The nurse is assigned to a quality improvement committee to decide on a quality improvement project for the unit. Which issues should the nurse discuss at the committee meeting?

Choice A rationale
While ensuring that nurses demonstrate competency by passing a medication administration test is important, it is not the first step in developing a program to decrease medication administration errors. This strategy focuses on the individual skills of the nurses, but does not address the systemic issues that may have contributed to the errors.
Choice B rationale
Reviewing the circumstances leading up to each medication error is the first step in understanding why the errors occurred. This process allows the committee to identify patterns and common factors that contribute to errors. It is a crucial step in the development of effective strategies to prevent future errors.
Choice C rationale
Developing a quality improvement program for nurses involved in medication errors is a strategy that could be implemented after understanding the root causes of the errors. This approach ensures that the program addresses the specific issues that led to the errors.
Choice D rationale
Conducting an in-service training on medication administration for all nurses is a valuable strategy for preventing medication errors. However, it should be based on the findings from the review of the circumstances leading up to each error. Therefore, it is not the first strategy to consider.

Choice A rationale
This situation represents an ethical conflict. The nurse is faced with a dilemma where the children’s wishes for their parent to be a full code contradict the client’s expressed wish in their living will for Do Not Resuscitate (DNR)2. Ethical conflicts often arise in healthcare when there are differing opinions about the right course of action.
Choice B rationale
Scarcity, safety, and security are not the primary sources of conflict in this situation. While these factors can contribute to conflict in certain contexts, they do not directly apply to the ethical dilemma presented in this scenario.
Choice C rationale
Competition between groups is not evident in this situation. The conflict arises from differing views on the appropriate course of action for the client’s care, not from competition.
Choice D rationale
Cultural differences are not the main source of conflict in this scenario. The conflict arises from an ethical issue related to the client’s end-of-life care, not from cultural differences.