A nurse is reviewing the medical record for a client who has a health care-associated infection (HAI). The nurse should identify which of the following findings as a risk factor for acquiring an HAI?

A) It is a good idea to use the handrails in the bathroom: This statement indicates a correct understanding of fall prevention. Handrails in bathrooms help provide stability and support, especially when getting in and out of the shower or bathtub. They are an essential safety feature to reduce the risk of falls in areas where slipping is more likely, such as wet or slippery bathroom floors.

B) "I should get a longer cord for my telephone": While this may seem like a way to improve accessibility, a longer telephone cord could actually increase the risk of tripping or entangling, especially if it is placed in a walking path. Keeping cords short and secured out of walking areas is a better fall prevention strategy.

C) "I should place a throw rug over electrical cords": Placing a throw rug over electrical cords creates a hazard rather than preventing falls. The rug could slip, and the cord may create a tripping hazard, which increases the risk of falls. It's important to secure cords and avoid placing them in areas where people walk.

D) "I should use chairs without armrests": Chairs without armrests may actually be less supportive for individuals with mobility issues, as armrests can provide extra stability when sitting down or standing up. It is better to use chairs that offer support, including armrests, to help prevent falls. The focus should be on ensuring that chairs are stable and easy to use, not eliminating armrests.

A) Ensure four fingers fit under the restraints to prevent constriction: While it is important to ensure that restraints are not too tight, the general recommendation is to allow enough room for two fingers, not four. The primary goal is to prevent impaired circulation and nerve damage while also ensuring that the restraint is secure enough to prevent the patient from causing harm to themselves or others. Four fingers may be too loose and could lead to unnecessary movement.

B) Secure the restraints to the lowest bar of the side rail: Restraints should never be secured to a side rail, as the side rails may move and cause the restraint to become tight, which could lead to injury. Restraints should be tied to a fixed part of the bed frame to prevent them from becoming loose or causing undue pressure. Securing to side rails can increase the risk of harm.

C) Secure the restraints using a quick-release tie: This is the correct action. The nurse should always use a quick-release tie to ensure that the restraints can be removed immediately if needed. Quick-release ties allow for rapid removal in case of emergency, reducing the risk of injury or distress to the patient. This ensures safety while still maintaining control over the restraint application.

D) Anticipate removing the restraints every 4 hr: While restraints should be removed periodically to check the skin, circulation, and comfort of the patient, the time frame for removal varies depending on the patient's condition and the facility's protocol. Restraints should be removed more frequently than every 4 hours, if possible, to ensure the patient’s safety and comfort. The nurse should follow the facility's specific protocol for restraint monitoring and removal.