A nurse manager is leading a discussion on legal guidelines for the use of restraints. Which of the following information should the nurse include?

"You can place a client in a chair with a table or tray blocking them as an alternative to restraints."

"Monitoring the client less often than required can be considered negligence."

"Family members cannot file a lawsuit when restraints are used for clients who have a mental illness."

"Chemical restraints are allowed when there is a high client-to-nurse ratio."

Answer and Explanation

The Correct Answer is B

A. "You can place a client in a chair with a table or tray blocking them as an alternative to restraints.": Using furniture to block a client can restrict their movement and may still be considered a form of restraint. Legal guidelines emphasize the importance of promoting client safety and dignity, so alternative measures should be explored that do not involve restricting movement.

B. "Monitoring the client less often than required can be considered negligence.": Monitoring a client in restraints less frequently than required breaches the duty of care and can lead to harm. Proper monitoring is crucial for the safety and well-being of clients, ensuring that their physical and psychological needs are adequately addressed while they are in restraints.

C. "Family members cannot file a lawsuit when restraints are used for clients who have a mental illness.": Family members retain the right to file lawsuits if they believe that the use of restraints was inappropriate or caused harm, regardless of the client's mental health status. Legal rights apply equally to all clients, including those with mental illness, ensuring accountability in the use of restraints.

D. "Chemical restraints are allowed when there is a high client-to-nurse ratio.": The use of chemical restraints is subject to strict regulations and cannot be justified based solely on staffing levels. These restraints should only be used when necessary for the client's safety and must align with established legal and ethical guidelines, ensuring that they are not used as a solution for managing staffing challenges.

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Correct Answer is A

Explanation

A. A client awaiting a screening colonoscopy later that day: This client is appropriate for early discharge. As the procedure is non-invasive and not urgent, the client can be discharged and return for the scheduled screening without compromising their health. This decision allows for the efficient use of hospital resources following a mass casualty event.

B. A client whose discharge was cancelled the prior day because they developed respiratory distress: Recommending discharge for this client is not advisable, as their recent respiratory distress indicates ongoing health issues that require monitoring and care. Early discharge could jeopardize their safety and recovery.

C. A client who is 6 hr postoperative following an open cholecystectomy: This client is not a suitable candidate for early discharge. Postoperative patients typically require observation and care to monitor for complications, such as infection or bleeding, in the hours following surgery. Early discharge could put this client's recovery at risk.

D. A client who is prescribed gastric lavage treatments to treat acute aspirin toxicity: This client should not be recommended for early discharge, as they require ongoing treatment and monitoring for aspirin toxicity. Discharging this client prematurely could lead to serious health complications and does not ensure their safety and well-being.

A. "We should start tracking how soon clients are discharged after laparoscopic versus open surgery." B. "We should be sure to log out of the computers immediately following documentation." C. "We should involve our clients' partners in care planning as much as possible." D. "We should provide change-of-shift report as a team, including the assistive personnel who assisted with care."

Correct Answer is A

Explanation

A. "We should start tracking how soon clients are discharged after laparoscopic versus open surgery.": This statement reflects the QSEN concept of quality improvement by focusing on collecting and analyzing data related to patient discharge times. By tracking this information, the team can identify trends, evaluate the effectiveness of care, and implement changes to improve patient outcomes and streamline the discharge process.

B. "We should be sure to log out of the computers immediately following documentation.": While this statement emphasizes an important aspect of safety and confidentiality in documentation, it does not directly address quality improvement initiatives. It focuses more on operational procedures rather than evaluating and enhancing the quality of patient care.

C. "We should involve our clients' partners in care planning as much as possible.": Involving clients' partners in care planning aligns with the QSEN concept of patient-centered care. While this approach is essential for improving patient satisfaction and outcomes, it is not specifically a quality improvement initiative.

D. "We should provide change-of-shift report as a team, including the assistive personnel who assisted with care.": This statement reflects teamwork and communication strategies, which are important for effective patient care. However, it does not directly focus on quality improvement initiatives aimed at evaluating and enhancing the overall quality of care provided to clients.

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A nurse manager is leading a discussion on legal guidelines for the use of restraints. Which of the following information should the nurse include?

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