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?

Choice A rationale

Developing a strategy to alert other nurses about the need for change is a later step in the process. Promoting awareness is essential but does not provide a foundation for understanding the necessary improvements or align the team with evidence-based best practices, which must precede this action for effective change.

Choice B rationale

Reviewing evidence-based literature establishes a scientific basis for change, ensuring that new practices are supported by current research. This step aligns with quality improvement principles that emphasize evidence-based interventions, fostering better outcomes and adherence to established standards of care.

Choice C rationale

Creating a new shift reporting process without a preliminary review of best practices risks implementation of ineffective or unsupported strategies. A foundation of evidence-based research ensures the creation of processes that address specific issues and align with optimal nursing practices.

Choice D rationale

Organizing a task force is a collaborative approach but is premature without an evidence-based framework. Reviewing literature to understand effective interventions must guide the task force's focus, ensuring the implementation of strategies that are scientifically validated and beneficial.

This scenario follows the RACE protocol for fire response in healthcare settings:

• R – Rescue: Remove anyone in immediate danger. ✅ Already done.

• A – Alarm: Activate the fire alarm system to alert others. 🔺 Next step

• C – Confine: Close doors/windows to contain the fire and smoke.

• E – Extinguish/Evacuate: Use a fire extinguisher if safe, or continue evacuation.

So after rescuing the client, the nurse should activate the fire alarm to initiate the facility’s emergency response. Closing the door (A), reporting details (B), and turning off equipment (D) are important, but they come after the alarm is triggered.