A nurse is assisting with teaching a class about categories of nurse sensitive quality indicators. The nurse should instruct the class that which of the following is included in the outcome category?

Choice A reason: If client is uninsured the ED can decline to render services is not an information that the nurse should include in the teaching. This is a false statement that contradicts the purpose and the provision of EMTALA. According to EMTALA, any hospital that participates in Medicare and has an emergency department must provide an appropriate medical screening examination to anyone who requests it, regardless of their insurance status or ability to pay.
Choice B reason: The ED has the right to refuse to provide client services is not an information that the nurse should include in the teaching. This is a false statement that violates the principle and the requirement of EMTALA. According to EMTALA, any hospital that participates in Medicare and has an emergency department has a duty to provide stabilizing treatment to any individual who has an emergency medical condition or is in active labor, unless an appropriate transfer is arranged.

Choice C reason: The ED can transfer medically unstable clients to other facilities is not an information that the nurse should include in the teaching. This is a false statement that breaches the rule and the regulation of EMTALA. According to EMTALA, any hospital that participates in Medicare and has an emergency department must not transfer an individual who has an emergency medical condition or is in active labor, unless the transfer is requested by the individual or their representative, or the transfer meets certain criteria, such as the benefits outweigh the risks, the receiving facility has agreed to accept the transfer, and the transfer is effected by qualified personnel and equipment.
Choice D reason: Clients must receive a medical screening evaluation (MSE) is an information that the nurse should include in the teaching. This is a true statement that reflects the essence and the standard of EMTALA. According to EMTALA, any hospital that participates in Medicare and has an emergency department must provide an appropriate medical screening examination to anyone who comes to the emergency department and requests examination or treatment for a medical condition, to determine whether or not an emergency medical condition exists

Choice A reason: This task is unsafe to assign to an AP, as it requires clinical judgment and critical thinking skills that are beyond the scope of practice of an AP. A confused surgical client who has multiple tubes may be at risk of complications such as infection, bleeding, or dislodgement of the tubes. The nurse is responsible for monitoring the client's condition, assessing the tubes' function and placement, and intervening as needed.

Choice B reason: This task is safe to assign to an AP, as it does not involve direct client care or clinical decision making. Providing postmortem care for a client who has died involves preparing the body for transport, removing any tubes or devices, and ensuring respect and dignity for the deceased and their family. The nurse should supervise and instruct the AP on how to perform this task according to the facility's policies and procedures.

Choice C reason: This task is safe to assign to an AP, as it is part of the basic care and comfort activities that an AP can perform under the nurse's delegation. Assisting a client to eat who has difficulty seeing the foods on the tray involves helping the client identify the food items, cutting or opening them if needed, and encouraging adequate intake. The nurse should ensure that the client has no dietary restrictions or swallowing difficulties before assigning this task to the AP.

Choice D reason: This task is safe to assign to an AP, as it is a routine and noninvasive procedure that an AP can perform under the nurse's direction. Delivering a client’s urine specimen to the laboratory involves labeling the specimen container, placing it in a biohazard bag, and transporting it to the designated area. The nurse should provide the AP with clear instructions on how to collect and handle the specimen.