A nurse manager is implementing a quality improvement project to reduce the number of methicillin-resistant Staphylococcus aureus (MRSA) infections at the facility. Which of the following actions should the nurse manager take first?

A. "I have a severe allergy to amoxicillin." A severe allergy to amoxicillin suggests a potential cross-reactivity with ceftriaxone, as both belong to the beta-lactam antibiotic class. While cross-reactivity between penicillins and cephalosporins is lower with third-generation cephalosporins like ceftriaxone, a history of severe allergic reactions, such as anaphylaxis, warrants consultation with the provider before administration.

B. "I get sick when I take diuretics." Adverse effects from diuretics do not typically indicate a contraindication to ceftriaxone. While diuretics like furosemide can interact with aminoglycosides to increase nephrotoxicity, ceftriaxone does not share this risk. Monitoring for individual tolerances is important, but this statement does not require holding the medication.

C. "I have a history of hearing problems." Ceftriaxone is not associated with ototoxicity, unlike aminoglycosides or vancomycin. A history of hearing problems does not necessitate withholding the medication, though the nurse should monitor for any new or worsening symptoms if concurrent ototoxic medications are prescribed.

D. "I take prednisone for my asthma." Corticosteroid use does not directly contraindicate ceftriaxone administration. While prolonged corticosteroid therapy may increase the risk of infections or mask symptoms of an allergic reaction, it does not warrant holding the antibiotic. The nurse should continue routine monitoring but can safely proceed with administration.

A. Check the newborn's identification bracelet with the chart: While checking the identification bracelet is important for ensuring the correct identification of the newborn, the request from the grandparent should not be fulfilled without proper identification. It is crucial to prioritize safety and adherence to protocols regarding the newborn's discharge.

B. Obtain permission from the newborn's guardian: Obtaining permission from the newborn's guardian is a necessary step, but the lack of identification from the grandparent still prevents the nurse from allowing the grandparent to take the newborn. The guardian's consent cannot override the identification protocols.

C. Respectfully deny the grandparent's request: Denying the request is the appropriate action in this situation. The nurse must ensure that the newborn is not released to anyone who does not have proper identification, as this is critical for the safety and security of the infant.

D. Review the newborn's footprint record: While reviewing the footprint record can help verify the newborn's identity, it does not address the immediate issue of the grandparent not having an identification bracelet. The nurse's priority should be ensuring that the newborn is only released to authorized individuals with proper identification.