The nurse is reviewing charts for quality improvement. A patient experienced a complication during labor. The nurse is uncertain if the labor nurse took the appropriate action during the situation

Question

What is the best method for the quality improvement nurse to determine what the appropriate action by the nurse should have been?
1. Call the nurse manager of the labor and delivery unit and ask what the nurse should have done.
2. Ask the departmental chair of the obstetrical physicians what the best nursing action should have been.
3. Examine other charts to find cases of the same complication, and determine how it was handled in those situations.
4. Look in the policy and procedure book, and examine the practice guidelines published by a professional nursing organization.

Answer 1

Correct Answer: 4
Rationale 1: The nurse should find the standards herself and not rely on another person, such as the labor and delivery nurse manager, to determine appropriateness of care.
Rationale 2: Physician care and nursing care are very different; physicians might not be up to date on nursing standards of care or nursing policies and procedures.
Rationale 3: What nursing action was undertaken in a different situation might not be based on the policies and procedures or other standards of care. The quality improvement nurse will obtain the most accurate information by examining the policies, procedures, and standards of care.
Rationale 4: Agency policies, procedures, and protocols contain guidelines for nursing action in specific situations. Professional organizations such as the Association of Women's Health, Obstetrical, and Neonatal Nurses (AWHONN) also publish standards of practice that should guide nursing care.