A charge nurse is observing a nurse perform a sterile dressing change for a client. Which of the following actions should the charge nurse identify as demonstrating sterile technique?

Choice A rationale:

A client who is scheduled for a tubal ligation in 2 hr and is crying. Rationale: While the emotional well-being of this client is important, the absence of pulse in the right foot of the client in choice B indicates a potentially critical vascular issue that requires immediate attention.

Choice B rationale:

A client who has peripheral vascular disease and has an absent pulse in the right foot. Rationale: The correct choice. An absent pulse in a client with peripheral vascular disease suggests compromised blood flow and potential tissue ischemia. This is a critical situation that requires urgent intervention to prevent further complications.

Choice C rationale:

A client who has type 1 diabetes mellitus and needs the first dressing change for an ulcer. Rationale: While dressing changes are important, they are not as time-sensitive as addressing compromised blood flow and potential tissue damage seen in choice B.

Choice D rationale:

A client who has methicillin-resistant Staphylococcus aureus (MRSA) and has an axillary temperature of 38°C (100.4°F). Rationale: Although an elevated temperature can be concerning, the absence of a pulse in a peripheral vascular disease client (choice B) takes precedence as it suggests a more immediate threat to the client's limb and overall health.

The correct answer is choice B: Perform a chart review to gather data about the clients who developed infections.

Choice A rationale: Conducting an in-service on proper catheter insertion and maintenance may be helpful in addressing the issue but should not be the first step.

Choice B rationale: Performing a chart review to gather data about the clients who developed infections is an essential first step. This allows the nurse manager to analyze potential trends or common factors contributing to the infections, which can help identify specific areas for improvement or intervention (NurseLabs, n.d.).

Choice C rationale: Observing each staff nurse perform a urinary catheter insertion could help identify improper techniques that contribute to the infections. However, this is time-consuming and should be done after a chart review has been conducted.

Choice D rationale: Requiring completion of a self-paced instruction program might improve staff knowledge, but it should not be the first action taken by the nurse manager.

In conclusion, the nurse manager should first perform a chart review to gather data about the clients who developed urinary tract infections. This will help identify possible factors contributing to the infections and guide the nurse manager in developing targeted interventions to address the issue.