A nurse is a member of a quality improvement committee utilizing the Plan-Do-Check-Act (PDCA) model for quality improvement. The nurse should identify evaluation as part of which of the following components of the PDCA model?

A. Refusing to speak to parents could indicate normal adolescent behavior, stress, or other reasons unrelated to maltreatment. It does not immediately raise suspicion of abuse.

B. Regression in toilet training is a common reaction to hospitalization or stress, particularly in young children, and does not necessarily suggest maltreatment.

C. A toddler crying whenever a parent enters the examination room is concerning for maltreatment, as it could indicate fear or discomfort around the parent, which is a red flag for potential abuse.

D. Abrasions on a school-age child’s legs could be consistent with normal childhood activities, such as playing or falling, and alone do not suggest maltreatment without other indicators.

A. Client 1 - Lyme disease is a reportable infectious disease in many jurisdictions due to its potential public health implications. Given that it is transmitted by tick bites, it is crucial to notify the health department to help track the incidence and potential outbreaks in the area.

B. Client 2 - Acute hepatitis C is also a reportable disease, especially given the client's history of IV substance use. Reporting aids in monitoring and controlling the spread of the disease, as it can be transmitted through blood and sharing of needles.

C. Client 3 - Clostridium difficile infections are typically not reported to the health department, as they are often linked to healthcare settings and do not pose a public health threat in the same way as other infectious diseases.

D. Client 4 - Salmonellosis is a reportable illness as it can be associated with outbreaks linked to foodborne transmission. Reporting is essential for investigating sources of infection and preventing further cases.

E. Client 5 - While Streptococcal pharyngitis is common and can cause outbreaks, it is generally not classified as a reportable disease to public health departments. Instead, treatment and monitoring are usually managed within healthcare settings.

F. Client 6 - Pertussis (whooping cough) is highly contagious and considered a reportable disease due to its potential to cause outbreaks, especially among vulnerable populations. Reporting allows for monitoring and preventive measures to be implemented in the community.