A new graduate nurse asks their manager for guidance on how to respond to a patient who refuses to sign a surgical consent form. The patient says that she won’t sign because she wishes to explore other options. Which of the following responses made by the manager are most appropriate? (Select all that apply)

Choice A Reason

The availability and accessibility of blood glucometers are important for ensuring that patients can have their blood glucose levels monitored effectively. However, this aspect is more related to the process and structure of care rather than the outcomes. Outcome audits focus on the results of care provided to patients, such as health improvements or complications.

Choice B Reason

The quality of nursing care provided is a broad concept that can encompass various aspects of patient care, including both processes and outcomes. While it is crucial to assess the quality of nursing care, outcome audits specifically measure the results of care, such as patient health status and complications. Therefore, while quality of care is important, it is not the specific focus of an outcome audit.

Choice C Reason

Nurse-to-patient ratios are a structural measure that impacts the delivery of care. Adequate staffing levels are essential for providing high-quality care and ensuring patient safety. However, this measure is related to the resources available and the organization of care rather than the direct outcomes of patient care. Outcome audits aim to evaluate the effectiveness of care by looking at the results achieved.

Choice D Reason

The incidence of central line-associated bloodstream infections (CLABSIs) is a specific outcome measure that reflects the quality and safety of patient care. CLABSIs are serious infections that can occur when bacteria or viruses enter the bloodstream through a central line. Monitoring the incidence of these infections helps assess the effectiveness of infection control practices and the overall quality of care provided. This measure directly relates to patient outcomes and is a key focus of outcome audits.

Choice A Reason:

Introducing substitute staff with fresh perspectives can harm the unit’s culture. While introducing substitute staff can bring fresh perspectives, it can also disrupt the established team dynamics and culture. Frequent changes in staff can lead to inconsistencies in patient care and communication issues among team members. However, this is not the primary consequence of absenteeism.

Choice B Reason:

Unacceptable patient care may result. The most significant consequence of absenteeism in a nursing unit is the potential for unacceptable patient care. When nurses are absent, the remaining staff may be overworked, leading to fatigue and burnout. This can result in errors, missed care, and overall lower quality of patient care. Ensuring adequate staffing levels is crucial to maintaining high standards of care and patient safety.

Choice C Reason:

Lower personnel numbers lead to reduced salary expenses, creating a positive variance. While it is true that fewer staff members can reduce salary expenses, this is not a positive outcome in the context of healthcare. Reduced staffing can compromise patient care quality and increase the workload for the remaining staff, leading to burnout and higher turnover rates. Therefore, this is not a desirable consequence of absenteeism.

Choice D Reason:

It may encourage other team members to engage in absenteeism. Absenteeism can indeed create a negative work environment where other team members may feel justified in also being absent. This can lead to a cycle of absenteeism, further exacerbating staffing issues and negatively impacting patient care. However, this is a secondary consequence compared to the direct impact on patient care quality.