A nurse is reviewing the electronic medical record on clients following the implementation of a quality improvement plan to reduce health care associated infections on a medical surgical unit.

Exhibits

Select the 3 clients whose findings indicate the program is effective.

A. Client 1 - The findings for this client indicate a worsening of the pressure injury, with an increase in size from 2.5 cm x 2.5 cm to 3 cm x 3 cm. Additionally, the presence of purulent drainage suggests an infection rather than improvement, indicating that the quality improvement plan is not effective for this client.

B. Client 2 - The white blood cell (WBC) count for this client decreased from 11,500/mm³ to 9,500/mm³, which falls within the normal range. This reduction in WBC count suggests an improvement in the client's pneumonia, indicating that the quality improvement initiative to reduce healthcare-associated infections is effective in this case.

C. Client 3 - Although the WBC count increased from 2 to 6, it remains within the acceptable range of 0 to 4 per low-power field for urinary tract infections (UTIs). There are no significant improvements in the urinalysis results, which suggests that the program may not be effectively addressing the client's condition.

D. Client 4 - This client's urinalysis results remained consistent with no significant changes in urine pH and specific gravity. The WBC count remains unchanged at 2, indicating stability and no evidence of infection progression. This lack of worsening suggests that the quality improvement plan is effectively managing the client's UTI.

E. Client 5 - This client shows improvement, with a decrease in the size of the pressure injury from 3.5 cm x 2.5 cm to 2.8 cm x 2 cm and the absence of purulent drainage. These findings indicate that the quality improvement plan is effective in preventing further infection and promoting healing in this client.