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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Correct Answer is C
Explanation
Choice A rationale
While the application of anti-embolism stockings can be beneficial in preventing deep vein thrombosis in postoperative patients, it is not the most prioritized nursing intervention in the immediate postoperative period for a patient who has undergone a left pneumonectomy. The immediate postoperative period after a pneumonectomy is critical for monitoring and managing potential complications such as respiratory distress, hemorrhage, and bronchopleural fistula.
Choice B rationale
The use of the incentive spirometer is an important nursing intervention for postoperative patients to promote lung expansion and prevent atelectasis. However, in the immediate postoperative period following a pneumonectomy, the priority is to monitor for complications and ensure the stability of the patient.
Choice C rationale
Assessment of the chest tube and pleur-evac is the most prioritized nursing intervention in the immediate postoperative period for a patient who has undergone a left pneumonectomy. After a pneumonectomy, a chest tube is placed to drain air, blood, and fluid from the pleural space to allow the remaining lung to re-expand. It is crucial to monitor the chest tube system for proper functioning and to assess for complications such as excessive bleeding, infection, or pneumothorax.
Choice D rationale
Repositioning the patient in bed is a standard nursing intervention in postoperative care to enhance comfort, promote lung expansion, and prevent complications such as pressure ulcers and deep vein thrombosis. However, it is not the most prioritized intervention in the immediate postoperative period following a pneumonectomy, where monitoring for respiratory complications and ensuring the stability of the patient are paramount.
Correct Answer is C
Explanation
Choice A rationale
While medication errors are indeed considered adverse events, this statement does not fully capture the scope of patient safety and prevention of harm.
Choice B rationale
Errors of execution are usually unintentional, not intentional. They often occur due to system failures rather than time or resource constraints.
Choice C rationale
It is estimated that as many as 90% of medication errors are preventable. This highlights the importance of safety measures and protocols in healthcare settings to prevent harm to patients.
Choice D rationale
Poorly coordinated care and nosocomial infections are examples of errors, but they represent only a fraction of the potential safety issues in healthcare.
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