A nurse manager observes ongoing interpersonal conflicts among nursing staff that impact team morale and patient care quality. Based on the types of conflict in nursing and conflict resolution strategies, which of the following actions should the nurse manager prioritize to effectively manage and resolve these conflicts? (Select all that apply)

Rationale:

A. Ignoring a patient's call for assistance is an intentional unsafe act because it represents a deliberate decision not to provide care, putting the patient at risk of falls, injury, or deterioration. This behavior demonstrates neglect and failure to fulfill the nurse’s duty to the patient, which can have serious ethical and legal implications.

B. Disregarding hand hygiene protocols is an intentional unsafe act because hand hygiene is a fundamental infection prevention measure. Choosing not to perform hand hygiene exposes patients to preventable healthcare-associated infections, showing a conscious disregard for safety standards and professional guidelines.

C. Administering medication without proper verification is intentional when the nurse knowingly bypasses safety checks, such as the five rights of medication administration (right patient, right drug, right dose, right route, right time). This increases the risk of adverse drug events and reflects a willful breach of safe practice standards.

D. Accidentally administering blood through an 18-gauge IV catheter while insulin is also infusing is unintentional. This constitutes a human error rather than a deliberate act. While it may be harmful, it is considered negligence or a system error, not intentional misconduct.

E. Improperly documenting patient information is an intentional unsafe act when it involves falsifying, omitting, or inaccurately recording patient data. Such documentation can mislead other healthcare providers, compromise care, and potentially result in patient harm. Intentional documentation errors are considered unethical and unsafe practice.

Rationale:

A. A young adult client who is 24 hr postoperative following an appendectomy is correct because this client is generally stable, with a routine postoperative course expected. Vital signs at this stage are considered predictable and non-complex, making them appropriate for delegation to an assistive personnel (AP). The AP can accurately measure and record the vitals, while the nurse retains responsibility for interpreting the results and responding to any abnormalities.

B. A middle adult client who has status asthmaticus is incorrect. Status asthmaticus is a life-threatening condition that can deteriorate rapidly. Vital signs in this context are dynamic and critical for clinical decision-making. Only a licensed nurse should obtain and interpret them, as immediate interventions may be required if respiratory status worsens.

C. A young adult client receiving a continuous IV infusion of regular insulin for diabetic ketoacidosis (DKA) is incorrect. Clients in DKA are critically ill, with fluctuating glucose levels, fluid imbalances, and electrolyte disturbances. Vital signs must be obtained by a nurse who can assess trends, correlate findings with lab values, and adjust treatment as needed. Delegating this task to an AP could delay recognition of a potentially life-threatening change.

D. An older adult client who is 36 hr postoperative from a traditional cholecystectomy is correct. Provided the client is stable, pain is controlled, and there are no complications, vital signs are considered routine. The AP can safely obtain and record them, freeing the nurse to focus on more complex tasks, such as assessing surgical sites or managing medications.

E. An older adult client who has a history of heart failure and is ready for discharge is correct. This client is stable and not exhibiting acute symptoms, making routine vital signs appropriate for AP delegation. The nurse retains responsibility for reviewing the vitals, interpreting trends, and providing education prior to discharge.