issue. It should be addressed, but it may not reflect the overall quality of the unit.
Correct Answer is B
Explanation
Choice A rationale
While it is important to monitor oxygen use to prevent hypoxia and hypercapnia, taking breaks from oxygen use is not typically recommended for clients with COPD. These clients often require supplemental oxygen to maintain adequate oxygen saturation.
Choice B rationale
Maintaining a low flow rate of oxygen is crucial in clients with COPD. These clients are often “CO2 retainers,” and administering a high concentration of oxygen can suppress their respiratory drive, leading to further CO2 retention and respiratory distress.
Choice C rationale
While it is important to assess for signs of skin breakdown in clients receiving oxygen therapy, this is not the priority when administering nasal oxygen to a client with COPD38.
Choice D rationale
Clients should not adjust their oxygen flow rate without medical supervision. Increasing the oxygen flow rate can lead to hyperoxia, which can be harmful, especially in clients with COPD who are CO2 retainers.
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