A nurse is researching data about best practice for reducing medication errors on a surgical unit. Which of the following steps of evidence based practice (EBP) is the nurse taking?

Explanation:

A. A 6-year-old child with a spiral fracture of the tibia and fibula, reportedly occurring while riding a bicycle:

While a spiral fracture can be concerning, it is also a common injury seen in children due to falls or accidents during physical activities such as riding a bicycle. Without further evidence or suspicion, this may not immediately indicate physical abuse.

B. A 14-month-old toddler reportedly learning to walk and has several bruises on bony prominences of the lower legs and elbows:

Bruises on bony prominences can be common in toddlers who are learning to walk and explore their environment. These bruises are often seen on areas such as the lower legs and elbows. Without additional concerning signs or patterns, this may not indicate physical abuse.

C. A 9-month-old infant who sustained near drowning when he reportedly climbed into the tub and turned on the water:

Near drowning incidents can occur accidentally, especially in curious and mobile infants who may explore their surroundings. While this is a serious event, it does not necessarily suggest physical abuse unless there are other suspicious findings or a history of non-accidental injuries.

D. A 3-year-old toddler with scalding burns over the face and chest reportedly sustained when the child pulled on a tablecloth, spilling a cup of tea on himself:

Scalding burns, especially over sensitive areas like the face and chest, can raise concerns about physical abuse, especially when the reported mechanism of injury (spilling a cup of tea) seems inconsistent or disproportionate to the severity of the burns. The pattern and location of burns may not align with accidental spillage, leading to suspicion of abuse.

Explanation:

A. Whisper to the patient that she will be saved.

This action is inappropriate and does not address the underlying issues of the patient's condition or the presence of the family friend. Whispering such a statement may also be confusing or alarming to the patient.

B. Confront the family friend to allow the patient to ask questions.

While it's important to facilitate open communication with the patient, confronting the family friend directly may not be the most effective approach initially. It's crucial to first assess the patient's comfort level and safety before addressing the situation with the friend.

C. Consult the healthcare team about the suspicions and call local authorities to investigate.

Jumping to conclusions and involving authorities without gathering more information or assessing the patient's feelings directly could escalate the situation unnecessarily. It's important to handle such concerns with sensitivity and professionalism, involving appropriate resources only when needed.

D. Ask the patient if she feels safe, while the friend is in the room.

This is the most appropriate action initially. By directly asking the patient about her feelings of safety, the nurse can gauge the patient's comfort level and assess any potential concerns or risks. This approach allows the nurse to gather information and address any issues in a supportive and patient-centered manner. If the patient expresses concerns or discomfort, further assessment and appropriate interventions can be implemented, which may include involving other members of the healthcare team or authorities if necessary.