When examining the present healthcare delivery model, the nurse manager acknowledges that a demographic shift with substantial implications for future healthcare delivery systems is:

Choice A Reason:

Focusing the assessment on the unit and ignoring the needs of the hospital as a whole is not a viable approach. While it is important to address the specific needs of the unit, it is equally crucial to consider the broader context of the hospital. Ignoring the hospital’s overall needs can lead to fragmented care and inefficiencies. A holistic approach ensures that changes in the unit align with the hospital’s goals and resources.

Choice B Reason:

Hiring an outside consultant to oversee and manage the project can provide specialized expertise and an external perspective. However, this approach may not fully leverage the insights and experiences of the staff who are directly involved in patient care. Consultants can be valuable, but their role should complement, not replace, the active involvement of the unit’s staff.

Choice C Reason:

Engaging involved staff at all levels in the decision-making process is the best approach. This strategy aligns with complexity principles, which emphasize the importance of collaboration, shared decision-making, and leveraging the collective expertise of the team. Involving staff fosters a sense of ownership and commitment to the changes, leading to more effective and sustainable implementation. It also ensures that the adaptations are practical and directly address the needs of both patients and staff.

Choice D Reason:

Seeking a resolution from upper management may be necessary for securing resources and support, but it should not be the primary approach. Top-down directives can overlook the nuanced understanding and practical insights of frontline staff. Effective change management requires a bottom-up approach that engages those who are most familiar with the day-to-day operations and challenges of the unit.

Choice A Reason:

Displaying the client’s medical diagnosis on a message board within the client’s room is a violation of patient privacy and confidentiality. According to the Health Insurance Portability and Accountability Act (HIPAA), patient information must be kept confidential and only shared with individuals directly involved in the patient’s care. Displaying such information publicly could lead to unauthorized access and breaches of confidentiality.

Choice B Reason:

Sharing her password with a new nurse during orientation to enable the new nurse to input her client’s vital signs is inappropriate. Password sharing is a significant security risk and violates hospital policies designed to protect patient information. Each healthcare worker should have their own login credentials to ensure accountability and maintain the integrity of the electronic health record system.

Choice C Reason:

Signing out of the computer system after recording a client’s intake and output measurements is an appropriate action. This practice ensures that patient information is secure and that the system is not left open for unauthorized access. It also helps maintain the accuracy and integrity of patient records by ensuring that only authorized personnel can make entries.

Choice D Reason:

Disposing of her nursing activity worksheet in a trash bin near the elevator at the conclusion of the shift is inappropriate. Nursing activity worksheets often contain sensitive patient information, and disposing of them in a public trash bin can lead to breaches of confidentiality. Proper disposal methods, such as shredding, should be used to ensure that patient information is securely destroyed.