Scenario Analysis: This scenario is professionally challenging because it requires immediate, critical assessment and decisive action in a high-stakes situation where a patient’s life is at risk. The nurse must balance the urgency of the patient’s deteriorating condition with the need for clear, effective communication and adherence to established protocols for escalation. Failure to act appropriately can lead to adverse patient outcomes and potential professional repercussions. Correct Approach Analysis: The best professional practice involves immediately assessing the patient’s vital signs and clinical presentation, recognizing the signs of deterioration, and initiating the hospital’s established emergency response protocol. This includes promptly notifying the responsible physician or designated rapid response team, providing a concise and accurate handover of the patient’s status, and remaining with the patient to provide ongoing care and support until the escalation team arrives. This approach aligns with ethical principles of beneficence and non-maleficence, ensuring the patient receives timely and appropriate intervention. It also adheres to professional nursing standards and hospital policies designed to manage deteriorating patients effectively and safely. Incorrect Approaches Analysis: Initiating a rapid response without first performing a focused assessment and gathering objective data is premature and may lead to unnecessary alarm activation, diverting resources from other critical needs. While prompt action is crucial, it must be informed by clinical judgment. Delaying notification of the physician or rapid response team to attempt further interventions independently, without consulting or escalating, constitutes a failure to adhere to established protocols for patient deterioration. This can lead to a critical delay in receiving advanced medical care, potentially worsening the patient’s condition and violating the duty of care. It also bypasses the collaborative nature of patient management in a hospital setting. Focusing solely on documenting the patient’s decline without initiating the escalation process is a severe dereliction of duty. Documentation is essential, but it is a secondary action to the primary responsibility of ensuring patient safety and timely medical intervention. This approach prioritizes administrative tasks over immediate patient needs, which is ethically and professionally unacceptable. Professional Reasoning: Professionals should employ a structured approach to patient assessment and escalation. This typically involves the ABCDE (Airway, Breathing, Circulation, Disability, Exposure) assessment to quickly identify life-threatening issues. Following this, the nurse should consult the hospital’s early warning score (EWS) or similar system to quantify the level of deterioration. Based on this assessment and score, the appropriate escalation pathway, as defined by hospital policy, should be activated without delay. Clear, concise communication using a standardized handover tool (e.g., SBAR – Situation, Background, Assessment, Recommendation) is vital when communicating with the medical team. Continuous reassessment and monitoring are also critical throughout the process.

Scenario Analysis: This scenario is professionally challenging because it requires a nurse to navigate the nuanced requirements for advanced certification while balancing personal career aspirations with the integrity of the certification process. Misinterpreting eligibility criteria can lead to wasted effort, potential professional embarrassment, and a failure to uphold the standards set by the certifying body. Careful judgment is required to ensure adherence to the established framework for advanced practice. Correct Approach Analysis: The best professional approach involves meticulously reviewing the official eligibility criteria published by the Nordic Hematology and Oncology Nursing Board. This includes understanding the specific educational prerequisites, the required duration and nature of relevant clinical experience in hematology and oncology, and any necessary professional endorsements or examinations. Adhering strictly to these documented requirements ensures that the applicant meets the established standards for advanced practice, thereby validating their knowledge and skills and upholding the credibility of the certification. This aligns with the purpose of the certification, which is to recognize nurses who have attained a high level of expertise and competence in the specialized field. Incorrect Approaches Analysis: Pursuing certification based solely on anecdotal advice from colleagues, without verifying the information against official sources, is professionally unsound. This approach risks misinterpreting requirements, potentially leading to an application that does not meet the board’s standards, thus failing to achieve the intended certification. It bypasses the due diligence necessary to ensure compliance with the regulatory framework. Relying on outdated information from previous certification cycles without confirming current requirements is also a significant professional failure. Certification standards and eligibility criteria can evolve to reflect advancements in the field and changes in professional practice. Failure to consult the most current guidelines means the applicant may not be assessed against the present-day expectations for advanced practitioners. Assuming that a general oncology nursing background is sufficient without confirming specific hematology components, if required by the certification, is another flawed approach. Advanced certifications often have very specific domain requirements. Overlooking or assuming coverage of these specific areas can lead to an incomplete or ineligible application, undermining the purpose of specialized board certification. Professional Reasoning: Professionals should approach advanced certification with a systematic and evidence-based mindset. This involves: 1. Identifying the specific certification sought. 2. Locating and thoroughly reviewing the official documentation outlining purpose, eligibility, and application procedures. 3. Cross-referencing personal qualifications against each stated requirement. 4. Seeking clarification from the certifying body directly if any aspect of the criteria is unclear. 5. Documenting all steps taken to ensure compliance. This structured approach minimizes the risk of error and ensures that the pursuit of advanced certification is grounded in a clear understanding of the established professional standards.

The efficiency study reveals a need to optimize the diagnostic workup for suspected hematologic malignancies in pediatric patients presenting with new onset lymphadenopathy and fatigue. This scenario is professionally challenging due to the potential for delayed diagnosis, the emotional distress experienced by families, and the critical need for accurate and timely information to guide treatment decisions. Balancing the urgency of diagnosis with the need for a comprehensive, age-appropriate assessment requires careful judgment and adherence to established protocols. The best approach involves a multi-faceted strategy that prioritizes a thorough history and physical examination, followed by targeted diagnostic investigations based on clinical suspicion and age-specific risk factors. This includes a detailed family history for relevant genetic predispositions, a comprehensive review of systems focusing on constitutional symptoms, and a meticulous physical examination of all lymph node regions, spleen, and liver. Initial laboratory investigations should include a complete blood count with differential, peripheral blood smear review, and basic metabolic panel. Imaging, such as ultrasound of enlarged lymph nodes, should be guided by clinical findings and local protocols. Crucially, this approach emphasizes clear communication with the family, explaining the diagnostic process, potential findings, and next steps in an age-appropriate manner, while also ensuring the child’s comfort and minimizing unnecessary procedures. This aligns with ethical principles of beneficence, non-maleficence, and patient autonomy, as well as professional guidelines for pediatric hematology and oncology care that advocate for evidence-based, patient-centered diagnostic pathways. An incorrect approach would be to immediately proceed with invasive procedures like bone marrow aspiration and biopsy without a thorough initial assessment and less invasive investigations. This fails to adhere to the principle of judicious use of resources and can cause undue physical and psychological harm to the child and family. It also bypasses the opportunity to gather crucial preliminary information that might refine the diagnostic focus. Another incorrect approach would be to rely solely on imaging studies, such as CT scans, without a comprehensive clinical evaluation. While imaging can be valuable, it is not a substitute for a detailed history and physical examination, which can reveal subtle signs and symptoms that guide the interpretation of imaging results and the selection of further diagnostic tests. Over-reliance on imaging without clinical correlation can lead to misinterpretation, unnecessary anxiety, and potentially inappropriate interventions. Finally, an incorrect approach would be to delay diagnostic workup due to concerns about patient anxiety or parental distress, without implementing strategies to mitigate these factors. While patient and family well-being are paramount, delaying necessary diagnostic procedures can have severe consequences for the child’s prognosis. Professional practice requires proactive communication, provision of support, and age-appropriate explanations to manage anxiety and facilitate timely diagnosis. The professional reasoning process for similar situations should involve a systematic approach: 1) Gather comprehensive clinical data (history, physical exam). 2) Formulate differential diagnoses based on the data. 3) Prioritize diagnostic investigations, starting with the least invasive and most informative. 4) Consider age-specific factors and potential risks/benefits of each test. 5) Maintain open and honest communication with the patient and family throughout the process. 6) Consult with specialists as needed.

This scenario is professionally challenging due to the inherent complexity of managing a patient with advanced hematologic malignancy experiencing a new, potentially life-threatening symptom. The nurse must integrate advanced knowledge of pathophysiology with immediate clinical assessment and decision-making, all while adhering to strict ethical and professional guidelines. The patient’s deteriorating condition necessitates rapid, accurate, and evidence-based interventions. The correct approach involves a systematic, pathophysiology-informed assessment to identify the underlying cause of the patient’s dyspnea. This includes a focused physical examination, review of recent laboratory results (e.g., complete blood count, coagulation studies, inflammatory markers), and consideration of the patient’s specific diagnosis and treatment history. Based on these findings, the nurse should then collaborate with the medical team to initiate targeted investigations and management strategies. For instance, if pulmonary embolism is suspected based on risk factors and clinical presentation, the nurse would advocate for prompt diagnostic imaging and anticoagulation. This approach aligns with the ethical principles of beneficence (acting in the patient’s best interest) and non-maleficence (avoiding harm) by prioritizing accurate diagnosis and appropriate treatment. It also reflects professional accountability and the expectation that advanced practice nurses will utilize their specialized knowledge to guide patient care. The Nordic healthcare system emphasizes a patient-centered approach, shared decision-making, and evidence-based practice, all of which are embodied in this systematic, diagnostic strategy. An incorrect approach would be to immediately administer a broad-spectrum antibiotic without a clear indication of infection. While infection is a common complication in hematology/oncology patients, dyspnea can have numerous etiologies, including fluid overload, pulmonary embolism, or tumor progression. Administering antibiotics without a confirmed or highly suspected bacterial infection could lead to unnecessary side effects, contribute to antimicrobial resistance, and delay the diagnosis and treatment of the actual cause of the dyspnea. This fails to uphold the principle of non-maleficence by potentially causing harm through inappropriate medication and delays in effective treatment. Another incorrect approach would be to solely rely on symptom management, such as administering a mild opioid for perceived pain-related dyspnea, without investigating the underlying pathophysiology. While symptom relief is important, it should not supersede the imperative to diagnose and treat the root cause. This approach risks masking a critical condition, potentially leading to further deterioration and adverse outcomes, thus violating the principle of beneficence. Finally, an incorrect approach would be to wait for a physician to explicitly order every diagnostic step without proactive nursing involvement. While collaboration is essential, advanced practice nurses are expected to exercise independent judgment and initiate necessary investigations based on their assessment and understanding of the patient’s condition. Delaying essential diagnostic steps while awaiting explicit orders, especially in an acute situation, can be detrimental to patient outcomes and does not reflect the expected level of professional autonomy and responsibility. The professional decision-making process in such situations should involve a continuous cycle of assessment, diagnosis, planning, intervention, and evaluation, guided by the patient’s clinical presentation, underlying pathophysiology, available evidence, and ethical considerations. Advanced practice nurses should feel empowered to initiate diagnostic workups and advocate for timely interventions based on their expert judgment.

This scenario is professionally challenging due to the inherent vulnerability of the patient, the complexity of the treatment regimen, and the potential for significant adverse events. The nurse must balance the patient’s autonomy with the need to ensure their safety and well-being, all within the framework of established ethical and legal guidelines for patient care in Nordic healthcare settings. Careful judgment is required to navigate potential conflicts between patient wishes and recommended medical interventions, ensuring that decisions are made in the patient’s best interest while respecting their rights. The best approach involves a comprehensive and collaborative discussion with the patient, their family (with consent), and the multidisciplinary team. This includes clearly explaining the rationale behind the proposed treatment escalation, detailing the potential benefits and risks, and actively listening to the patient’s concerns and values. This approach aligns with the principles of shared decision-making, which is a cornerstone of patient-centered care in Nordic healthcare. It respects patient autonomy by ensuring they are fully informed and empowered to participate in decisions about their care. Furthermore, it adheres to ethical obligations to provide beneficence (acting in the patient’s best interest) and non-maleficence (avoiding harm) by thoroughly assessing risks and benefits. Regulatory frameworks in Nordic countries emphasize patient rights, informed consent, and the right to refuse treatment, all of which are upheld by this method. An incorrect approach would be to proceed with the treatment escalation without a thorough, documented discussion of the risks and benefits, or to override the patient’s expressed reservations without a clear, documented clinical justification and a subsequent comprehensive discussion. This would violate the principle of informed consent, potentially leading to a breach of patient autonomy and trust. Ethically, it could be seen as paternalistic and failing to respect the patient’s right to self-determination. Legally, it could expose the healthcare provider and institution to liability for battery or negligence. Another incorrect approach would be to solely rely on the family’s wishes without adequately involving the patient in the decision-making process, especially if the patient has the capacity to participate. While family support is crucial, the patient’s own expressed wishes and understanding are paramount, provided they have the capacity to make decisions. This approach risks undermining the patient’s autonomy and could lead to treatment that is not aligned with their personal values or goals of care. Finally, a failure to document the discussions, the patient’s understanding, and the rationale for the chosen course of action would be a significant professional and ethical failing. Comprehensive documentation is essential for continuity of care, legal protection, and demonstrating adherence to professional standards and regulatory requirements. Without it, it becomes difficult to prove that informed consent was obtained or that decisions were made in the patient’s best interest. Professionals should employ a decision-making framework that prioritizes open communication, thorough assessment of the patient’s capacity, clear explanation of medical information, active listening to patient and family concerns, and collaborative decision-making with the multidisciplinary team. This framework should be supported by robust documentation at every stage.

Scenario Analysis: This scenario is professionally challenging because it requires the candidate to balance personal learning needs with the demands of a busy clinical environment and the ethical obligation to provide safe patient care. The pressure to prepare for a rigorous certification exam while maintaining high standards of practice can lead to suboptimal decision-making regarding resource allocation and time management. Careful judgment is required to ensure that preparation does not compromise patient well-being or professional responsibilities. Correct Approach Analysis: The best professional approach involves proactively integrating study time into a structured personal development plan that is communicated to and agreed upon with the clinical manager. This approach acknowledges the importance of professional growth and certification while ensuring that patient care remains the absolute priority. By scheduling dedicated study periods during non-clinical hours or negotiating flexible shifts where feasible, the candidate demonstrates responsibility and foresight. This aligns with the ethical principles of professional accountability and continuous learning, which are implicitly supported by professional nursing standards that encourage skill enhancement and knowledge acquisition. It also respects the operational needs of the healthcare facility by ensuring adequate staffing and coverage. Incorrect Approaches Analysis: One incorrect approach involves solely relying on informal learning during patient care activities. This is professionally unacceptable because it risks diverting attention from critical patient needs, potentially leading to errors or suboptimal care. It also fails to provide the focused, in-depth study required for advanced certification, undermining the purpose of the preparation. Furthermore, it does not demonstrate a structured or accountable approach to professional development. Another incorrect approach is to neglect preparation altogether due to perceived time constraints and workload. This is ethically problematic as it demonstrates a lack of commitment to professional growth and may result in the candidate being unprepared for the certification exam. This can indirectly impact patient care by limiting the application of advanced knowledge and skills. It also fails to meet the implicit expectation of pursuing advanced qualifications in a specialized field. A third incorrect approach is to request significant time off work without a clear plan for utilizing that time for study and without considering the impact on team staffing and patient coverage. While dedicated study time is important, this approach can be disruptive to the clinical team and may not be a sustainable or responsible use of employer resources. It lacks the collaborative and considerate element of professional development planning. Professional Reasoning: Professionals preparing for advanced certifications should adopt a proactive and collaborative approach. This involves self-assessment of knowledge gaps, identification of appropriate study resources, and the development of a realistic study schedule. Crucially, this plan should be discussed with supervisors to ensure it aligns with operational needs and to seek support where appropriate. Ethical considerations regarding patient safety and professional responsibility must always be paramount, guiding all decisions about time allocation and resource utilization.

Scenario Analysis: This scenario is professionally challenging because it requires the nurse to navigate the complexities of board certification policies, specifically concerning blueprint weighting, scoring, and retake procedures, while also managing a candidate’s emotional and professional well-being. Misinterpreting or misapplying these policies can lead to significant professional consequences for both the candidate and the certifying body, impacting the candidate’s career progression and the integrity of the certification process. Careful judgment is required to ensure fairness, transparency, and adherence to established guidelines. Correct Approach Analysis: The best professional approach involves clearly and accurately communicating the established blueprint weighting and scoring methodology, as well as the precise retake policy, directly from the official certification board’s documentation. This approach is correct because it upholds the principles of transparency and fairness inherent in professional certification. By referencing the official guidelines, the nurse ensures that the candidate receives accurate information, preventing misunderstandings and potential disputes. This aligns with ethical obligations to provide truthful and evidence-based information, and regulatory requirements for standardized assessment procedures. Incorrect Approaches Analysis: Providing a generalized overview of how certification exams are typically weighted and scored, without specific reference to the Advanced Nordic Hematology and Oncology Nursing Board Certification’s official policies, is professionally unacceptable. This approach risks misinforming the candidate, as specific weighting and scoring can vary significantly between certifications. It fails to meet the ethical standard of providing accurate, specific information and may violate regulatory expectations for standardized and transparent assessment. Suggesting that the candidate focus solely on areas where they feel weakest, based on a subjective assessment of the blueprint, without understanding the actual weighted importance of each section, is also professionally flawed. This approach can lead to inefficient study habits and a skewed preparation strategy, potentially causing the candidate to under-prepare for heavily weighted sections. It bypasses the established, objective weighting system designed to ensure comprehensive competency assessment. Recommending that the candidate contact the board directly to “negotiate” the retake policy or inquire about exceptions, without first understanding the established policy, is inappropriate. Certification boards have established, non-negotiable policies for retakes to maintain the integrity and standardization of the certification process. Such an approach undermines the established procedures and can create an expectation of special treatment, which is not in line with fair and equitable assessment practices. Professional Reasoning: Professionals faced with this situation should adopt a framework that prioritizes accuracy, transparency, and adherence to established policies. This involves: 1. Consulting and understanding the official documentation for the specific certification (blueprint, scoring, retake policies). 2. Communicating this information clearly and directly to the candidate, using the official language and details. 3. Explaining the rationale behind the policies (e.g., why certain sections are weighted more heavily, the purpose of retake limitations) to foster understanding. 4. Offering support within the bounds of the established policies, such as directing the candidate to official study resources or practice materials, without deviating from the stated rules.

Scenario Analysis: This scenario is professionally challenging due to the inherent risks associated with polypharmacy in an elderly patient with multiple comorbidities, specifically the potential for drug-drug interactions and adverse drug events. The nurse’s role in medication safety is paramount, requiring a proactive and systematic approach to identify and mitigate these risks before administering potentially harmful medications. Careful judgment is required to balance the therapeutic benefits of prescribed medications with the patient’s vulnerability. Correct Approach Analysis: The best professional practice involves a comprehensive review of the patient’s current medication regimen, including over-the-counter drugs and herbal supplements, in conjunction with the newly prescribed medication. This review should specifically focus on identifying potential interactions, contraindications, and contraindications based on the patient’s age, renal and hepatic function, and existing conditions. This approach aligns with the principles of patient-centered care and the professional responsibility to ensure medication safety, as mandated by nursing professional standards and guidelines for pharmacovigilance. It prioritizes a thorough understanding of the patient’s complete medication profile to prevent harm. Incorrect Approaches Analysis: Initiating the new medication without a thorough review of the patient’s existing medication list and medical history is a significant ethical and regulatory failure. This oversight bypasses critical safety checks designed to prevent adverse drug events and drug-drug interactions, potentially leading to patient harm. It demonstrates a lack of due diligence and adherence to best practices in medication management. Administering the new medication based solely on the prescribing physician’s order without independent verification of its appropriateness in the context of the patient’s full clinical picture is also professionally unacceptable. While physicians prescribe, nurses have a professional and legal responsibility to question and clarify orders that appear potentially unsafe or inappropriate for the individual patient. This approach abdicates the nurse’s role as a patient advocate and safety gatekeeper. Relying on the patient’s self-report of their current medications without cross-referencing with their medical records or pharmacy profiles is risky. Patients may forget medications, misunderstand dosages, or fail to report over-the-counter or herbal remedies, leading to an incomplete and potentially inaccurate assessment of their medication regimen. This can result in missed interactions and an increased risk of adverse events. Professional Reasoning: Professionals should employ a systematic approach to medication administration, often referred to as the “rights of medication administration” (right patient, right drug, right dose, right route, right time, right documentation), but extending this to include the right reason and the right to refuse. Crucially, this must be underpinned by a thorough understanding of the patient’s current clinical status and all medications they are taking. When faced with a new prescription, especially for a vulnerable population, a critical thinking process should be initiated: 1) Review the new medication’s indication, mechanism of action, common side effects, and potential interactions. 2) Review the patient’s complete medication profile (prescription, OTC, herbal). 3) Assess for potential drug-drug, drug-food, and drug-disease interactions. 4) Evaluate the patient’s renal and hepatic function. 5) Consider the patient’s age and comorbidities. 6) If any concerns arise, consult with the prescribing physician or pharmacist before administration. This layered approach ensures patient safety and upholds professional accountability.

Scenario Analysis: This scenario is professionally challenging due to the inherent conflict between patient autonomy, the need for timely and effective treatment, and the potential for misinterpretation of a patient’s wishes when they are experiencing significant distress and pain. The nurse must navigate these complexities while adhering to ethical principles and professional standards of care, ensuring the patient’s well-being and dignity are paramount. The pressure to act quickly in a critical care setting can also exacerbate the difficulty of making nuanced judgments. Correct Approach Analysis: The best professional practice involves a multi-faceted approach that prioritizes clear communication and collaborative decision-making. This includes actively listening to the patient’s expressed concerns, validating their feelings, and gently exploring the underlying reasons for their distress and their request. It necessitates involving the patient’s treating physician and potentially a palliative care specialist or ethics committee to ensure all aspects of the patient’s care are considered and that their wishes, as far as they are able to express them, are respected within the legal and ethical framework. This approach aligns with the core ethical principles of beneficence, non-maleficence, and respect for autonomy, as well as professional nursing standards that emphasize patient-centered care and interdisciplinary collaboration. Incorrect Approaches Analysis: One incorrect approach involves immediately overriding the patient’s request based on the assumption that their distress negates their capacity to make decisions. This fails to uphold the principle of patient autonomy and can lead to a breakdown in trust. It also bypasses the crucial step of assessing the patient’s understanding and capacity, which is a fundamental ethical and professional obligation. Another incorrect approach is to proceed with the requested intervention without further consultation or assessment, solely based on the patient’s verbal request in a moment of distress. This neglects the responsibility to ensure the patient’s request is informed, voluntary, and aligned with their overall care plan and best interests. It also fails to involve the necessary healthcare team members who can provide a comprehensive evaluation of the situation. A third incorrect approach is to dismiss the patient’s request as simply a manifestation of pain and to focus solely on pain management without exploring the patient’s broader concerns or wishes. While pain management is critical, it should not preclude addressing the patient’s expressed desire for a change in care, which may stem from factors beyond physical discomfort. This approach risks failing to address the patient’s holistic needs and may lead to a sense of being unheard or misunderstood. Professional Reasoning: Professionals should employ a decision-making framework that begins with active listening and empathetic engagement. This is followed by a thorough assessment of the patient’s current state, including their capacity to understand their situation and make decisions. Crucially, it involves open and honest communication with the patient about their concerns and options, and collaborative discussion with the interdisciplinary healthcare team. Ethical principles and professional guidelines should always inform these decisions, ensuring that patient well-being, autonomy, and dignity are respected.

The audit findings indicate a recurring issue with medication administration errors on the oncology ward, specifically concerning the timely and accurate delivery of chemotherapy. This scenario is professionally challenging due to the high stakes involved in patient safety, the complexity of chemotherapy regimens, and the need for effective teamwork within a multidisciplinary setting. Careful judgment is required to identify the root cause and implement sustainable solutions that align with professional nursing standards and regulatory expectations. The best approach involves a proactive and collaborative strategy. This includes the charge nurse initiating a structured discussion with the interprofessional team, specifically the physicians and pharmacists, to review the medication administration process for chemotherapy. The focus should be on identifying systemic issues, such as unclear orders, potential drug interactions, or inadequate staffing levels, rather than solely on individual performance. This collaborative review, documented and leading to agreed-upon action plans, directly addresses the audit findings by fostering shared responsibility and leveraging the expertise of all team members to improve patient care and safety. This aligns with the ethical principles of beneficence and non-maleficence, as well as professional guidelines emphasizing teamwork and communication in patient safety initiatives. An incorrect approach would be for the charge nurse to immediately implement a new, unproven protocol without consulting the interprofessional team. This bypasses essential communication channels and fails to leverage the collective knowledge of physicians and pharmacists, who are critical in ensuring the safe and effective administration of chemotherapy. Such an action could lead to unintended consequences or further errors due to a lack of comprehensive understanding of the underlying issues. Another incorrect approach would be to address the audit findings by solely focusing on individual nurses through mandatory retraining sessions without investigating systemic factors. While individual competency is important, this approach ignores potential organizational or process-related issues that may be contributing to the errors. This could lead to frustration among staff and fail to resolve the root cause of the problem, potentially leading to continued errors. A further incorrect approach would be to delegate the responsibility of investigating and resolving the medication errors to a junior nurse without adequate support or oversight. Delegation requires careful consideration of the delegatee’s skills, knowledge, and workload, as well as clear objectives and ongoing supervision. This abdication of leadership responsibility by the charge nurse would be professionally unacceptable and could jeopardize patient safety. The professional decision-making process for similar situations should involve a systematic approach: first, acknowledge and analyze the audit findings; second, engage in open and honest communication with the interprofessional team to identify root causes; third, collaboratively develop and implement evidence-based solutions; fourth, monitor the effectiveness of interventions and make adjustments as needed; and finally, ensure thorough documentation of all actions taken.