Nurse Jordan, a seasoned member of the team, has been openly belittled by Nurse Taylor, a newer nurse. During handoffs, Nurse Taylor makes sarcastic remarks about Nurse Jordan's decisions, saying, "I can't believe you thought that was the right approach." This behavior creates a tense atmosphere and affects team dynamics. What type of behavior is Nurse Taylor exhibiting in this scenario?

A. Prepare to assist with intubation of the client: This action should be prioritized for a client diagnosed with acute respiratory distress syndrome (ARDS). ARDS can lead to significant respiratory distress and hypoxemia, requiring advanced airway management. Assisting with intubation ensures that the client receives adequate ventilation and oxygenation, which is critical in managing ARDS effectively. Immediate preparation for intubation is essential to prevent further deterioration of the client’s respiratory status.
B. Place a tracheostomy tray at the client's bedside: While having a tracheostomy tray available can be important in cases of prolonged respiratory failure, this action is not the immediate priority. The focus should be on ensuring proper airway management and oxygenation first. A tracheostomy is typically considered if the client requires long-term ventilation, but initial intervention for ARDS often involves intubation.
C. Administer IV prophylaxis for thromboembolism: While providing prophylaxis for thromboembolism is important in the overall management of patients at risk, especially in those with limited mobility, it is not the first priority in an acute situation. The immediate need is to address the client’s respiratory distress and ensure proper ventilation.
D. Administer IV prophylaxis for stress ulcers: Providing prophylaxis for stress ulcers is also a relevant consideration, particularly in critically ill patients. However, it is not an urgent action compared to securing the airway and ensuring effective oxygenation. Addressing respiratory failure and maintaining airway patency should take precedence in the acute management of ARDS.

A. The number of medication errors committed by another nurse. Quality improvement focuses on systemic issues rather than individual performance. Addressing medication errors should involve evaluating factors such as workflow inefficiencies, high workloads, or unclear protocols rather than singling out a specific nurse. Identifying system-wide improvements enhances patient safety more effectively.
B. Systems that make it difficult for the nurses to do their job. Quality improvement initiatives aim to identify and correct systemic barriers that hinder nursing efficiency and patient care. Issues such as inadequate staffing, poor communication, or outdated technology can lead to errors and inefficiencies. Addressing these barriers can improve workflow, reduce mistakes, and enhance patient outcomes.
C. Collective bargaining activity at a nearby hospital. Discussions about union activities or labor disputes are not directly related to quality improvement. While working conditions can impact patient care, this topic is more relevant to human resources or labor relations than a quality improvement committee focused on systemic patient safety issues.
D. How unhappy the nurses are with their current pay. While job satisfaction is important, a quality improvement committee focuses on patient safety, workflow efficiency, and care outcomes. Salary concerns are best addressed through administration or labor negotiations rather than a committee designed to implement clinical and operational improvements.