A charge nurse is coordinating a consult with a wound care specialist for a client who has a pressure injury. Which of the following actions should the charge nurse take?

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.

A. The "Do" component refers to the implementation of the plan, where changes or improvements are put into action, but evaluation does not occur in this phase.

B. The "Check" component involves evaluating the results of the implemented changes to determine their effectiveness, making this the appropriate phase for assessment and analysis of outcomes.

C. The "Act" component involves making adjustments based on the evaluation results, but the actual evaluation itself is part of the "Check" phase.

D. The "Plan" component involves identifying problems and planning interventions but does not include evaluating the effectiveness of those interventions, which is why it is not the correct answer.