When implementing evidence-based recommendations, what should a nurse primarily consider?

A. Infectious agent: While targeting pathogens is important, nurses typically do not directly eliminate all infectious organisms in the environment. Strategies such as hand hygiene and aseptic technique focus on preventing access rather than eradicating microbes entirely.

B. Mode of transmission: Interventions like hand hygiene, wearing gloves, and using sterile technique reduce transmission, but in this scenario, the infection occurred via the catheter. Targeting transmission alone may not fully prevent bloodstream infections.

C. Susceptible host: The patient’s immune status contributes to risk, but modifying inherent susceptibility (age, comorbidities) is not always feasible. Interventions more directly target controllable factors related to infection risk.

D. Portal of entry: The central venous catheter provides a direct pathway for pathogens into the bloodstream. Using strict aseptic technique during insertion and maintenance, proper dressing changes, and catheter care directly addresses this portal, making it the most effective link to target for prevention.

A. Suggest that the patient focus on their medical condition rather than family concerns: Redirecting the patient away from their emotional concerns dismisses their feelings and does not provide holistic, patient-centered care. Emotional support is essential in terminal illness.

B. Encourage the patient to discuss their feelings openly and involve the family in the care process: Facilitating open discussion allows the patient to express fears and emotions, strengthens family communication, and provides psychological support. This approach respects the patient’s values and promotes holistic care.

C. Avoid discussing emotional concerns to prevent upsetting the patient further: Avoidance can increase anxiety and isolation. Addressing emotional concerns directly, with empathy, supports coping and provides comfort during end-of-life care.

D. Refer the patient to pastoral care without addressing their concerns directly: Referral can be beneficial, but it should complement—not replace—the nurse’s direct engagement. The nurse should first acknowledge and validate the patient’s feelings before involving additional resources.