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. Provide educational in-services for staff: While staff education is an important component of a quality improvement project, it is not the first action to take. Understanding the underlying factors contributing to MRSA infections should be the priority to ensure that educational initiatives are targeted and relevant.

B. Develop a MRSA protocol for implementation: Developing a protocol is necessary for guiding practice and reducing infections. However, it is essential to first gather data on existing practices and factors contributing to MRSA infections to ensure the protocol addresses specific issues.

C. Evaluate outcomes resulting from interventions: Evaluation of outcomes is a crucial step in the quality improvement process but occurs after implementing interventions. Initial actions should focus on identifying the root causes of MRSA infections before assessing the effectiveness of any interventions.

D. Conduct a chart review to evaluate precipitating factors of clients who develop MRSA: Conducting a chart review is the first action the nurse manager should take. This step allows for the identification of patterns and factors contributing to MRSA infections, providing valuable data that will inform the development of effective protocols and interventions tailored to the facility's needs.

A. "The client has a new prescription for incentive spirometry.": This statement is more appropriate for the "Assessment" or "Recommendation" section, as it pertains to current treatment plans and interventions rather than the background context of the client's history.

B. "The client's partner plans to return later today.": This information is relevant to the client's social support and engagement but is not critical background information. It may be included in the "Situation" or "Recommendation" sections instead.

C. "The client has no living family members.": This statement is pertinent to the "Background" portion, as it provides important context regarding the client's social situation and support system. Understanding the client's background helps the receiving nurse assess potential psychosocial needs and planning for care.

D. "I initiated a consultation by a nutritionist.": This action relates to ongoing care and assessment of the client's nutritional needs, making it more appropriate for the "Assessment" or "Recommendation" section. It is not part of the historical background needed for effective handoff.