While auditing the medical records of clients currently on an oncology unit, the nurse manager finds that six of the 15 records lack documentation regarding advance directives. Which of the following is the priority action for the nurse to take?

A. Meeting with the nursing staff to review the policy regarding advance directives addresses the systemic issue of documentation. This action helps to ensure that all staff are aware of the importance of advance directives and the necessity for proper documentation moving forward.

B. Reinforcing potential consequences is important but may not directly resolve the immediate lack of documentation in the records. Education without action does not change current practice.

C. Asking nurses to obtain the information is a necessary step, but it is essential first to address the overall understanding and policy compliance with the entire nursing staff.

D. Reminding nurses to obtain this information during the admission process is a good practice, but it does not address the current records that are lacking documentation.

A. Client 1 - The findings for this client indicate a worsening of the pressure injury, with an increase in size from 2.5 cm x 2.5 cm to 3 cm x 3 cm. Additionally, the presence of purulent drainage suggests an infection rather than improvement, indicating that the quality improvement plan is not effective for this client.

B. Client 2 - The white blood cell (WBC) count for this client decreased from 11,500/mm³ to 9,500/mm³, which falls within the normal range. This reduction in WBC count suggests an improvement in the client's pneumonia, indicating that the quality improvement initiative to reduce healthcare-associated infections is effective in this case.

C. Client 3 - Although the WBC count increased from 2 to 6, it remains within the acceptable range of 0 to 4 per low-power field for urinary tract infections (UTIs). There are no significant improvements in the urinalysis results, which suggests that the program may not be effectively addressing the client's condition.

D. Client 4 - This client's urinalysis results remained consistent with no significant changes in urine pH and specific gravity. The WBC count remains unchanged at 2, indicating stability and no evidence of infection progression. This lack of worsening suggests that the quality improvement plan is effectively managing the client's UTI.

E. Client 5 - This client shows improvement, with a decrease in the size of the pressure injury from 3.5 cm x 2.5 cm to 2.8 cm x 2 cm and the absence of purulent drainage. These findings indicate that the quality improvement plan is effective in preventing further infection and promoting healing in this client.