A nurse is collecting data from a client who uses a continuous positive airway pressure (CPAP) machine at night for sleep apnea. The nurse should identify which of the following findings as an indication of proper CPAP use?

A. There is one finger width between the strap on the mask and the client's face is correct. A properly fitted CPAP mask should have a snug fit, with a space of about one finger width between the strap and the face to ensure adequate seal and comfort. A mask that is too tight can cause discomfort, while a loose mask may not provide the necessary pressure to treat sleep apnea.

B. The therapeutic dose of albuterol is being inhaled is incorrect. Albuterol is used for bronchodilation in conditions like asthma, but it is not related to CPAP use. CPAP is designed to provide positive pressure to keep the airways open, not to treat asthma or other respiratory issues directly.

C. The mask fits loosely so air can escape from underneath is incorrect. A loose fit would lead to air leakage, reducing the effectiveness of the CPAP therapy. The mask should fit securely to ensure the proper amount of air pressure is delivered during sleep.

D. The mask is secured over the client's mouth and the client's nose is uncovered is incorrect. For effective CPAP therapy, the mask should cover both the nose and mouth, unless the client specifically uses a nasal CPAP mask designed to deliver pressure only through the nose.

A. "Define the problem.": While defining the problem is important in the early stages of performance improvement, evaluating effectiveness requires looking at data or outcomes, not just the initial identification of the issue.

B. "Identify data collection methods.": Identifying data collection methods is part of the planning phase, but evaluating the effectiveness involves reviewing actual data to see if the goals of the program were achieved.

C. "Perform chart audits.": This is correct. Performing chart audits allows the nurse to assess if the desired improvements have been implemented and whether the performance outcomes are being met. Chart audits are a common method for evaluating the effectiveness of a performance improvement program.

D. "Review the facility's policy and procedure manual.": While reviewing policies is important for understanding standards of care, it does not directly evaluate the effectiveness of a performance improvement program. Data from actual practice, such as chart audits, would be more relevant for evaluation.