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A nurse is contributing to a quality improvement plan to improve the shift reporting process on the unit. Which of the following actions is the first step the nurse should suggest to promote a change in the reporting process?

A.

Review evidence-based literature to determine best practices in the shift reporting process.

B.

Organize a task force to review interventions to change the shift reporting process.

C.

Create a new shift reporting process to present at the next staff meeting.

D.

Develop a strategy to alert other nurses about the need for changes in the shift reporting process.

Answer and Explanation

The Correct Answer is A

A. Reviewing evidence-based literature is essential to understand best practices in shift reporting and can inform the development of effective interventions. This foundational step helps ensure that any proposed changes are supported by research and proven methods.  

 

B. While organizing a task force can be beneficial, it should occur after understanding the current best practices, as the task force's efforts would be better guided with existing evidence.  

 

C. Creating a new reporting process without first gathering information or reviewing best practices may result in ineffective or unnecessary changes.  

 

D. Developing a strategy to alert nurses is important, but it should be based on informed decisions derived from literature and data analysis, which should come first.


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Correct Answer is D

Explanation

A. Establishing the priorities of client care is part of the planning phase, not the implementation phase.

B. Comparing laboratory values is an assessment activity that occurs before planning and implementing care.

C. Asking the client about pain is an assessment activity used to gather information rather than an implementation task.

D. Reinforcing teaching about the client's diagnosis is an action that occurs during the implementation phase, as it involves executing the care plan and providing direct client education.

Correct Answer is A

Explanation

A. Autonomy refers to the right of individuals to make their own decisions regarding their healthcare, including the right to refuse treatment, which the nurse has supported in their response.

B. Fidelity involves being faithful to commitments made to patients, such as providing care and support, but does not directly pertain to the client's right to refuse treatment.

C. Beneficence focuses on promoting the well-being of the client, which may not align with the client’s decision to refuse treatment in this context.

D. Justice refers to fairness in healthcare and ensuring equitable treatment, but it does not address the specific right of the client to refuse treatment.

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