A home health nurse is assessing an older adult client’s home after providing teaching about home safety. Which of the following actions by the client indicates an understanding of the teaching?

a. Is the client’s family present so the AP can show them how to turn the client:

While involving the client's family in care can be beneficial for education and support, this assessment does not directly pertain to the AP's ability to provide care or the client's immediate needs.

b. Does the AP have time to change the client’s central IV-line dressing after turning her:

This assessment is relevant to the AP's workload and scheduling, but it does not directly address the client's care needs related to bathing and turning.

c. Has data been collected about specific client needs related to turning:

This assessment is crucial before delegating care. The nurse should ensure that relevant information about the client's condition, including any specific needs or considerations related to turning, has been gathered and communicated to the AP to provide appropriate care.

d. Has the AP checked the client’s pain level prior to turning her:

This assessment is essential to ensure the client's comfort and safety during care activities. Assessing the client's pain level before turning helps prevent exacerbation of pain and ensures that turning is performed with appropriate consideration for the client's comfort.

a. Review current literature regarding client falls:

This option involves conducting a review of existing research and literature on client falls. Reviewing current literature can provide valuable insights into evidence-based practices and interventions for fall prevention. However, conducting a literature review typically follows problem identification and is part of the process of developing an evidence-based approach to addressing the issue.

b. Implement a fall prevention plan:

Implementing a fall prevention plan involves putting in place strategies and interventions aimed at reducing the risk of falls among clients. While implementing a fall prevention plan is an essential step in addressing the issue, it should be based on a thorough assessment of clients at risk for falls (which comes before planning interventions) to ensure that interventions are targeted and effective.

c. Identify clients who are at risk for falls:

This is the most appropriate first step in the quality improvement process. Identifying clients who are at risk for falls allows healthcare providers to focus interventions on those who are most vulnerable. It involves conducting comprehensive assessments, considering factors such as age, mobility, cognitive status, medications, and history of falls, to determine individual risk levels.

d. Notify staff of the increased fall rate:

While communication with staff about the increased fall rate is important for raising awareness and promoting a culture of safety, it should not be the first action taken in the quality improvement process. Before notifying staff, it's essential to identify clients at risk for falls and develop targeted interventions to address the issue effectively.