A charge nurse is planning the care of four newborns. An assistive personnel and licensed practical nurse are available for staffing. Which of the following tasks should the nurse assign to a licensed practical nurse?

Rationale:
A. Ambulating a postoperative client is within the scope of practice for an AP, as long as the client is stable and the nurse has assessed them first. The AP can assist with mobility under the nurse’s supervision.

B. Performing a simple dressing change may be within the AP’s scope if it is a basic, non-sterile dressing. APs are allowed to perform routine hygiene or dressing tasks that do not require assessment or sterile technique.

C. Measuring urinary output is a routine task that APs can perform. The nurse is responsible for interpreting the measurements, but obtaining and recording output is appropriate delegation.

D. Evaluating the effectiveness of pain medication requires assessment, judgment, and clinical decision-making, which are nursing responsibilities. APs do not have the training or authority to determine if a client’s pain management is adequate or to make decisions about medication administration. This action requires immediate intervention by the nurse.

Rationale:
A. Documentation audits for use of clinical guidelines measure process compliance, not direct client outcomes. They help ensure protocols are followed but do not directly reflect improvement in health outcomes.

B. Percentage of completed client plans of care is also a process measure, assessing whether documentation tasks are completed, rather than whether clients’ health outcomes have improved.

C. Surgical site infection rates are a direct client outcome measure. A decrease in infection rates indicates that care interventions and quality improvement initiatives are effectively improving patient health outcomes. This measurement reflects the actual impact of nursing and medical care on patient safety and recovery.

D. Staffing ratio audits assess resource allocation and workload but do not directly measure patient health outcomes. While staffing affects outcomes indirectly, it is a structural measure rather than an outcome measure.