determine that the incident is NOT minor Ignored a substantial risk that exposed a patient or other person to significant physical, emotional or financial harm or the potential for such harm Nurse A didn’t ignore any risks that exposed these 5 pediatric patients to any harm. The nurse assumed that since the vial was still in the fridge is was still OK to use. She should have looked at the expiration date on the vial prior to using it the first time. Lacked a conscientious approach to or accountability for his/her practice Nurse A acknowledged her mistake and took responsibility for it when it was brought to her by her unit manager. Lacked the knowledge and competencies to make appropriate clinical judgments and such knowledge and competencies cannot be easily remediated Nurse A is a competent nurse who is clinically competent. She took a shortcut by not returning the vial each time it was used, and thereby didn’t check the expiration date each time it was used. Indicates the nurse has engaged in a pattern of multiple minor incidents that demonstrate the nurse's continued practice would pose a risk of harm to patients or others Nurse A has not shown a pattern of multiple incidents, but since this did happen to 5 different patients it counts as 5 separate incidents. In evaluating whether multiple incidents constitute grounds for reporting it is the responsibility of the nurse manager or supervisor or peer review committee to determine if the minor incidents indicate a pattern of practice that demonstrates the nurse's continued practice poses a risk and should be reported. ©2015 UTA School of Nursing 2
N3375 Health Policy & Legal Aspects B. Minor Incident? Apply the facts of the case to each criterion above. In the second column of the table, record your explanation as to whether the facts support or do not support each of the criteria. C. Your Decision. Record whether, as a member of the Peer Review Committee (PRC), you would vote to report or not report Nurse A to the Board of Nursing. (Insert an X in the box that reflects your decision.) Report X Not report Part 2: Applying Rule 217.19 Incident-Based Peer Review Read the following scenario and then reflect upon the actions it portrays. Last month, the chairperson of your hospital’s Peer Review Committee (PRC) passed you in the hallway and said, “I’m glad I ran into you. You’re going to be peer-reviewed.” The chairperson continued, saying, “Your manager found out that you called the Texas Department of State Health Services two months ago and reported that LVNs were being allowed to do the complete initial assessment on patients. Also, you made some medication errors over the past couple of months. I’ll let you know when the meeting is to occur.” You heard nothing more about the PRC meeting. Today, the chairperson came to you and told you that you had been reported to the Texas Board of Nursing. She said, “It was just felt by the work group that you are a troublemaker and lack the skills to practice due to your med errors. I’m also
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- Summer '16