Journal- Legal Overview and Peer Review Process

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xnagunevehyrm26

Business Finance

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YOU MUST ANSWER ALL 3 QUESTIONS ABOUT YOUR KEY POINT in document REFLECTIVE JOURNAL MODULE 2(ATTACHED*******) IN ORDER TO RECEIVE CREDIT (NO PARTIAL CREDIT). PLEASE COME UP WITH YOUR OWN KEY POINTS FOR EACH MODULE. attached 2 lectures for the class and provided links to all documents viewed for this module.

http://www.bne.state.tx.us/faq_peer_review.asp

http://www.bon.texas.gov/rr_current/217-11.asp

http://www.bon.texas.gov/rr_current/217-12.asp

http://www.bne.state.tx.us/laws_and_rules_nursing_...

http://www.bon.texas.gov/laws_and_rules_nursing_pr...

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Reflective Journal Module 2: Legal Overview and Peer Review Process: Identify 3 key points from this module. Reflect on why each point is important, how it impacts on your work experience or nursing practice, and how will you change your practice in the future based on each key area. Place Key Point in this column: Key Point 1: Answer each question below with at least 4-6 well written sentences using critical thinking. 1. Why it is important? at least 4-6 well written sentences using critical thinking 2. How does it impact my work/nursing practice? at least 4-6 well written sentences using critical thinking 3. How will I change my practice? at least 4-5 well written sentences using critical thinking Key Point 2 1. Why it is important? at least 4-6 well written sentences using critical thinking 2. How does it impact my work/nursing practice? at least 4-6 well written sentences using critical thinking 3. How will I change my practice? at least 4-6 well written sentences using critical thinking Key Point 3 1. Why it is important? at least 4-6 well written sentences using critical thinking 2. How does it impact my work/nursing practice? at least 4-6 well written sentences using critical thinking 3. How will I change my practice? at least 4-5 well written sentences using critical thinking 1   As  the  years  went  along  and  more  and  more  nurses  were  peer  reviewed  in  Texas  and   other  states  in  the  Na�on,  it  became  clear  that  a  puni�ve  approach  was  being  taken   by  licensing  boards.  The  Ins�tute  of  Medicine-­‐  a  non-­‐profit  think-­‐tank  that  exists  to   study  and  influence  the  delivery  of  health  care  in  the  US-­‐  called  this  puni�ve   approach  the  “Bad  Apple”  approach.  The  concept  was  that  if  we  just  pluck  enough   bad  apples  [unsafe   prac��oners]  out  of  the  health  care  delivery  system,  then  the  system  should  be  safe   for  the  pa�ents.  But  research  didn’t  support  this  Bad  Apple  approach.  The  IOM   found,  as  a  result  of  a  study  that  it  published  in  1999/2000  en�tled  “To  Err  is   Human,”  that  the  healthcare  system  doesn’t  have  a  lot  of  unsafe  prac��oners,  but   that  the  system  itself  was  unsafe  or  “Sick”.  The  system  itself  had  many  Failures.   Therefore,  ever  since  the  2000  prin�ng  of  the  “To  Err  is  Human”  study,  there  has   been  supposed  to  have  been  an  added  emphasis  on  the  system’s  shortcomings;  in   other  words,  a  systems   approach  to  unsafe  pa�ent  care,  rather  than  the  Bad  Apple  approach.     Nurses  s�ll  must  take  responsibility  and  accountability  for  their  part  in  an  incident.   But  the  system  must  take  responsibility  also.  Though  we  s�ll  have  along  way  to  go   before   Peer  Review  is  viewed  as  non-­‐puni�ve  by  many  prac�cing  nurses,  we  are  making   headway  toward  a  more  fair  process.     2   I  want  to  discuss  with  you  four  of  the  basic  concepts  of  Peer  Review  in  Texas.  Other   states  may  have  these  same  basic  concepts,  or  there  may  be  some  varia�on  from   state-­‐to-­‐  state.   1st-­‐  there  is  MANDATORY  repor�ng.  If  you  have  a  reasonable  suspicion  that  a  Nurse   is  prac�cing  unsafely  and  exposing  a  pa�ent  to  a  significant  risk  of  harm,  then  you   must  report  that  fellow  Nurse.  It  isn’t  a  guideline  or   an  ethical  sugges�on,  it  is  a  legal  mandate.  Since  the  requirement  to  report  is   MANDATORY  and  the  mandate  comes  from  your  Nursing  Prac�ce  Act,  then  if  you  do   not  report,  you  have  violated  the  Prac�ce  Act  and  the  Board  may  inves�gate  you  for   failing  to  ensure  pa�ent  safety.  The  defini�on  of  what  MUST  be  reported  has   changed  over  the  years,  since  1987.  For  example,  you  don’t  have  to  report  to  the   Board,  a  Nurse  whose  ac�ons  were  a  MINOR  viola�on  of  the  Prac�ce  Act.   The  2nd  concept  is  that  the  Nurse  being  inves�gated  has  the  right  of  Confiden�ality.   This  right  belongs  to  the  nurse  and  can  be  broken,  without  poten�al  legal   consequences  in  only  a  few  specific  instances.  A  person  can  be  sued  in  a  civil  court  of   law  for  breach  of  confiden�ality.  Again,  Confiden�ality  of  the  process  is  given  to  the   nurse  under   inves�ga�on  by  the  law.  If  you  are  the  Nurse  under  inves�ga�on,  you  don’t  have  to   tell  anyone  [with  few  excep�ons]  that  you  are  under  inves�ga�on-­‐  you  do  not  have   to  tell  fellow  employees,  you  do  not  have  to  tell  future  employers  or  even  current   employers,  that  you  are  under  inves�ga�on.  It  is  an   3   1   If  I  had  to  choose  only  one  Rule  for  Nurses  to  know,  it  would  be  Rule  217.11.  This   Rule  is  divided  into  4  parts.  Part  1  is  for  all  nurses-­‐LVN’s,  RN’s  and  Advanced  Prac�ce   Nurses-­‐  and  delineates  the  Standards  of  Nursing  Prac�ce  by  which  ALL  Nurses,  no   ma�er  their  prac�ce  site,  must  abide.  It  is  in   this  part  of  the  Rule  that  the  tremendous  legal  responsibility  and  accountability  is   placed  on  you  to:  Know  and  conform  to  the  Texas   Nursing  Prac�ce  Act  and  the  board's  rules  and  regula�ons  as  well  as  all  federal,  state,   or  local  laws,  rules  or  regula�ons  affec�ng  the  nurse's  current  area  of  nursing   prac�ce.   As  you  sit  there  today,  can  you  state  that  you  have  met  this  mandate?  It  is  in  this  part   of  the  Rule  that  Documenta�on  is  demanded  and  defined.  It  is  in  this  part  of  the  Rule   that  the  Board  makes  clear  that  you  can  MAKE  for  OTHERS  or  ACCEPT  for  YOURSELF   ONLY  those  assignments  that  take  into  considera�on  client  safety  and  that  are   commensurate  with  the  educa�onal  prepara�on,  experience,  knowledge,  and   physical  and  emo�onal  ability  of  the  Nurse  to  whom  the  assignments  are  made.  You   can  be   disciplined  for  making  inappropriate   assignments  and  you  can  be  disciplined  for  taking  inappropriate  assignments.  I  want   you  to  read,  understand  and  know  part  1  of  217.11.  It  is  rich  with  guidance  for  the   prac�cing  Nurse-­‐  guidance  as  to  what  the   Board  expects  of  you.  Part  2  of  217.11  has  to  do  with  the  scope  of  prac�ce  for  LVNs     2  
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