An incident based nursing peer review committee

Overview: Peer Review

In the Module 3 Reflection Assignment, you will reflect upon what you have learned about Peer Review Committee processes and Texas Board of Nursing rules as you consider the actions of fictitious nurses and committee members in scenarios. REMEMBER, YOU ARE USING THE TEXAS BOARD OF NURSING RULES, NOT THE STATE YOU LIVE IN. Please use the link provided in the assignment for the Texas BON Rule 217.16.

ALSO, THERE ARE 2 PARTS TO THIS ASSIGNMENT. PLEASE MAKE SURE YOU COMPELTE BOTH PARTS.

Refer to your course readings and lectures as you complete the assignment.

Performance Objectives:

· Apply the Minor Incident Rule to specific incidents.

· Describe the due process protections for a nurse who is peer-reviewed.

Rubric

Use this rubric to guide your work on the assignment, “Peer Review.”

Task

Accomplished

Proficient

Needs Improvement

Part 1 (a) Applying Rule 217.16 (Total 50 points)

Lists all the correct 5 criteria, accurately explains application of criteria clearly. (25 points)

Lists 3 or 4 of the correct criteria, accurately explains application of these criteria (15 points)

Lists 2 applications of criteria. 10 points)

Incorrectly lists criteria (0 point)

Part 1 (b) Reflects upon applications of Rule 217.16 (Total 25 points)

Correctly states if nurse should be reported or not reported with 3 substantial sentences. (25 points)

Correctly states if nurse should be reported or not reported with 2 sentences. (15 point)

Writes 1 sentence. (10 points)

Incorrectly judges whether violations occurred (0 point)

Part 2

Violation of IBPR Rule 217.19 (Total 25 points)

Correctly listed the 4 violations and provides correct explanations (25 points)

Correctly lists 2-3 violations and explanations (15 points)

Lists 1 violation and explanation (10 points)

Incorrectly lists criteria (0 point)

Part 3

Multiple choice and true/false questions- 5 points each

(Total 25 points)

All 5 questions correct (25 points)

4 questions correct (20 points)

3 questions correct (15 points)

2 questions correct (10 points)

1 question correct (5 points)

0 questions correct (0 point)

Part 1: (a) Applying Rule 217.16(h) Minor Incidents

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?

Let’s review what deems a minor vs. a reportable (NOT minor) incident-

A minor incident is- 217.16(a)- as defined under the Texas Nursing Practice Act, Texas Occupations Code §301.401(2), means conduct by a nurse that may be a violation of the Texas Nursing Practice Act or a Board rule but does not indicate the nurse's continued practice poses a risk of harm to a patient or another person.

A reportable incident is- 217.16(h)- conduct that falls outside of the definition of a minor incident and must be reported to a PRC or BON.

Apply the Minor Incident Rule to reach and support your decision. This Rule 217.16 can be found at http://www.bon.texas.gov/rr_current/217-16.asp

Use this specific link only- it is the official updated Texas Board of Nursing information. Click on the link and scroll down to the bottom to find the letter (h), where criteria are listed that describes actions that must be reported to the Peer Review Committee or BON.

Criteria. In the first column of the table, list the 5 criteria as it appears in the rule that are essential in determining if an incident is a reportable action. All 5 must be listed for full credit. Then, in the second column, record your explanation as to why or why not the nurse’s actions deem it reportable and therefore harmful to a patient.

Criteria that determine an incident is reportable

Rule 217.16(h)

Explanation of whether or not Nurse A’s actions are minor vs. reportable

1. Conduct that ignores a substantial risk that exposed a patient or other person to significant physical emotional or financial harm or the potential for such harm

2. Conduct that violates the Texas Nursing Practice Act or a Board rule and contributed to the death or serious injury of a patient

3. A practice related violation involving impairment or suspected impairment by reason of chemical dependency, intemperate use, misuse or abuse of drugs or alcohol, mental illness, or diminished mental capacity

The nurse was not impaired by reason of chemical dependency, mental illness or diminished mental capacity therefore should not have been reported

4. A violation of Board Rule 217.12 with actions that constitute abuse, exploitation, fraud, or a violation of professional boundaries

5. Actions that indicate the nurse lacks knowledge, skill, judgment, or conscientiousness to such an extent that the nurse's continued practice of nursing could reasonably be expected to pose a risk of harm to a patient or another person, regardless of whether the conduct consists of a single incident or a pattern of behavior

Part 1: (b) Report vs. Not Report

Based on the Rule 217.16(h) criteria you listed above, would you report Nurse A to the Board? Please explain why or why not. At least 3 substantial sentences are needed for full credit.

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 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 violations of the rule occurred in the above scenario?

First, review your learning about incident-based peer review. In the first column of the table, list any 4 criteria from Rule 217.19 that were violated (there are more than 4 to choose from). In the second column, explain how each criterion was violated. All 4 boxes must be completed for full credit. Please use the link provided at http://www.bon.texas.gov/rr_current/217-19.asp

Which part of the rule was violated?

(Subsection number and letter OR descriptive phrase)

(Rule 217.19)

Explanation of violation

1.

2.

3.

4.

Submitting Your Assignment:

· Click the word Assignment in the Module.

· Click on the words Module 3 Assignment. The assignment submission document will open.

· Go to 2. Assignment Materials-Submission. Click Browse and navigate to your Desktop where you saved your paper. Select the final version of your paper to upload from your computer.

· When you’ve selected your paper, click Attach Files and your saved assignment document should appear in the submission box just above the Attach Files button.

· Click Submit at the bottom of the Assignment Submission screen and your saved document assignment will appear the gradebook with a green exclamation point that alerts your Academic Coach that your assignment is ready for grading.