A charge nurse is discussing evidence-based practice (EBP) and the hierarchy of evidence with a newly licensed nurse.
Which of the following examples should the nurse provide when discussing Level I evidence?

Choice A rationale:

TJC (The Joint Commission) does not provide licensure for healthcare providers. Licensing is typically issued by state regulatory bodies, and it ensures that healthcare professionals meet the minimum qualifications and standards to practice within their respective states. TJC's role is different from providing licensure.

Choice B rationale:

TJC is primarily responsible for accrediting healthcare facilities, including hospitals and clinics, to ensure that they meet specific quality and safety standards. Accreditation by TJC is a mark of quality and demonstrates that the facility complies with nationally recognized healthcare standards.

Choice C rationale:

TJC is not a for-profit organization. It is an independent, non-profit organization dedicated to improving healthcare quality and safety. It does not seek to generate profits but rather focuses on enhancing the quality of care provided to patients.

Choice D rationale:

TJC is not an organization that monitors insurance claims. Monitoring insurance claims is typically the responsibility of insurance companies and regulatory agencies. TJC's primary role is to assess and accredit healthcare facilities to promote patient safety and quality care.

The correct answer is to select the following three findings that require immediate follow-up:C. Urticaria,D. Blood pressure at 1630, andE. Report of dysphagia.

Choice A rationale:

“Breath sounds at 1600.” The breath sounds at 1600 were clear and present throughout, which is a normal finding and does not require immediate follow-up.

Choice B rationale:

“Temperature.” The temperature readings at both 1600 and 1630 are slightly elevated but not critically high. This does not require immediate follow-up compared to the other findings.

Choice C rationale:

“Urticaria.” The presence of urticaria (hives) indicates an allergic reaction, which can potentially escalate to a more severe reaction such as anaphylaxis.Immediate follow-up is necessary to prevent further complications.

Choice D rationale:

“Blood pressure at 1630.” The blood pressure at 1630 is significantly lower (78/52 mm Hg) compared to the earlier reading (110/58 mm Hg).This hypotension could indicate a serious reaction to the medication or another underlying issue that requires prompt attention.

Choice E rationale:

“Report of dysphagia.” The client’s report of difficulty swallowing and feeling a lump in their throat is concerning for a potential airway obstruction or severe allergic reaction, such as anaphylaxis.This symptom requires immediate follow-up to ensure the client’s airway remains open and to provide necessary interventions.