TERCAP Proposal

Full Answer Section

       

• Ineffective Communication: Lack of clear and consistent communication regarding patient care needs.
• Breaches in Nursing Standards: Failure to conduct hourly rounding and perform a comprehensive patient assessment post-medication administration.

These factors highlight systemic issues within the organization as well as individual nurse performance concerns. Part Two: Factors and Actions Factors Contributing to the Event

• Situational Factors: High patient acuity, understaffing, and inadequate clerical support created a challenging environment for nurses.
• Nursing Factors: The inexperienced nurse's judgment was impaired by fatigue and the overwhelming workload.
• Human Factors: The nurse's failure to adhere to nursing standards and protocols contributed to the incident.
• Organizational Factors: High turnover rates, inadequate staffing levels, and a lack of support systems contributed to the overall problem.

Negligence or Malpractice Negligence occurs when a nurse fails to meet the standard of care, resulting in harm to the patient. Malpractice is a type of negligence that involves professional misconduct. In this case, the nurse's failure to adhere to nursing standards of care, such as hourly rounding and post-medication assessment, constitutes negligence. However, whether this rises to the level of malpractice would depend on the specific state's laws and regulations governing nursing practice. Nursing Board Options The nursing board has several options for disciplinary action, including:

• Warning: A formal reprimand without license restrictions.
• Probation: Placing the nurse on probation with specific conditions, such as additional education or supervision.
• License Suspension: Temporarily revoking the nurse's license for a specified period.
• License Revocation: Permanently revoking the nurse's license to practice.

Recommended Action Given the circumstances, a probationary period with mandatory continuing education on patient safety, time management, and delegation would be appropriate. This action would allow the nurse to continue practicing while addressing the identified deficiencies. Rationale While the nurse's actions were substandard, the contributing factors of understaffing and high patient acuity must also be considered. A probationary period with mandatory education would provide an opportunity for the nurse to improve her practice while protecting the public. Revocation of the license would be excessive, given the absence of a history of disciplinary action. Recommendations for Continuing Education To minimize legal risks for practicing nurses, the following continuing education topics are recommended:

• Patient Safety and Fall Prevention: Emphasize the importance of hourly rounding, patient assessment, and fall prevention strategies.
• Time Management and Prioritization: Teach nurses how to effectively manage their workload and prioritize patient care tasks.
• Delegation and Supervision: Provide education on appropriate delegation of tasks and effective supervision of unlicensed assistive personnel.
• Communication and Collaboration: Enhance communication skills among nurses and other healthcare team members.
• Legal and Ethical Issues in Nursing: Discuss the legal and ethical implications of nursing practice, including negligence and malpractice.

By addressing these areas, the hospital can improve patient safety, reduce the risk of legal action, and enhance the overall quality of care.  

Sample Solution

       

Part One: Review of TERCAP Report Summary

The TERCAP report outlines a case involving a patient fall post-surgery due to inadequate nursing care. Key factors contributing to the incident include:

• Understaffing: Two RNs for 28 patients, exacerbated by a vacancy and staff call-in.
• New Graduate Nurse: The inexperienced nurse was assigned a high-risk patient load.
• Overworked Nurse: The nurse worked three consecutive 12-hour shifts while 29 weeks pregnant.