A nurse is teaching a group of newly hired nurses about evidence-based practice. The nurse should include which of the following as the first step in the process?

Choice A reason: The state nurse practice act is an appropriate resource for the nurse to consult in planning for this policy. The state nurse practice act defines the scope of practice and the legal authority for nurses in each state. The nurse should ensure that the policy is consistent with the state regulations and does not exceed the nurse's level of competence and education.

Choice B reason: The ANA Standards of Practice are not the most appropriate resource for the nurse to consult in planning for this policy. The ANA Standards of Practice describe the expectations and responsibilities for the professional nursing practice, such as assessment, diagnosis, outcome identification, planning, implementation, and evaluation. The standards are general and broad, and do not provide specific guidance on the procedure of removing chest tubes.

Choice C reason: The ANA Code of Ethics is not the most appropriate resource for the nurse to consult in planning for this policy. The ANA Code of Ethics outlines the ethical principles and values that guide the nursing practice, such as respect, autonomy, beneficence, nonmaleficence, justice, fidelity, and veracity. The code does not address the technical or legal aspects of removing chest tubes.

Choice D reason: The Institute of Medicine is not the most appropriate resource for the nurse to consult in planning for this policy. The Institute of Medicine is an independent, nonprofit organization that provides evidence-based recommendations and research on health care issues, such as quality, safety, and innovation. The institute does not regulate or define the nursing practice or scope.

Choice A reason: Reassigning the AP to other clients on the unit is not an appropriate action for the nurse to take. This action does not address the issue of the breach of client confidentiality, and it may disrupt the continuity of care for the clients. The nurse should not punish the AP without giving them feedback and education.

Choice B reason: Instructing the AP to discontinue the conversation is an appropriate action for the nurse to take. This action stops the violation of client confidentiality and protects the client's privacy and dignity. The nurse should also remind the AP of the ethical and legal principles of confidentiality, and the consequences of violating them.

Choice C reason: Completing an incident report about the breach of client confidentiality is not an appropriate action for the nurse to take. This action is not necessary, as the breach was not intentional or harmful to the client. The nurse should document the incident in the AP's performance evaluation, and provide guidance and coaching to prevent future occurrences.

Choice D reason: Notifying the client's provider about the incident is not an appropriate action for the nurse to take. This action is not relevant, as the provider is not responsible for the AP's behavior or education. The nurse should notify the AP's supervisor or manager, and collaborate with them to address the issue.