incident reports punitive?

  1. Hi all. I Need to know if it is legal for a nurse to get punished if there are too many incident reports against this nurse. NOthing mayor but several of the same kind. is it better to be dishonest and not report it.
    Also, is it legal and still a good practice for hospitals to still provide prefilled pens for sq medication. these nedles don't have a safety retractable nedle, you have to manually remove it from the pen and dispose of it.
    thank you for your info.
    Monica
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  2. 6 Comments

  3. by   neneRN
    Its NEVER better to "be dishonest and not report it." Not even an option. One of the reasons for having incident reports is to monitor trends; it does raise a red flag if the same nurse is repeating whatever mistake/offense because there obviously is an issue that needs to be addressed. It would be less concerning to me if a nurse had a couple of incident reports regarding different issues as opposed to one incident repeated over and over-this shows a need for a different plan of correction/follow up. Incident reports are not always a bad thing; by monitoring trends, you are able to identify the cause of problems, whether that be the need for additional staff, more education, new protocols, etc.

    As for the prefilled pens, I'm not sure I understand why you would have to remove the needle- why not just throw the whole needle and pen into the sharps?
  4. by   wrkoutgirl
    Thank you for your info.
    I am referring to a multiple dose pen called Byetta. it is used for diabetes control but it is not insulin. the pharmacy dispenses the pen in a box w/ multiple dose (you activate each dose similar to Advair). the pharmacy also sends a number of tinny litle nedles that you kind of screw to the pen and then you literally unscrew it and discard. this is not safe at all. you then put the pen back in the refrigerator for the next dose.
  5. by   DeLana_RN
    Quote from wrkoutgirl
    Thank you for your info.
    I am referring to a multiple dose pen called Byetta. it is used for diabetes control but it is not insulin. the pharmacy dispenses the pen in a box w/ multiple dose (you activate each dose similar to Advair). the pharmacy also sends a number of tinny litle nedles that you kind of screw to the pen and then you literally unscrew it and discard. this is not safe at all. you then put the pen back in the refrigerator for the next dose.
    Never heard of this, but I thought that sharps are no longer allowed in hospitals if something safer is available? In any case (and I know how it is, when I worked in a dialysis clinic we had nothing but sharps and had to stick needles into unstable blood lines all the time), if they make you use this and you're not ready to leave your job (sadly, this is often the only option - the clinic still uses sharps!) I would use a very large hemostat or similar clamp and treat the thing like a loaded gun.

    DeLana

    P.S. How about an anonymous call or e-mail to Joint Commission or OSHA?
  6. by   nservice
    I've used Byetta and you're right, there needs to be a safer way to change those needles. Perhaps we should contact the Company that makes it.
  7. by   hollyvk
    Quote from wrkoutgirl
    Hi all. I Need to know if it is legal for a nurse to get punished if there are too many incident reports against this nurse. NOthing mayor but several of the same kind. is it better to be dishonest and not report it.
    Also, is it legal and still a good practice for hospitals to still provide prefilled pens for sq medication. these nedles don't have a safety retractable nedle, you have to manually remove it from the pen and dispose of it.
    thank you for your info.
    Monica
    1. Can a nurse be subjected to employment consequences for events that have been tracked through incident reports? YES, but hopefully the NM will evaluate what's going on and determine whether it represents a systems problem, a problem with the nurse's training regarding the situation that can be remedied, or a repeated pattern by the nurse of disregarding facility and/or unit policies & procedures.

    2. Can incident reporting be used in a punitive fashion? YES, by either a coworker or 2 targeting another nurse they don't like, or by a NM who decides he/she wants to get rid of the nurse for reasons other than questionable professional competence or refusal to follow established policies & procedures.

    3. Is this "legal?" That depends on the employment situation. Is the nurse an employee at will? Is the NM following the facility's procedure for employment discipline? If so, the facility is probably not doing anything improper. Might there be other factors that could affect this situation? Certainly--there are many.

    4. Byetta needle problems. This is probably an OSHA issue as this product sounds like it violates federal safety laws regarding needle safety for healthcare workers. OSHA routinely visits healthcare facilities to assess for violations (most heathcare workers are generally not aware of this). You can report your concerns to your facility's risk manager, or you contact OSHA yourself to report your concerns. (FYI--when OSHA find violations at a facility, they issue fines and do followup to see if the situation has been remedied).

    HollyVK, RN, BSN, JD
    (Risk managers love getting that phone call that someone from OSHA is here to visit their facility)
  8. by   spider11
    Can't the Byetta pens use the same safety needles as the disposable Novolog pens? The kind that screw on, but once used it's like a spring loaded cover. Am I making sense??? lol

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