Discussion Prompt 2
Explore your clinical site and relate one quality improvement (QI) study currently being analyzed. What is benchmarked in the study? What role does the nurse play in the QI study?
Click on this link to complete the DNR Interactive Case Study for this week. 
Associate what you have learned in your weekly materials with what was presented in the case study.
After you complete the case study, click on the “Interactive Case Study Journals” link to reflect upon what you have learned from the case study and related learning materials this week. Once opened, choose the DNR Interactive Case Study Journal and follow the instructions listed within the journal. Compare this case study to your nursing practice and give a similar example from your nursing experience in which you might have run into an ethical situation.
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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 COMPLETE 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)
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
Criteria :
1.
2.
3.
4.
5.
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.: (Explain below)
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).
1-
2-
3-
4-
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 ( from the 4 criteria above):
1.
2.
3.
4.
Create a 1-page fact sheet that your healthcare organization could hypothetically use to explain the health or nursing informatics policy/regulation you selected. Your fact sheet should address the following:
To Prepare:
The Assignment: (4-5 pages)
In a 4- to 5-page project proposal written to the leadership of your healthcare organization, propose a nursing informatics project for your organization that you advocate to improve patient outcomes or patient-care efficiency. Your project proposal should include the following:
ExcellentGoodFairPoorIn a 4- to 5-page project proposal written to the leadership of your healthcare organization, propose a nursing informatics project for your organization that you advocate to improve patient outcomes or patient care efficiency. Your project proposal should include the following:
· Describe the project you propose.
· Identify the stakeholders impacted by this project.
· Explain the patient outcome(s) or patient-care efficiencies this project is aimed at improving, and explain how this improvement would occur. Be specific and provide examples.
· Identify the technologies required to implement this project and explain why.
· Identify the project team (by roles) and explain how you would incorporate the nurse informaticist in the project team.77 (77%) – 85 (85%)The response accurately and thoroughly describes in detail the project proposed.
The response accurately and clearly identifies the stakeholders impacted by the project proposed.
The response accurately and thoroughly explains in detail the patient outcome(s) or patient-care efficiencies that the project proposed is aimed at improving, including an accurate and detailed explanation, with sufficient supporting evidence of how this improvement would occur.
The response accurately and clearly identifies the technologies required to implement the project proposed with a detailed explanation why.
The response accurately and clearly identifies the project team (by roles) and thoroughly explains in detail how to incorporate the nurse informaticist in the project team.68 (68%) – 76 (76%)The response describes the project proposed.
The response identifies the stakeholders impacted by the project proposed.
The response explains the patient outcome(s) or patient-care efficiencies that the project proposed is aimed at improving, including an explanation, with some supporting evidence of how this improvement would occur.
The response identifies the technologies required to implement the project proposed with an explanation why.
The response identifies the project team (by roles) and explains how to incorporate the nurse informaticist in the project team.60 (60%) – 67 (67%)The response describing the project proposed is vague or inaccurate.
The response identifying the stakeholders impacted by the project proposed is vague or inaccurate.
The response explaining the patient outcome(s) or patient-care efficiencies the project proposed is aimed at improving, including an explanation of how this improvement would occur, is vague or inaccurate, or includes little to no supporting evidence.
The response identifying the technologies required to implement the project proposed with an explanation why is vague or inaccurate.
The response identifying the project team (by roles) and an explanation of how to incorporate the nurse informaticist in the project team is vague or inaccurate.0 (0%) – 59 (59%)The response describing the project proposed is vague and inaccurate, or is missing.
The response identifying the stakeholders impacted by the project proposed is vague and inaccurate, or is missing.
The response explaining the patient outcome(s) or patient-care efficiencies the project proposed is aimed at improving, including an explanation of how this improvement would occur, is vague and inaccurate, includes no supporting evidence, or is missing.
The response identifying the technologies required to implement the project proposed with an explanation why is vague and inaccurate, or is missing.
The response identifying the project team (by roles) and an explanation of how to incorporate the nurse informaticist in the project team is vague and inaccurate, or is missing.Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance.5 (5%) – 5 (5%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity.4 (4%) – 4 (4%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.3.5 (3.5%) – 3.5 (3.5%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%- 79% of the time.0 (0%) – 3 (3%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation5 (5%) – 5 (5%)Uses correct grammar, spelling, and punctuation with no errors.4 (4%) – 4 (4%)Contains a few (1-2) grammar, spelling, and punctuation errors.3.5 (3.5%) – 3.5 (3.5%)Contains several (3-4) grammar, spelling, and punctuation errors.0 (0%) – 3 (3%)Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.5 (5%) – 5 (5%)Uses correct APA format with no errors.4 (4%) – 4 (4%)Contains a few (1-2) APA format errors.3.5 (3.5%) – 3.5 (3.5%)Contains several (3-4) APA format errors.0 (0%) – 3 (3%)Contains many (≥ 5) APA format errors.Total Points: 100
Create a 1-page fact sheet that your healthcare organization could hypothetically use to explain the health or nursing informatics policy/regulation you selected. Your fact sheet should address the following:
Review the steps of the Systems Development Life Cycle (SDLC) and reflect on the scenario presented.
The Assignment: (2-3 pages)
In preparation of filling this role, develop a 2- to 3-page role description for a graduate-level nurse to guide his/her participation on the implementation team. The role description should be based on the SDLC stages and tasks and should clearly define how this individual will participate in and impact each of the following steps:
In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Be sure to address the following:
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