Week 2 Reflection Assignment – Peer Review
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Overview: Peer Review
In this Reflection Assignment, reflect upon what you have learned about the Minor Incident Rule and Peer Review Committee processes as you consider the actions of fictitious nurses and committee members in scenarios. USE THE TEXAS BOARD OF NURSING RULES and link to the Texas BON Rule 217.16. Refer to your course readings and lectures as you complete the assignment.
Performance Objectives:
· Differentiate between the the Minor Incident Rule (217.16 a) vs. a Reportable Incident 217.16 h)
· Describe the due process protections (Rule 217.19) for a nurse who is peer-reviewed.
Rubric
| Task | Complete | Incomplete |
| Part 1 Applying Rule 217.16 Minor vs. Reportable Incident | 4 professionally written sentences demonstrating critical thinking are present. | Less than required number of professionally written sentences, poor or no critical thinking |
| Part 2 Applying IBPR Rule 217.19 a (2) Bad Faith
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All 4 professionally written sentences demonstrating critical thinking are present. | Less than required number of professionally written sentences or no critical thinking |
| Professional Writing
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Assignment is written clearly without any grammatical or spelling errors. | Assignment is unclear or grammatical or spelling errors. |
Part 1: Applying Rule 217.16
Minor Incident (217.16 a) vs. a Reportable incident (217.16 h):
A minor incident – 217.16(a) – a nurses’ actions may be a violation of a board rule but does not indicate the nurses 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 Peer Review Committee or the BON.
Let’s come up with an easy way to remember what a minor incident is. If you are ever in this situation or are participating on a peer review committee evaluating a fellow nurse’s actions, think about the word “harp.â€
· H- no significant Harm
· A- nurse must take Accountability
· R- easily Remediated
· P- no Pattern of this behavior
Minor incidents must still be documented, tracked, and remedied. The nurse must be reported to the nursing Peer Review committee if a nurse commits five (5) minor incidents within a 12-month period.
Look at this case study scenario below.
“The Nurse is caring for a newly admitted 67-year-old male patient with infectious endocarditis due to a bacterial infection of his prosthetic heart valve. After blood cultures come back positive for staphylococcus aureus, IV Vancomycin is ordered. The patient tells the Nurse and the doctor that the last time he got this medication, he experienced hives and hot, itchy skin but he was not allergic to it. The doctor ordered the medication to be infused slowly as to avoid Red Man Syndrome (500 mg IV bag at a rate of two hours as opposed to the standard one hour). The Nurse sets the IV pump incorrectly, and the infusion is given within a 30-minute period. The patient experiences an allergic reaction. The Nurse calls the doctor and immediately gives the ordered 50 mg diphenhydramine and ranitidine 50 mg via IV. The patient experienced mild flushing, but the episode resolved within 20 minutes. The Nurse is a well-seasoned nurse with over 20 years of experience and no prior history of incidents who took immediate responsibility for this error when meeting with the unit manager. As to remediation, the Nurse will now need another RN to witness and sign when she administers IV medication for the next 60 days. The Nurse agrees to this plan.”
Using the Texas BON Rule 217.16, review (a) a Minor Incident vs. (h) a reportable incident. This information can be found at https://www.bon.texas.gov/rr_current/217-16.asp
Based on your assessment of the criteria, was this a Minor Incident or reportable event? Why or Why not? Write professionally written sentences with examples from the Rule to support your thoughts for full credit in the box below.
Minor or Reportable?
Why? Why not? Include examples from the Rule.
Part 2: Applying Rule 217.19 Incident-Based Peer Review
First, review Incident-Based Peer Review. The purpose of an IBPR is to determine whether a nurse should be reported to the Texas Board of Nursing (BON) for professional misconduct or licensure violations based on one or more such events. Use the link provided to review: https://www.bon.texas.gov/rr_current/217-19.asp. Apply the information to this case study.
“The Nurse is charting at the nurse’s station where there are co-workers, physicians and a unit secretary gathered. The Nurse and the nurse manager have not been seeing eye to eye lately (verbal altercations both in the halls and in the cafeteria recently). The nurse manager approaches the Nurse and loudly states, “I am glad you are here. Just to let you know, the Incident Based Peer Review Committee is meeting tomorrow, and we are investigating your recent questionable behavior. I know you have made many recent medication errors and safety violations noted by the Patient Safety Committee. I also heard that you are dating that patient who was in Room 256B last month. I thought you would want to know this was happening. You could be in big trouble and probably fired. I don’t have anything official to give you, but you better find a lawyer, although I doubt you can with this short notice.â€
How did this nurse manager violate the IBPR? Refer to the Rule listed below and discuss in the text box.
Rule 219.17 a (2) Bad Faith – knowingly or recklessly acting without the supported of reasonable or legal basis, misrepresenting the facts surrounding the facts under review, acting out of malice or personal animosity towards the nurse, acting from a conflict of interest, or knowingly or recklessly denying due process.
How did this nurse manager violate the IBPR based on this rule? Please write professionally written sentences with examples from the Rule to support your thoughts for full credit in the box below.
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