A nurse is attending a quality improvement meeting. Which of the following actions should the nurse take first when initiating a quality improvement program to address health care-associated infections?
Select a potential intervention to lower the current infection rate.
Incorporate the process change into daily practice within the facility.
Determine if the implemented change has lowered the current infection rate.
Identify current infection rates from facility data.
The Correct Answer is D
A. Selecting an intervention is a subsequent step and should be informed by the baseline data on infection rates.
B. Incorporating the change into daily practice is necessary later in the process, once a specific intervention has been chosen and planned.
C. Determining if the change has lowered the infection rate is part of the evaluation phase, following the implementation of interventions.
D. Identifying current infection rates provides baseline data, which is essential for measuring the effectiveness of future interventions. Without this data, it is impossible to determine whether any implemented changes result in improvement.
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Correct Answer is D
Explanation
A. Postoperative emesis is a common occurrence and may not be critical unless it persists or is accompanied by other concerning signs.
B. While an 8 out of 10 pain level is significant, it can be managed with appropriate interventions and does not indicate an immediate complication.
C. Urinary output of 30 mL over 1 hour is low but does not necessarily indicate a critical condition that requires immediate intervention.
D. Mottling in the affected leg is a serious finding that may indicate compromised circulation or a thromboembolic event, making it the priority for reporting to the provider.
Correct Answer is B
Explanation
A. Seclusion is a highly restrictive intervention and is not the first action for managing agitation in dementia clients.
B. Engaging the client in a repetitive activity as a distraction is the least restrictive intervention and can help calm the client by redirecting their attention. Non-pharmacological and less restrictive approaches are preferred as initial responses to manage agitation in dementia clients.
C. Administering PRN haloperidol IM is a pharmacological intervention and should be reserved for situations where less restrictive measures have failed.
D. Applying wrist restraints is a restrictive intervention that can increase agitation and is not appropriate as a first-line approach.