A nurse is caring for a client who reports experiencing alteration in sense of smell following surgery for a total laryngectomy. The nurse should address the client's concern through which of the following response?

A. Evaluate outcomes at the end of the shift: This is an important recommendation as it allows nurses to assess the effectiveness of interventions and the overall condition of patients. Evaluating outcomes helps in identifying areas for improvement, ensuring that patient care meets safety and quality standards. This practice fosters accountability and continuous improvement in patient-centered care.
B. Evaluate outcomes at the start of the shift: While evaluating outcomes at the beginning of the shift can provide valuable information, it is more effective to evaluate outcomes after care has been provided. Starting the shift with a review of previous outcomes can guide care planning, but the actual evaluation of interventions should occur after implementation to assess their effectiveness.
C. Plan and report outcomes: Planning and reporting outcomes are essential components of providing safe, quality, patient-centered care. This involves setting clear goals for patient care and documenting the expected results, which allows for effective communication among the healthcare team and ensures that everyone is aligned in their approach to patient care.
D. Communicate the plan: Effective communication of the care plan is critical to patient safety and quality care. Sharing the plan with all team members ensures that everyone is aware of the goals and interventions, facilitating collaboration and reducing the risk of errors. Clear communication enhances the patient's understanding of their care and promotes involvement in the decision-making process.
E. Think critically: Critical thinking is fundamental to nursing practice and promotes safe, quality, patient-centered care. It involves analyzing information, evaluating evidence, and making informed decisions based on patient needs and circumstances. Encouraging critical thinking enables nurses to assess situations thoroughly, anticipate potential problems, and implement appropriate interventions.

A. Develop a quality improvement program for nurses involved in medication administration errors. While quality improvement programs are essential, implementing a targeted program without first analyzing the root causes of errors may not effectively address the underlying issues. A broader review of system-wide factors contributing to medication errors is necessary before designing an intervention.
B. Require staff nurses to demonstrate competency by passing a medication administration examination. Competency assessments may help identify knowledge gaps, but they do not address system-based errors such as workload issues, unclear protocols, or distractions during medication administration. A root cause analysis should be conducted first to ensure that interventions target the actual sources of errors.
C. Provide an inservice on medication administration to all the nurses. Educational sessions can reinforce safe practices, but without identifying the specific factors contributing to errors, they may not be effective. Training should be tailored to address the findings from an initial review of the medication errors.
D. Review the events leading up to each medication administration error. The first step in continuous quality improvement is conducting a thorough analysis of the errors, identifying patterns, and determining root causes. This helps in designing targeted interventions, whether they involve process changes, additional training, or improved safety protocols.