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?
Review evidence-based literature to determine best practices in the shift reporting process.
Organize a task force to review interventions to change the shift reporting process.
Create a new shift reporting process to present at the next staff meeting.
Develop a strategy to alert other nurses about the need for changes in the shift reporting process.
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. Encouraging the expression of feelings about illness can be a part of patient-centered care, but it does not fully encompass the role of advocacy, which involves more comprehensive support for the client's needs.
B. Reinforcing teaching about prescribed medications is important but falls under education and patient care rather than advocacy itself.
C. Collaboration with other team members is essential in providing holistic care but does not solely represent advocacy, which focuses more on the client's interests.
D. Supporting the client's needs is the core of advocacy, as it involves standing up for the client's rights, preferences, and well-being within the healthcare system.
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.