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Difficulty: MediumAccident, Error, and Injury Prevention

A client diagnosed with a right-sided pleural effusion is preparing for a bedside thoracentesis. The healthcare provider is at the bedside arranging the sterile equipment. Which action should the practical nurse prioritize to prevent a procedural error?

  1. Conduct a pre-procedure time-out with the team to verify the client, procedure, and anatomical site.Answer
  2. B
    Explain the potential risks and complications of the procedure before asking the client to sign the consent form.
  3. C
    Administer a prescribed intravenous sedative to minimize client movement during the needle insertion.
  4. D
    Assist the client into a supine position to provide the healthcare provider with a clear anatomical view.

Answer

Conduct a pre-procedure time-out with the team to verify the client, procedure, and anatomical site.
The correct answer emphasizes the Universal Protocol, which mandates a 'time-out' immediately prior to the start of any invasive procedure. This step involves all active team members pausing to verbally verify the correct client, the correct procedure, and the correct anatomical site, which is the most effective method for preventing procedural errors.

Step-by-Step Solution

1
Identify the primary safety goal for a client undergoing an invasive bedside procedure.
The primary goal is to prevent adverse events such as wrong-site, wrong-person, or wrong-procedure errors.
Invasive procedures carry a high risk of preventable harm if safety protocols are bypassed.
2
Evaluate the nurse's scope of practice regarding the provided options.
Providing informed consent education and administering IV push sedation are immediately eliminated as they fall outside the practical nurse's scope of practice.
Maintaining client safety requires practicing strictly within legal and professional boundaries.
3
Determine the correct clinical positioning for a thoracentesis.
The supine position is eliminated because it does not optimize lung expansion or safe needle access for pleural fluid removal.
Incorrect positioning increases the risk of lung puncture (pneumothorax).
4
Select the universally recognized error-prevention standard.
Conducting a time-out before the procedure begins is the definitive action to prevent medical errors.
The Universal Protocol mandates a time-out involving all team members to ensure absolute accuracy prior to incision or insertion.

Key Concept

Universal Protocol and Procedural Error Prevention
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Topics

Accident, Error, and Injury Prevention

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