A nurse is searching for a new job. Which of the following is a good recommendation for a nurse who is searching for a job using the internet?

A. To facilitate weaning off the mechanical ventilator. While PEEP is an important component of mechanical ventilation, its primary function is not to facilitate weaning. Instead, it improves oxygenation by preventing alveolar collapse. Weaning involves gradually reducing ventilatory support, but PEEP is typically adjusted based on oxygenation needs rather than as a direct step in weaning.
B. To decrease trapped oxygen in the alveoli. PEEP does not decrease trapped oxygen; instead, it maintains alveolar patency and prevents atelectasis. In conditions like ARDS, alveoli tend to collapse due to fluid accumulation and inflammation, and PEEP helps counteract this collapse to improve gas exchange. Reducing "trapped" oxygen is not a function of PEEP.
C. To promote independent breathing efforts. PEEP itself does not promote spontaneous breathing; instead, it provides positive pressure at the end of exhalation to improve oxygenation. In fact, high levels of PEEP can suppress spontaneous breathing by increasing intrathoracic pressure, requiring careful adjustment to balance oxygenation and ventilatory effort.
D. To keep the airways and small lung spaces open. PEEP prevents alveolar collapse by maintaining positive pressure in the lungs at the end of expiration. This improves oxygenation and gas exchange, which is critical in ARDS, where alveoli are prone to collapse due to inflammation and fluid accumulation. Keeping alveoli open reduces shunting and improves oxygen delivery to tissues.

A. Develop a quality improvement program for nurses involved in medication administration errors. While quality improvement programs are essential, implementing a targeted program without first analyzing the root causes of errors may not effectively address the underlying issues. A broader review of system-wide factors contributing to medication errors is necessary before designing an intervention.
B. Require staff nurses to demonstrate competency by passing a medication administration examination. Competency assessments may help identify knowledge gaps, but they do not address system-based errors such as workload issues, unclear protocols, or distractions during medication administration. A root cause analysis should be conducted first to ensure that interventions target the actual sources of errors.
C. Provide an inservice on medication administration to all the nurses. Educational sessions can reinforce safe practices, but without identifying the specific factors contributing to errors, they may not be effective. Training should be tailored to address the findings from an initial review of the medication errors.
D. Review the events leading up to each medication administration error. The first step in continuous quality improvement is conducting a thorough analysis of the errors, identifying patterns, and determining root causes. This helps in designing targeted interventions, whether they involve process changes, additional training, or improved safety protocols.