A facility provides annual staff education regarding ethical practice. A charge nurse recognizes a need for further education when which of the following behaviors is observed?

A. Instructing a client on self-administration of a tap water enema involves providing education and guidance, which is within the scope of the nurse’s role. This task requires assessing the client’s understanding and ability to perform the procedure correctly.
B. Suctioning a client’s long-term tracheostomy involves specialized skills and knowledge, including the ability to manage potential complications and assess the client’s respiratory status. This task should be performed by a registered nurse or a licensed practical nurse who has the necessary training and expertise.
C. Changing the dressing on a PICC line involves sterile technique and specialized knowledge to prevent infection and ensure proper care of the central line. This task should be performed by a registered nurse or a licensed practical nurse with the appropriate training, as it requires assessment skills and adherence to infection control practices.
D. Using a pain rating scale to monitor a client’s pain level is a task that can be safely delegated to assistive personnel. It involves asking the client to rate their pain and recording the response, which is a straightforward task that does not require advanced clinical judgment.

A. The incident report should not be placed in the client’s medical record. Incident reports are considered internal documents and are used for quality improvement and risk management purposes. Including the report in the client’s medical record could compromise the objectivity of the report and may lead to legal and ethical issues.
B. There is no need to obtain an order from the client’s provider to complete an incident report. The report is a standard procedure for documenting errors and is part of the nurse’s responsibility to ensure patient safety and quality of care. It should be completed as per the facility’s protocol without requiring a provider’s order.
C. It is essential to include specific details such as the medication name and dosage administered in the incident report. This information helps in understanding what went wrong and is crucial for investigating the error, identifying patterns, and implementing corrective actions.
D. Making a personal copy of the incident report is not recommended. Incident reports are confidential and should be handled according to facility policies. Personal record keeping of such reports can violate confidentiality agreements and potentially lead to legal issues.
E. Including the time the medication error occurred is important for the incident report. This detail helps in understanding the timeline of the events leading up to and following the error, which is crucial for investigating the cause and impact of the error.