A nurse from a medical floor is serving on a committee that is performing an outcome audit of the hospital. Which of the following aspects of client care is measured by an outcome audit?

Choice A Reason:

Saying “You have been very inconsiderate of others by not completing your share of the work” is confrontational and accusatory. This approach can lead to defensiveness and conflict rather than a constructive conversation. Effective communication in nursing should be respectful and focused on resolving issues collaboratively.

Choice B Reason:

“I need to speak with you about unit expectations regarding delegating and completing tasks” is the most appropriate statement. It is direct yet respectful, focusing on the expectations and standards of the unit rather than personal shortcomings. This approach opens the door for a constructive dialogue about performance and responsibilities, which is essential for resolving the issue and improving teamwork.

Choice C Reason:

“If you don’t do your share of the work, I will have to inform the nurse manager” is a threat and can create a hostile work environment. While it is important to address performance issues, using threats can escalate the situation and damage professional relationships. Constructive feedback should aim to support improvement rather than instill fear.

Choice D Reason:

“Several staff members have commented that you don’t do your fair share of the work” relies on hearsay and can be perceived as gossip. This approach can undermine trust and does not address the issue directly. It is more effective to focus on specific behaviors and expectations rather than what others have said.

Choice A Reason:

Organizing a mandatory training to reorient nurses to the drug administration policy is an important step in addressing medication administration errors. However, it should not be the first step. Without understanding the underlying causes of the errors, training may not effectively address the specific issues that led to the sentinel event. Training should be tailored based on the findings of a root cause analysis to ensure it targets the actual problems.

Choice B Reason:

Requiring staff nurses to demonstrate competency by passing a medication administration examination is a useful strategy to ensure that nurses have the necessary knowledge and skills. However, similar to mandatory training, this step should follow a thorough investigation of the errors. Conducting a root cause analysis first will help identify whether competency issues are a factor and what specific areas need to be addressed.

Choice C Reason:

Conducting a root cause analysis is the appropriate first step. This process involves systematically identifying the underlying causes of the medication administration errors. By understanding the root causes, the committee can develop targeted interventions to prevent future errors. Root cause analysis helps ensure that the solutions are based on evidence and address the actual problems rather than just the symptoms.

Choice D Reason:

Developing a quality improvement program for nurses involved in medication administration errors is a valuable strategy for long-term improvement. However, this should be based on the findings of the root cause analysis. The quality improvement program should be designed to address the specific issues identified during the analysis, ensuring that it effectively reduces the risk of future errors.