Nursing Rules and Regulations

Read the following scenario and then answer the questions that follow You are on your hospital's Peer Review Committee (PRC). You are reviewing Nurse A's practice. She works on the pediatric unit. In the past, Nurse A has practiced safely without incidents. However, four months ago, Nurse A gave immunizations to five pediatric patients (3 months, 9 months, 2 years, 4 years, and 5 years of age). She used a vial of Hepatitis B vaccine that had been expired for 30 days but still was being stored in the unit refrigerator.

She gave the five immunizations within a few minutes of each other, and she got the vial from the refrigerator only once (i.e., She did not take it out and replace it five times). She took responsibility for the errors when she was informed by her unit manager. Should Nurse A be reported to the BON? Apply the Minor Incident Rule to reach and support your decision A. Criteria. First, review your learning about minor incidents - those which are NOT reportable to the BON.

In the first column of the table, list the 4 criteria that are essential in determining if an incident is not "minor." Criteria that determine an incident is NOT minor Explanation of whether or not the facts determine that the incident is NOT minor There is a significant risk of harm. The facts of the case support this criteria. As per the case, there is no risk of significant harm to the patients immunized with the expired vial. A vaccination works to prevent the occurrence of the disease (Kuenstler, 2014).

Therefore and expired vaccine would not have any risk of harm to the patient. The nurse lacks a conscientious approach or accountability for the incident. The nurse did take responsibility for the errors. Nurse A did not offer excuses and it is clear she was unaware the vaccine had expired before administering it to the patients. Nurse lacks easily remediated knowledge and competencies for making appropriate clinical judgements (Texas Board of Nursing, 2016). Nurse A has not had any other incidents and has always practised safely.

The knowledge of nurse A can be remediated and Nurse A can be shown how to check the expiration date for drugs. There is a pattern of multiple minor incidents Based on the facts of the case, this was the first incident the nurse has faced. This clearly indicates that there is no need to eport the nurse as this was a minor case and the first time that the nurse had an incident. 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 module, 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 giving you a 'heads up' that you are going to be put on suspension for at least three days by your unit manager." Applying Rule 217.19, what, if any, violations of the rule occurred in the above scenario? NOTE: If your state has its own rule regarding incident-based peer reviews, identify the rule in your responses, and apply it to the scenario instead. A. No, the scenario does not describe violations of Rule 217.19.

Explain which parts of the scenario might cause questions, but why they are not violations of Rule 217.19. You will lose major points if explanation with critical thinking is not provided. (If you believe that violations did occur, leave this space blank and proceed to the next section.) B. Yes, violations occurred. First, review your learning about incident-based peer review. In the first column of the table, list the criteria from Rule 217.19 that were violated. In the second column, explain how each criterion was violated.

Which part of the rule was violated? (Subsection number and letter OR descriptive phrase) Explanation of violation 3 (C) There was no written notice stating the nurses conduct was under review or being evaluated (Texas Board of Nursing, 2013), instead the information was relayed in an informal manner. The peer review committee did not report to the nurse when they would be meeting to discuss the nurse's conduct and medical errors. This was a violation of the nurse's rights to a fair notice period and hearing.

3 (D) Since there was no notice given to the nurse, the peer review committee did not provide the nurse with any detailed information regarding the events being reviewed and evaluated. It is stated that a detailed description of the particular events being evaluated must be provided to the nurse. The description should include the date and time it occurred, where it happened, and the individuals involved. There should have also been a contact person identified whom the nurse should have given her response to, but this was not the case.

3 (F) The nurse was not.