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A nurse manager along with members of the nurse practice committee are conducting a skills day for assistive personnel in the medical surgical unit to validate competency.

Fire Safety

Objectives:

All Staff will:

Know the location of exits, alarms, fire extinguishers, and oxygen turnoff valves.

Make sure equipment does not block fire doors.

Know the evacuation plan for the unit and the facility.

Enact RACE sequence for fire response.

Remove

Alarm

Confine

Extinguish/Evacuate

Fall Safety

Infection Control

Objectives

The staff will:

Perform proper hand hygiene.

Properly put on and remove personal protective equipment.

Gloves

Gowns

Masks

Properly disinfect patient care equipment

Review levels of precaution (standard, airborne, droplet, contact)

Which skills demonstrated by assistive personnel require immediate follow-up. Select the "3" findings that require immediate follow-up.

AP 1-Quickly pulls fire alarm, then proceeds to remove the client from room. AP 3-Raised bedrails of the bed for client who was reported not alert or oriented, and was sleeping.

AP 2-Verifies with nurse the order in which protective equipment should be removed.

AP 7- While disinfecting portable vital sign monitor wore gloves and washed hand prior to leaving room.

AP 6 - During simulation, which included assisting client into bed, there was no observed handwashing.

AP 5-Following simulation, was unable to identify the locations of alarms on medical surgical unit.

AP 4-Successfully completed skills of simulation including emptying the client's trash can

Answer and Explanation

Correct Answer : A,D,E

A. While pulling the fire alarm is correct, removing the client from the room without following the full RACE sequence (Remove, Alarm, Confine, Extinguish/Evacuate) is incorrect. The immediate safety measures should include ensuring that the alarm is activated before evacuation and confining the fire if possible.

B. Verifying the order of protective equipment removal with the nurse shows a good practice and adherence to proper infection control procedures.

C. Washing hands prior to leaving the room after disinfecting equipment indicates proper infection control practice.

D. Handwashing is a crucial aspect of infection control. Failure to perform hand hygiene during or after patient care increases the risk of infection transmission. Immediate follow-up is needed to ensure that proper hand hygiene practices are adhered to.

E. Knowing the locations of alarms is vital for effective fire safety. Inability to identify these locations indicates a significant gap in preparedness for emergencies. Immediate follow-up is necessary to ensure that staff are familiar with fire safety procedures and equipment locations.

F. Successfully completing the skills in simulation, including emptying the client's trash can, shows adherence to task requirements but is not a critical issue requiring immediate follow-up compared to the other findings.

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Correct Answer is B

Explanation

Rationale:

A. The National Council of State Boards of Nursing Decision Tree provides guidance for decision-making but does not specifically address delegation.

B. The state Nurse Practice Act defines the scope of practice for RNs and LPNs and is essential for understanding what tasks can be delegated.

C. The Omnibus Budget Reconciliation Act of 1987 primarily pertains to nursing home regulations and does not directly address task delegation.

D. The National Association for Practical Nurse Education and Services focuses on LPN education and standards, but the state Nurse Practice Act is more directly relevant to delegation.

A. "I should encourage clients to receive an annual flu immunization." B. "I should wait to empty my client's drainable colostomy until it is three-fourths full." C. "I should recommend that my clients who have an established tracheostomy use sterile technique at home to provide ostomy care." D. "I should delegate providing closed irrigation to the assistive personnel (AP)."

Correct Answer is A

Explanation

Rationale:

A. Encouraging clients to receive an annual flu immunization is a cost-effective measure to prevent illness and reduce overall healthcare costs.

B. Waiting to empty a drainable colostomy until it is three-fourths full might not be the best practice for client comfort or prevention of leakage.

C. Recommending sterile technique for home care is important for infection prevention but not necessarily a cost-reduction strategy in the healthcare setting.

D. Delegating closed irrigation to AP may not be appropriate if it involves tasks beyond their scope of practice and does not directly relate to cost reduction.

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A nurse is planning to delegate tasks to a licensed practical nurse (LPN). Which of the following entities is important for the nurse to understand when delegating tasks to the LPN?

Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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