A nurse is observing an assistive personnel (AP) administer a 0.9% sodium chloride enema to an adult client. For which of the following actions by the AP should the nurse intervene?

Rationale:
A. Assisting the nurse to transfer the client to the bed is an appropriate task to delegate to assistive personnel (AP). It is considered basic care and does not require nursing judgment, making it safe and within the AP’s scope of practice. Safe patient handling protocols should be followed to prevent injury.

B. Checking the client’s dressing for bleeding requires assessment and clinical judgment, which are nursing responsibilities. The AP cannot accurately assess postoperative complications or interpret clinical findings.

C. Obtaining vital signs may sometimes be delegated to APs, but postoperative clients returning from the PACU are unstable, and the nurse must assess vital signs and interpret the data immediately to detect complications. Therefore, this task should remain with the nurse.

D. Asking the client if they require pain medication involves assessment of pain and clinical judgment regarding medication administration. Pain management is a nursing responsibility and cannot be delegated to APs.

Rationale:
A. The research participant is the only individual who can provide informed consent for participation in a study. This process ensures that the participant fully understands the purpose, procedures, potential risks and benefits, and their rights, including the right to withdraw from the study at any time without penalty. Obtaining informed consent is a cornerstone of ethical research practice and respects the autonomy and decision-making capacity of the participant. The nurse’s role includes educating the participant, clarifying questions, and ensuring understanding, but the ultimate decision lies with the participant.

B. A risk manager evaluates potential risks in healthcare settings and develops strategies to mitigate them. While they may provide consultation regarding safety or liability, they cannot provide consent on behalf of the client. Their role is administrative and preventive, not participatory in research decision-making.

C. The institutional review board (IRB) is responsible for reviewing and approving research protocols to ensure the safety and ethical treatment of participants. The IRB protects participants at the institutional level but does not enroll or consent individual participants.

D. The chair of the ethics committee provides guidance on ethical dilemmas and ensures that research practices adhere to ethical principles. However, like the IRB, they cannot substitute for the participant’s informed consent. Their role is advisory, not participatory in the consent process.