A nurse is working with an assistive personnel (AP) while caring for a surgical client who is 1 day postoperative. Which task should the nurse take responsibility for completing?

Rationale:

A. Removing the abdominal dressing is correct because this task involves clinical judgment, sterile technique, and assessment skills that are within the scope of practice for a licensed nurse. When removing a postoperative dressing, the nurse must assess the incision for signs of infection, bleeding, dehiscence, or unusual drainage. These assessments are critical for early identification of complications that could affect healing and overall patient outcomes. APs are not trained or licensed to perform these assessments or sterile procedures, so this task cannot be safely delegated.

B. Ambulating the client in the hallway is incorrect as ambulation is a non-invasive, routine activity. Once the nurse has assessed the patient’s mobility, stability, and tolerance for activity, an AP can safely assist the client. The nurse still maintains overall responsibility for ensuring the patient’s safety during ambulation.

C. Helping the client into the shower is incorrect because this is considered personal care and does not require clinical judgment. APs are trained to assist with hygiene and transfers, provided safety measures (e.g., gait belts, non-slip mats) are in place. The nurse is responsible for planning care and evaluating the patient’s ability to tolerate the activity, but the task itself can be delegated.

D. Measuring vital signs is incorrect because this is a routine, non-invasive task appropriate for delegation. APs can obtain and record vital signs, but the nurse must interpret the findings, identify abnormal values, and determine appropriate interventions.

Rationale:
A. Ensuring all staff use encrypted login credentials and automatic logoff features is correct because the HITECH Act strengthened HIPAA by emphasizing the protection of electronic protected health information (ePHI). Encryption prevents unauthorized access, and automatic logoff reduces the risk of accidental exposure of sensitive data. These measures are fundamental for compliance with HIPAA’s privacy and security rules and help safeguard patient information in electronic systems.

B. Disabling audit trails is incorrect because audit trails are a critical component of security monitoring and accountability. They allow organizations to track access to ePHI and detect potential breaches, which is a key enhancement emphasized under the HITECH Act. Disabling them would violate privacy and security requirements.

C. Sharing client PHI through unencrypted email is incorrect because it exposes sensitive information to potential interception. HITECH specifically requires that electronic communication containing PHI be secure and encrypted to prevent unauthorized access.

D. Allowing staff to use personal mobile devices freely is incorrect because unrestricted use of personal devices increases the risk of data breaches, loss, or theft of ePHI. The HITECH Act encourages strict policies for mobile device access, including encryption, password protection, and organizational oversight.