Nurse Practice Act Question

Freshman RN · Aug 24, 2009

Patients have 5 rights. right patient, right med, right dose among them the fact that they are outdated is the wrong dose/ med and 5. injections to 5 people is 5 med errors. the only combining that you can do is combining the wrong dose/med with the person given it to.

jfk_b · Aug 24, 2009

It is one medication error but you would have to write 5 different incidents errors. In doubt it really depends on the facility protocols and above all the pharmacy. It also depends on where you work LTC or Hospital. In doubt ask your boss.

Good luck

TessaMae · Aug 24, 2009

5 errors.

Age1 · Aug 24, 2009

5 errors... yup

morte, LPN, LVN · Aug 25, 2009

i presume this is homework, or you should have stopped the nurse from doing this.....

Tait, MSN, RN · Aug 25, 2009

Every person being an individual, with an independent medical record would need a seperate and individual incident report.

Tait

Worthless_Nut · Aug 25, 2009

yes Morte it is a scenario that I am trying to address. My classes are online and the only book I have to work with is the Texas Nursing Practice Act which is not an easy read. The question I am trying to determine is whether to report that nurse to the BON, or does this fall under the minor incident rule which states you can make 5 errors before reporting to the board. I think it is reportable due to the risk of harm it could cause. I just didn't know if since she didn't put the vial back in the fridge and pull it out each time, would drawing up 5 syringes be considered 1 incident or 5. I think it is 5 but I just want to be sure I am correct with my line of thinking.

elkpark · Aug 25, 2009

The nurse gave five different injection of outdated insulin (to five different clients, although I would consider it the same if she gave one client multiple injections from the vial of outdated insulin), so I would consider that five separate errors.

Freshman RN · Aug 25, 2009

"The question I am trying to determine is whether to report that nurse to the BON, or does this fall under the minor incident rule which states you can make 5 errors before reporting to the board."

I have never heard of the "minor incident rule, but this is a major error, what if the insulin wasn't effective?? what if the sugar isn't checked in a timely manner? Do you have a 2 person check in place for insulin?

Worthless_Nut · Aug 25, 2009

Thanks for your comments, the "minor incident rule" is part of the Texas Nursing Practice Act, it is rule 217.16. This is a homework assignment and I am having a hard time wading through the legal speak. Under 217.16, if you have less than 5 minor incidents in a 12 month time period, the peer review committee doesn't have to report you to the BON so my question really was this: if a nurse removes a vial of any medication, checks it once and fails to note it is outdated and proceeds to draw up and give that medication to 5 pts, is it only one incident since she only checked the vial once or is it 5 incidents because she should have checked the vial before drawing up the medication for each patient?

Whispera, MSN, RN · Aug 25, 2009

It's five incidents. Each improper administration is an incident. I don't know how someone would know another nurse did what you are being asked about, though, unless you were following her around.

Generally, if you find a medication error, as a nurse on the same or following shift, you don't generally report it to the BON. You do an incident or medication error report which goes to your manager, who follows up on it and reports it as necessary.