The busy emergency department at a hospital has experienced a sharp increase in negative outcomes among clients with heart conditions in the past month. Which of the following actions should the nursing staff take to improve client outcomes?

A. While state boards of nursing do have regulatory authority over nursing practice and can take action against nurses who abuse substances, this does not negate the need for an internal program. Organizations should proactively address substance abuse to support employee health and safety, rather than relying solely on external authorities.
B. While safety is a critical concern, emphasizing punishment can create a culture of fear and may discourage employees from seeking help. A punitive approach may lead to further issues, such as hiding problems rather than addressing them.
C. While confidentiality is important, the involvement of the personnel department alone may not be sufficient to address the complexities of substance abuse. A comprehensive program should include input from healthcare professionals, mental health experts, and employee assistance programs to effectively manage and support affected employees.
D. This is the most appropriate consideration. A program focusing on screening, prevention, and early intervention can help identify issues before they escalate, support employees in getting the help they need, and create a healthier workplace culture.

A. While RNs can be held liable for their actions and, to some extent, for the actions of those they delegate to, liability is not automatic for all tasks delegated. Liability depends on whether the RN acted appropriately in the delegation process and whether the delegated tasks were performed within the subordinate's scope of practice.
B. While subordinates are accountable for their actions, RNs also share responsibility when they delegate tasks. If the RN delegates a task inappropriately or fails to supervise adequately, they may still be held liable for any resulting harm.
C. This statement is true. When RNs delegate tasks appropriately, ensuring that they are within the subordinate's scope of practice and providing adequate supervision, their liability is reduced. Proper delegation includes assessing the situation, providing clear instructions, and monitoring the outcomes.
D. While delegating to licensed personnel may reduce some liability, it does not eliminate it entirely. RNs still have a duty to ensure that the tasks delegated are appropriate for the individual’s scope of practice and to provide supervision.