A nurse manager is leading a quality improvement initiative to reduce the incidence of medication administration errors on a medical-surgical unit.
The quality improvement (QI) team analyzes incident reports, identifies patterns, and develops interventions to address the root causes.
Which of the following actions should the nurse include as part of the quality improvement process?
Implement punitive measures for staff involved in errors.
Provide additional training on medication safety protocols.
Remove nurses who make errors from direct patient care.
Encourage staff to report near misses without fear of punishment.
Conduct a root cause analysis of reported errors.
Audit medication administration practices regularly.
Correct Answer : B,D,E,F
Choice A rationale
Implementing punitive measures for staff involved in errors can create a culture of fear, discouraging the reporting of errors and near misses. This inhibits the identification of systemic issues and prevents thorough investigation, ultimately hindering effective quality improvement. A blame-free environment is crucial for fostering open communication and learning from mistakes.
Choice B rationale
Providing additional training on medication safety protocols enhances nurses' knowledge and adherence to best practices. This directly addresses potential knowledge deficits or skill gaps that contribute to errors, improving medication administration techniques and promoting a safer environment for patients. Education reinforces critical safety principles and reduces variability in practice.
Choice C rationale
Removing nurses who make errors from direct patient care without proper investigation and support can be demoralizing and does not address the underlying systemic issues contributing to the errors. It can lead to staff shortages and a negative work environment, potentially increasing the risk of errors among remaining staff due to increased workload and stress.
Choice D rationale
Encouraging staff to report near misses without fear of punishment promotes a just culture. Near misses offer valuable insights into potential system failures and opportunities for proactive intervention before actual harm occurs. This fosters a learning environment where safety concerns are openly discussed and addressed, leading to system-wide improvements.
Choice E rationale
Conducting a root cause analysis of reported errors is a systematic process to identify the fundamental reasons for errors, not just the superficial symptoms. This in-depth investigation helps uncover system vulnerabilities, process flaws, or environmental factors that contribute to adverse events, enabling the development of targeted and effective interventions.
Choice F rationale
Auditing medication administration practices regularly provides objective data on adherence to protocols and identifies areas for improvement. This allows for continuous monitoring of performance, detection of emerging issues, and evaluation of the effectiveness of implemented interventions. Regular audits are essential for sustaining quality improvements and ensuring ongoing patient safety.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Hypertension is less likely to be a direct complication of peritoneal dialysis. In fact, effective peritoneal dialysis can help manage fluid balance and remove excess sodium, which can contribute to better blood pressure control in individuals with kidney failure. The process aims to remove solutes and water, often mitigating hypertensive states.
Choice B rationale
Hyperglycemia can be a complication of peritoneal dialysis due to the high dextrose concentration in the dialysate solution. Dextrose, a type of sugar, is used as an osmotic agent to draw excess fluid and waste products from the blood into the peritoneal cavity. This can lead to increased glucose absorption into the bloodstream.
Choice C rationale
Peritonitis, an inflammation of the peritoneum, is the most common and serious complication of peritoneal dialysis. It occurs due to bacterial or fungal contamination of the peritoneal cavity, often introduced during catheter manipulation or connection. Symptoms include abdominal pain, cloudy dialysate, and fever, requiring prompt antibiotic treatment.
Choice D rationale
Hypokalemia is generally not a common complication of peritoneal dialysis. The dialysate solution typically contains potassium or is potassium-free, allowing for controlled removal of potassium from the body. However, significant potassium imbalances are usually managed by adjusting the dialysate composition rather than being a frequent, inherent complication.
Correct Answer is B
Explanation
Choice A rationale
A newborn's heart rate typically ranges from 120 to 160 beats per minute, and respirations are normally between 30 and 60 breaths per minute. A heart rate of 160/min and respirations of 40/min fall within these normal physiological ranges for a newborn, indicating adequate cardiovascular and respiratory adaptation to extrauterine life.
Choice B rationale
The average head circumference for a full-term newborn ranges from 33 to 35 cm, and the chest circumference is typically 2 to 3 cm less than the head circumference. A head circumference of 40 cm is significantly larger than the normal range, and a chest circumference of 32 cm suggests an abnormal head-to-chest ratio. These measurements could indicate hydrocephalus or other developmental anomalies and warrant immediate reporting to the provider for further assessment.
Choice C rationale
A positive Babinski reflex, characterized by dorsiflexion of the big toe and fanning of the other toes, is a normal neurological finding in newborns and infants up to 12-24 months of age, indicating an immature corticospinal tract. A negative Ortolani's sign indicates the absence of hip dislocation or dysplasia, which is a normal and desired finding, reflecting stable hip joints.
Choice D rationale
Acrocyanosis, which is the bluish discoloration of the hands and feet, is a common and normal finding in newborns during the first 24 to 48 hours after birth due to immature peripheral circulation. Caput succedaneum, a localized swelling of the scalp that crosses suture lines, is also a common and benign finding resulting from pressure during vaginal birth, typically resolving spontaneously within a few days.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.