A nurse is preparing to transfer a client from the emergency department to a medical-surgical unit using the SBAR communication tool. Which of the following information should the nurse include in the background portion of the report?

A. Instructing a client on self-administration of a tap water enema involves providing education and guidance, which is within the scope of the nurse’s role. This task requires assessing the client’s understanding and ability to perform the procedure correctly.
B. Suctioning a client’s long-term tracheostomy involves specialized skills and knowledge, including the ability to manage potential complications and assess the client’s respiratory status. This task should be performed by a registered nurse or a licensed practical nurse who has the necessary training and expertise.
C. Changing the dressing on a PICC line involves sterile technique and specialized knowledge to prevent infection and ensure proper care of the central line. This task should be performed by a registered nurse or a licensed practical nurse with the appropriate training, as it requires assessment skills and adherence to infection control practices.
D. Using a pain rating scale to monitor a client’s pain level is a task that can be safely delegated to assistive personnel. It involves asking the client to rate their pain and recording the response, which is a straightforward task that does not require advanced clinical judgment.

A. While serving on a quality improvement committee is beneficial for long-term strategies and systemic changes, it is not the immediate action needed to address the specific increase in medication errors. The committee may work on broader issues and improvements over time, but addressing the current problem starts with understanding its root causes.
B. Conducting a root cause analysis (RCA) should be the first action. RCA is a systematic process for identifying the underlying causes of problems or events. By conducting an RCA, the nurse manager can determine the specific factors contributing to the increase in medication errors, whether they are related to processes, training, equipment, or other issues.
C. Developing preventative measures is essential for reducing future medication errors, but it should follow the root cause analysis. Without a clear understanding of the underlying causes, any preventative measures may not address the real issues or may be misdirected.
D. Reviewing current evidence-based practices is important for ensuring that care protocols align with the latest standards and guidelines. However, this should come after identifying the specific problems causing the medication errors.