A nurse is reviewing a client's clinical pathway upon discharge following hip arthroplasty. Which of the following information can assist the nurse in evaluating the cost effectiveness of the care?

Answer is: Wear an N95 respirator mask when in the client’s room.

Explanation: Pulmonary tuberculosis (TB) is a contagious disease caused by bacteria that can spread through the air. The most common way of transmission is through respiratory droplets that are expelled when a person with active TB coughs, sneezes, or speaks1. Therefore, the charge nurse should expect the newly licensed nurse to take precautions to protect themselves and the client from exposure to TB. One of these precautions is to wear an N95 respirator mask when in the client’s room2. An N95 respirator mask is a type of personal protective equipment (PPE) that filters out at least 95% of airborne particles, including bacteria and viruses3. It can prevent the nurse from inhaling or spreading TB to others.

The other options are incorrect because:

Place the client on droplet precautions: Droplet precautions are not enough to prevent transmission of TB, as they only protect against respiratory droplets that are less than 5 micrometers in diameter1. However, TB bacteria can be found in larger droplets that can travel farther and infect people who are not in direct contact with the source1.
Place the client in a room with positive-pressure airflow: Positive-pressure airflow is not effective against TB, as it does not reduce the concentration of airborne particles or prevent them from escaping through cracks and gaps in doors and windows. Moreover, positive-pressure airflow can create negative pressure in other areas of the facility, which can increase the risk of cross-contamination.
Wear a surgical mask when taking the client out of the room: A surgical mask is not sufficient to protect against TB, as it only filters out particles that are larger than 5 micrometers in diameter3. It also does not fit properly on the face and may allow some particles to pass through3.

Choice A rationale:

Role model a positive approach to the changes. Rationale: The correct choice. As a charge nurse, leading by example is crucial. Demonstrating a positive attitude toward the changes sets a tone for the unit and encourages staff members to approach the situation with an open mind.

Choice B rationale:

Redirect the conversation when staff members make negative comments about the changes. Rationale: The correct choice. Addressing negativity and redirecting the conversation helps maintain a constructive and respectful work environment. This approach allows for open dialogue while discouraging excessive negativity that can hinder the adaptation process.

Choice C rationale:

Encourage staff members who support the changes to discuss the issue with resistant staff. Rationale: While encouraging open communication is important, it might not be sufficient to address the resistance completely. The charge nurse should take a more active role in managing negativity and facilitating a positive transition.

Choice D rationale:

Suggest that resistant staff members transfer to a different unit. Rationale: Transferring staff members might not be a productive solution and can lead to further discord within the unit. It's important to address the issues within the current team before considering such drastic measures.

Choice E rationale:

Reprimand staff members who are resistant to the changes. Rationale: Adopting a punitive approach can escalate tensions and foster a negative work environment. It's better to focus on positive reinforcement and facilitating open conversations to manage resistance effectively.