The nurse administers an incorrect dose of medication to a patient. After assessing the patient, the nurse calls the physician to report the occurrence and then notifies the nursing supervisor about the medication error and completes an incident report. The nurse's manager takes a Quality Management (QM) approach. Which of the following is not a principle of QM?

Choice A reason: Utilizing individual expertise while sharing responsibility ensures that all team members are involved in problem-solving and that no single person is burdened with the outcome. This approach aligns with the principles of shared decision-making, which emphasize collaboration and collective accountability.

Choice B reason: Shared decision-making aims to reduce skepticism by involving staff in the decision-making process, thereby increasing buy-in and the likelihood of success. Widespread skepticism would suggest a failure in the decision-making process.

Choice C reason: In a shared decision-making model, accountability does not rest solely with the unit manager. Instead, it is distributed among all individuals involved in the decision-making process.

Choice D reason: The statement that no one has any accountability or responsibility for the changes is incorrect. Shared decision-making requires that all participants take responsibility for the decisions made and their outcomes.

Choice A reason: While promoting teamwork among healthcare providers is important, it is not the primary reason for maintaining a low nurse-to-patient ratio. Teamwork is a byproduct of adequate staffing, which allows nurses to collaborate effectively.

Choice B reason: Increasing adverse events is the opposite of what a low nurse-to-patient ratio aims to achieve. Research shows that higher nurse-to-patient ratios are associated with increased adverse events.

Choice C reason: A low nurse-to-patient ratio does not contribute to the duplication of services. Instead, it ensures that nurses can provide adequate attention and care to each patient, which can reduce the need for redundant services.

Choice D reason: Nursing research has validated that a low nurse-to-patient ratio improves client outcomes. Studies have shown that lower ratios are associated with reduced mortality, medication errors, ulcers, restraint use, infections, pneumonia, and improved intervention times.