A nurse manager notes that the number of medication administration errors has increased on the unit. Which of the following actions should the nurse take first?

A. Documenting a client's refusal to take prescribed medication is an important aspect of client advocacy. It respects the client’s right to refuse treatment and ensures that their decision is clearly recorded in their medical record.
B. Obtaining an interpreter for a client who speaks a different language is a key example of client advocacy. It ensures that the client can understand and participate in their own care, which is essential for informed consent and effective communication.
C. Providing written information about palliative care supports client advocacy by ensuring that the client is informed about their care options. This helps the client make informed decisions about their care, which is a crucial aspect of advocacy.
D. Implementing a plan of care based on nursing goals is part of routine nursing practice but does not directly reflect client advocacy unless those goals are specifically aligned with the client's preferences and needs.
E. Initiating IV access on a client who has dementia while they are sleeping does not exemplify client advocacy. Informed consent and respect for the client’s comfort and awareness are crucial, especially for clients with cognitive impairments.

A. A client leaving against medical advice (AMA) is a common situation where the primary concern is ensuring that the client understands the risks of leaving and that the decision is documented appropriately. While this situation can involve ethical considerations regarding informed consent and patient autonomy, it does not usually require ethics committee involvement unless there are exceptional circumstances or conflicts related to the client's decision.
B. Having advance directives on file indicates that the client has made decisions about their medical care preferences in advance. The presence of advance directives means that the client's wishes should be followed, assuming they are clear and legally valid.
C. Participation in a medical research study generally involves informed consent and adherence to research ethics and protocols. However, if there are concerns about the ethical conduct of the research, consent process, or potential exploitation, then ethics committee consultation might be warranted.
D. This scenario involves a significant ethical dilemma where the medical needs of the adolescent conflict with the parents' religious beliefs. In such cases, the ethics committee can provide guidance on balancing the principles of autonomy, beneficence, and non-maleficence.