Nurse Kelsey is a nurse manager assigned to the burn unit. Which client is best to assign to an RN who has floated from the surgery unit?
A. A client with infected partial-thickness back and chest burns who has a dressing scheduled.
B. A client who has just been admitted with burns over 30% of the body after a warehouse fire.
C. A client with full-thickness burns on both arms who needs assistance in positioning hand splints.
D. A client who requires discharge teaching about nutrition and wound care after having skin grafts.
Correct Answer: A. A client with infected partial-thickness back and chest burns who has a dressing scheduled.
Familiarity with the dressing change and practice of sterility by a nurse from the surgery unit will be appropriately used during the float in the burn unit. There are several options for burn dressings. Some are impregnated with antimicrobials (eg, silver). Most are a form of gauze, but there are biosynthetic dressings with some of the characteristics of skin that adhere to the wound and can be left in place for extended periods of time.
Option B: Admission assessment requires expertise in caring for burn patients. The needs of the client must be competently met with the knowledge, skills and abilities of the staff to meet these needs. In other words, the nurse who delegates aspects of care to other members of the nursing team must balance the needs of the client with the abilities of those to which the nurse is delegating tasks and aspects of care.
Option C: Splinting requires expertise in caring for burn patients. The staff members’ levels of education, knowledge, past experiences, skills, abilities, and competencies are also evaluated and matched with the needs of all of the patients in the group of patients that will be cared for.
Option D: Discharge teaching requires expertise in caring for burn patients. Validated and documented competencies must also be considered prior to assignment of patient care. No aspect of care can be assigned or delegated to another nursing staff member unless this staff member has documented evidence that they are deemed competent by a registered nurse to do so.
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