Incident Report-yes/no?

[~'JesusRocks'~]

I am frusterated and am so glad that I can vent here (probly the only safe place to). Anyway so I fill out an incident report on a med error (gave wrong pt med), bad I know but no harm came to pt followed him for rest of day, notified MD. About a month later I'm asked to re-explain the incident to management. I do but can't help but feel a little leary about it. 1st of all the info was put in the incident report right after it happened, that's what it's there for right??, why not go back and look at it. 2nd if I'm asked to talk about it 1 month later we could have conflicting info there. The whole thing makes me kinda nervous, like maybe I don't want to fill out a stupid IR next time. I know many other nurses who call the MD, no harm and they are done w/ it. I was taught in school to always do an IR, that it helps prevent errors next time, blah, blah, blah. I agree that in theory it should and could but in reality it doesn't seem that was-and that's a shame. Now I realize why other nurses I've seen don't do one. I can understand in some instances yes do an IR but in my case is seems that I am having to explain my mistake without regard to pt outcomes. What are anyone elses thoughts, I'd really like to know.

[DeepFriedRN]

You did the right thing by filling out the IR. The majority of errors (of all kinds) are directly related to system failure i.e. the system they've created to do a particular task is flawed. So you are doing everyone a favor by writing the IR because while in your particular incident there was no harm to the pt (thank God!), another person who makes the same mistake might not be so lucky (meaning harm COULD come to their pt.) And so by letting the hospital know what happened you could be potentially averting another mistake, because using the information given on the IR the system can be changed to make that mistake less likely. I know this doesn't always apply, and having to discuss it a month later is a total drag, but we all make mistakes and if we can find ways to avoid commiting them again, we owe it to ourselves and our patients to try. Just my .

BTW-I agree that you should do them on yourself, but I'm not a big fan of writing others up either...I don't like the "I'm telling on you" feel of it..

[NursKris82]

Love your screen name- I agree!!

I loathe incident reports most the time. They want us to fill them out for everything and sometimes I don't- I just make a nurses note when appropriate. We have a separate med error incodent report and I agree that should be filled out with each incident so they can prevent them from happening again, if possible. They may be asking because the manager finally got a chance to look at it or maybe an agency that looks at those things is coming in and they have to explain or something. I would be honest with them and tell them you don't remember certain things but to refer to the report so that you don't change your story on accident because you can't remember. Sometimes managers have to ask me about falls or something and when I can't remember I tell them. It should be in my charting and if I didn't mention it there and I can't remember it, I'm not going to try and conjure up an answer now.

So, incident report for med errors- my vote is yes.

[wooh, BSN, RN]

I do them on myself, but somehow never seem to find time when I get told I should do one on another nurse.

They always say they won't come back to "punish" you, but considering at both my jobs, they pulled out the number I had, I'm kind of leary.

Best reason to do them on yourself though (other than it looks better than someone else beating you to the punch, shows YOU caught your mistake instead of someone else), you can point out all the system problems that they aren't going to look at when "investigating" since it's so much easier to just blame the nurse. So always mention EVERYTHING that might have had something to do with it.:)

[meadow85]

I agree, how do you expect someone to remember something that happened a month ago? I cant even remember what I did last week. Just admit that you don't remember all the details but it is documented in your incident report. That's reasonable enough.

We were lectured about documentation from our manager. It scared me straight. The fact that if it isn't documented that means it didn't happen and how 10 years from now something may come up and, since you obviously cannot recall all your patients, they will rely on your documentation. I document everything. When in doubt document because I have heard RIDICULOUS stories.

[uscstu4lfe]

the crap they spew about an incident report being for "learning purposes, quality management, etc." is such complete **** IMO. they used one to write me up and it was placed in my file. it can most certainly be used against you. sure, it's the cookie cutter way of doing things, but if you gave a multivitamin to the wrong patient, odds are nothing ill will come from it and the MD couldn't give a flying fig anyway.

[mmurphy]

No, so not file an incident report. Report the error to the physician. Be honest. If no harm is done to the patient do not buy the "this is a learning experience, or this is a "process analysis to aid the hospital in determining how errors occur. This may have been the mentality several years ago. However, I see honest nurses writing up IR's in attempt to follow appropriate protocols, and then they are disciplined for making even the simpiliest mistakes.

It is a system, that dehumanizes hard working nurses, and continues the overall disrespct and total lack of understanding that management has for what concentious and hard working are forced to deal with on a daily basis.

[Straydandelion]

I would first report the incident to the doctor, it would depend on the med error/doctor's order etc. whether I would write it up as an IR. I am also guessing that the delay in time to ask you about it is possibly mainly due to Risk Management who receives all incident reports and may have a question on it, though not sure.

[pagandeva2000, LPN]

I would probably report it to the physician first as well. I don't trust the system, and writing an incident report on myself would depend strongly on the reaction from the doctor. Hate to say it, but, I don't want to put my head on the chopping block. The incident reports written at my job are not used to investigate system error, regardless of what they say. They are used to screw people who are not their favorites and nail them to the cross.

[uscstu4lfe]

ditto to what murphy and pagan said. they will use them against you!

[FireStarterRN, BSN, RN]

I think managers get back-logged with these, that's why you are being asked for feedback on it one month later. I've noticed that has happened. They end up with a pile of them on their desk that they have to attend to, and sometimes they don't get to them for awhile.

[pagandeva2000, LPN]

I suspect it can also be that reason as well, but because I see how the rules are selectively enforced, depending on who the supervisor and employees are at any given time, I avoid handing them my head if I can avoid it.