A nurse is attending a quality improvement meeting. Which of the following actions should the nurse take first when initiating a quality improvement program to address health care-associated infections?

This client has undergone a paracentesis for ascites, and since it was done 4 hours ago, they are likely stable and can be considered for discharge.

The client who is 6 hours postoperative following a hip arthroplasty may still require close monitoring and postoperative care. Discharging a postoperative client too early could lead to complications.

The client with a blood glucose level of 380 mg/dL receiving insulin via IV infusion requires ongoing monitoring and management of their diabetes. Discharging this client during an external disaster may not be appropriate due to the need for continued medical intervention.

The client with pneumonia receiving 100% oxygen via a nonrebreather mask likely requires continued medical attention and monitoring. Discharging a client with pneumonia who requires high-flow oxygen can pose risks to their respiratory status.

A. A staff member places a midstream urine sample in a specimen refrigerator after collecting it: This action is appropriate as long as the specimen is labeled correctly and stored at the correct temperature. Proper handling of specimens is essential for accurate testing and does not represent an infection control hazard.

B. A staff member wipes a countertop with chlorhexidine solution to clean the area following a blood spill: This action is appropriate for cleaning a contaminated surface. Chlorhexidine is an effective disinfectant for blood spills. Therefore, this action does not represent an infection control hazard.

C. A nurse uses alcohol-based antiseptic to clean his hands after talking with a client who has varicella zoster: While alcohol-based antiseptics are effective for most pathogens, varicella zosteris primarily spread through direct contact and airborne transmission. It is recommended to wash hands with soap and water after caring for a patient with varicella zoster, especially if hands are visibly soiled. This action may not adequately control the infection hazard.

D. A nurse pours sterile 0.9% sodium chloride irrigation solution on an open pressure wound prior to collecting a specimen for culture: This action is appropriate as long as sterile technique is maintained. Using sterile saline for irrigation is standard practice to minimize the risk of introducing pathogens before specimen collection. Therefore, this action does not represent an infection control hazard.