A nurse manager is evaluating a quality improvement initiative for reducing health care-associated infections. Which of the following findings indicate the initiative is effective?

A. Gently squeeze the tubing to remove excess drainage: Squeezing the tubing is not recommended as it could cause injury or increase pressure within the system. The nurse should not manipulate the tubing in this way, as it does not address the continuous bubbling.
B. Raise the drainage system to the client's chest level: The drainage system should always be below the level of the client's chest to promote proper drainage. Raising the system to chest level could disrupt the drainage process and cause complications.
C. Clamp the tubing to check for air leaks: Continuous bubbling in the water seal chamber may indicate an air leak in the system. The nurse should clamp the tubing temporarily to isolate the source of the leak and check for any external leaks or loose connections.
D. Empty the collection chamber: The collection chamber should only be emptied when it is full. Continuous bubbling in the water seal chamber is more likely an indication of an air leak. The nurse should first assess for leaks before considering emptying the chamber.

A. Raise the drainage bag above the level of the client's abdomen: This would decrease the flow rate of the dialysate. To facilitate proper drainage, the drainage bag should be kept lower than the level of the client's abdomen to allow gravity to assist in the outflow of dialysate.

B. Elevate the client to the high-Fowler's position: Elevating the client to a high-Fowler's position (sitting up at a 90-degree angle) can help improve the flow of dialysate by using gravity to promote better drainage, especially if there is fluid retention in the abdomen.

C. Measure the amount of the dialysate outflow: It's important to measure the dialysate outflow to assess the effectiveness of the dialysis and ensure that the prescribed amount of fluid is being drained. A decrease in outflow could indicate a blockage, kinked catheter, or other complications.

D. Monitor the access site for drainage: While monitoring the access site is important for assessing infection or leakage, a decrease in the dialysate flow rate is not related to drainage from the access site. Therefore, this is not a priority for addressing the decrease in flow rate.

E. Reposition the client onto the other side: Repositioning the client can help resolve any issues with the catheter position, which may be causing the decrease in flow. Moving the client can help improve drainage if the catheter is obstructed or kinked.