A newly graduated nurse in the hospital states that, since she is ...

[ARLKQ]

A newly graduated nurse in the hospital states that, since she is so new, she cannot participate in quality improvement (QI) projects. What response by the precepting nurse is best?
 
  a. All staff nurses are required to participate in quality improvement here.
  b. Even being new, you can implement activities designed to improve care.
  c. It's easy to identify what indicators should be used to measure quality.
  d. You should ask to be assigned to the research and quality committee.

Question 2

A nurse working on a cardiac unit delegated taking vital signs to an experienced unlicensed assistive personnel (UAP). Four hours later, the nurse notes the client's blood pressure is much higher than previous readings, and the client's mental status has
 
  changed. What action by the nurse would most likely have prevented this negative outcome?
  a.
  Determining if the UAP knew how to take blood pressure
  b.
  Double-checking the UAP by taking another blood pressure
  c.
  Providing more appropriate supervision of the UAP
  d.
  Taking the blood pressure instead of delegating the task

[kswal303]

Answer to Question 1

ANS: B
The preceptor should try to reassure the nurse that implementing QI measures is not out of line for a newly licensed nurse. Simply stating that all nurses are required to participate does not help the nurse understand how that is possible and is dismissive. Identifying indicators of quality is not an easy, quick process and would not be the best place to suggest a new nurse to start. Asking to be assigned to the QI committee does not give the nurse information about how to implement QI in daily practice.

Answer to Question 2

ANS: C
Supervision is one of the five rights of delegation and includes directing, evaluating, and following up on delegated tasks. The nurse should either have asked the UAP about the vital signs or instructed the UAP to report them right away. An experienced UAP should know how to take vital signs and the nurse should not have to assess this at this point. Double-checking the work defeats the purpose of delegation. Vital signs are within the scope of practice for a UAP and are permissible to delegate. The only appropriate answer is that the nurse did not provide adequate instruction to the UAP.

[ARLKQ]

TYSM

[okolip]

Thanks for the timely response, appreciate it