A medical unit wants to reduce client falls using the Plan-Do-Study-Act approach. Which action best represents the first test of change?
1Roll out hourly rounding on every unit before collecting any baseline data
2Replace the fall policy after one meeting and assume staff will follow it
3Test hourly rounding on one hallway and compare falls and call-light use✓ Correct answer
4Wait for annual outcome data before trying a focused fall intervention
Explanation
A PDSA cycle begins with a small, measurable test of a proposed change. Testing hourly rounding in one area lets the team study fall and call-light data, refine the process, and decide whether to adapt, adopt, or abandon the change before spreading it.
Quick answer Test hourly rounding on one hallway and measure what happens. PDSA favors a small, observable first test rather than an immediate organization-wide rollout.
Why this is correct A limited trial reduces risk and makes cause-and-effect easier to observe. The team can compare fall events, call-light use, and workflow problems, study the result, and revise the next cycle before expanding the intervention.
Easy analogy or mental picture A PDSA test is like trying a recipe in one small pan before cooking it for an entire banquet. The small batch reveals what needs adjustment, but a successful local test still requires thoughtful evaluation before broad adoption.
Memory hook Plan the change, do it small, study the data, then act on what was learned.
NCLEX decision rule When an NCLEX item asks for the first PDSA action, choose a defined small-scale test with a measurable outcome. Do not choose immediate full implementation, policy replacement without data, or passive delay.
Why the other choices are wrong Unit-wide rollout skips the learning phase. Replacing policy after one meeting does not test performance, and waiting for annual data delays a low-risk improvement that can be evaluated now.
References
[1]
NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing
[2]
AHRQ: Plan-Do-Study-Act WorksheetAgency for Healthcare Research and Quality