During a follow-up home visit, the care plan from the previous visit was not followed. What should the nurse do first?

• A. Discuss with the family what changes have occurred that have prevented them from following plan of care
• B. Document noncompliance
• C. Escalate to supervisor
• D. Reassess the condition

Answer: (A)

The situation tests how to handle nonadherence by exploring underlying reasons before taking punitive or repetitive steps. When a follow-up shows the care plan wasn’t followed, the best first move is to talk with the family to learn what changed or prevented adherence. This open, nonjudgmental discussion helps uncover real barriers—such as transportation, cost, caregiver workload, misunderstanding of instructions, cultural beliefs, or new symptoms—that make the plan difficult to follow. By identifying these factors, the nurse can adapt the plan, reinforce education, or connect the family with needed resources, improving the chances of successful care going forward.

Documenting noncompliance or escalating to a supervisor jumps ahead of gathering context and can strain trust or miss root causes. Reassessing the condition remains important, but it’s most effective after you’ve understood why the plan wasn’t followed, so you can determine whether the plan needs modification or additional supports.