Health Policy And Legal Aspect

Submit by 2359 (CT) Saturday of Module 3.

Name:		Date:

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.

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 Reflects upon applications of Rule 217.16(Total 50 points)	List the correct criteria, accurately explains application of criteria clearly, and arrives at correct decision.(50 points)	Lists the correct criteria, accurately explains application of at least two criteria, and arrives at correct decision.(40 points)	Incorrectly lists criteria, or inadequately explains at least two applications of criteria, or arrives at incorrect decision.(25 point)
Part 2 Reflects upon applications of Rule 217.19(Total 50 points)	Correctly judges and clearly explains each violation, or correctly states that no violation occurred.(50 points)	Correctly judges and explains at least one violation, or correctly states that no violation occurred.(40 point)	Incorrectly judges whether violations occurred.(25 points)

Part 1: Applying Rule 217.16 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? No

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(Rule 217.16)	Explanation of whether or not the facts determine that the incident is NOT minor
A) Ignored a substantial risk that exposed a patient or other person to significant physical, emotional or financial harm or the potential for such harm.	The nurse gave the immunizations minutes apart and was probably unaware that she was doing something wrong.
B) Lacked a conscientious approach to or accountability for his/her practice.	The nurse took responsibility for the errors.
C) Lacked the knowledge and competencies to make appropriate clinical judgments and such knowledge and competencies cannot be easily remediated.	She can be remediated since this is her first mistake.
D) 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.	This was her first 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

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 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)(Rule 217.19)	Explanation of violation
3C: Written notice provided about practice being evaluated.	The chairs person only provided verbal notice and did not fully describe the situation.
3D: Description of events that occurred.	Only a quick summary of the events that were to be reviewed.
3E: Provide nurse the opportunity to review documents.	No documents were provided to the nurse to review prior to reporting to the Texas BON.
3F: Provide nurse the opportunity to submit a statement.	The nurse was not given the opportunity to submit a statement regarding her actions.

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.

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