Primary resources for state law - correct answer Texas Board of Nursing Nursing Practice Acts
Nursing Jurisprudence - correct answer Rules/ Ethics/
... [Show More] Morals and how the nurses function in a healthcare setting
Texas Nurse Practice Acts - correct answer301
-BON, , defines responsibility for regulating nursing education, licensure and practice
303
-Regulates nursing peer review
304
-Relates to nursing Licensure compact
Texas BON Mission Statement - correct answer Protect and promote welfare of the people of Texas by ensuring that each person holding a license as a nurse is competent to practice safely.
-Protects the interest of the public
Chapter 301 NPA - correct answer How board is appointed
General powers/duties
License requirements/renewal
Practice by holder
Reporting violations and patient care concerns
Prohibited practices/disciplinary actions
Other penalties and enforcement previsions
Anesthesia in outpatient settings
Corrective action proceeding
Board of Nursing - correct answer Represent the people of Texas
Can't lobby the legislature
Does not regulate practice settings
-Licensing
-Enforcement Services
-Audit of CE
-Information Services
Professional Associations - correct answer Represent their members
Do lobby legislature
Efforts to improve work condition/benefit for nurses
-Job referral services
-Legal Referral
-Salary Q
-Co-Worker Disputes
-Employment issues
Licensure and Regulation - correct answer Temporary Permit
-GN permit expires in 75 days
-When pass/fail NCLEX
Renew Online
-60 days prior to expiration BON will send card
Continuing Education
-20 hours in 2 years
-Fist time renewal exempt
-CE hours in area of practice
-Keep records for 4 years
Initial Licensure by Examination - correct answer Must submit criminal background check
Submit a sworn application fee
Verify completion of an approved nursing edu.
Pass NCLEX
Pass NJE with 75%>, NPA/BON rules, 50Q
Disclosure of Criminal Behavior - correct answer Must report any past criminal behavior or pending charges
-Minor class C misdemeanors excluded
(parking tickets, speeding tickets, jaywalking)
Five Categories of Trust by BON - correct answer Honesty
Accountability
Trustworthiness
Reliability
Integrity
Good Professional Character - correct answer Distinguish right from wrong
Think and act rationally
Keep promises and honor obligations
Be accountable for own behavior
Promptly disclose facts that could enhance health of pt. and protect from harm
Professional boundaries - correct answer Must recognize/maintain professional boundaries
-Do or say nothing that can't be documented
Violations
-Physical, Sexual, Emotional, Financial exploitation
Nursing Peer Review - correct answer Separate from BON review
Confidential
(incident based or Safe harbor)
-Rule 217.19-PR and Whistleblower
-Rule 217.20-SH PR and Whistle blower protections
Incident Based Peer Review - correct answer Any facility employing 10+ must have one
Referral starts with error/incident
PR without administrators
Fact finding mission
Eval. of practice in atmosphere of collegiality
Determine if incident merit or should be to BON
RN Standards - correct answer Make Nursing Dx
Develop nursing care plan
Eval. pt response to care
Perform Comprehensive assessment
Delegate tasks to UAP
Practice independently w/in NPA board rules
Edu. to care for all pt's stable and unstable
LVN Standards - correct answer Participate in planning of nursing care
Assist in evaluation pt response to tx
Complete focused assessment
Implement appropriate aspects of care
Practice must be supervised
Educated to care for pt. with stable predictable
Duty to pt - correct answer Make/accept only assignments that take into consideration safety and commensurate with nurse's educational preparation, experience, knowledge, and physical/emotional ability.
Step 1 - correct answer Is the activity consistent with the NPA and BON rules?
Step 2 - correct answer Is the activity appropriately authorized?
- Valid order?
- Current policy exist regarding procedure?
- Clarify any questionable orders
Step 3 - correct answer Is it supported by nursing research?
- EBP
Step 4 - correct answer Do you possess the required knowledge and competency to carry out the act?
Step 5 - correct answer Would a reasonable and prudent nurse perform this activity in this setting?
Step 6 - correct answer Are you prepared to accept the consequences of your actions?
Prohibited Delegation Tasks - correct answer Nursing assessments
Plan of care
Professional Judgement/Intervention
Responsibility for initial teaching
Medication administration, IV fluids as well
-Prohibited in acute care settings
-may be delegated in independent living situations
Minor Incident - correct answer Conduct that does not indicate the nurses continuing to practice professional nursing poses a risk fo harm to the pt. or other person
Exclusion to Minor Incident Rule - correct answer A nurse involved in a MI does not need to reported to BON unless...
-Creates sig. risk fo physical, emotional, financial harm
-Lacks a conscientious approach for accountability
-Lacks knowl. and compet. and not easily remedial
-Pattern of multiple minor incidents
-5 minor incidents in a 12 month period must be reported to peer review
NEVER a Minor Incident - correct answer Error contributed to pt. death/serious harm
Criminal conduct
Serious violation (theft, faud, pt. abuse, exploiting)
Impairment/suspected impairment by chem. dep.
IBPR Due Process Rights - correct answer Facility must have policies in place for PR
PR committee must comply with req.
Nurse must receive notice/ opportunity to review documents/submit a response
Nurse may hire own attorney
Nurse will get feedback after decision
Nurse will have a chance to respond
Safe Harbor Peer Review - correct answer Allows a nurse to accept an assignment and provide best care without fear of licensure action if there is a practice error.
-Does not protect civil rights
-Before refusing assignment must recog. pt is 1st
May refuse an assignment if lack basic knowledge/ability to render care
Safe Harbor - correct answer Must be invoked BEFORE care given
Or anytime assignment has changed and pt may be in harm
-Must notify in writing
-Supervisor can't refuse
-May use quick req form to make initial req.
-Comprehensive request must be completed before leaving work setting
Quick Request Form - correct answer Written on blank piece of paper but must include
-Name/Signature
-Date/Time of request
-Location of where it is to be completed
-Name of person making assignment
-Brief explanation of why safe harbor is being req.
Chain after Safe Harbor Nurse completion - correct answer Nurse supervisor/administrator who gave assignment.
Nurse administrator
Peer Review Committee
Physician who reviews med reasonableness
Nurse administrator who reviews PR findings
Nurse who initiated request
Mandatory Overtime - correct answer Making you work extra shifts, you have the right to refuse.
NOT when
-Emergency disasters
-Ongoing procedure requires nurses presence
-Certain emergencies
Take Mandatory Overtime Concerns to - correct answer Unit manager
Staffing Committee
DSHS-if not addressed internally
Nurses duty is always - correct answer In the best interest of the patient
Patient Abandonment - correct answer NPA/BON do not define abandonment
-leaves employment-employment issue
-leaves patient-licensure issue
Not abandonment - correct answer Resignation without notice- assuming shift has been completed
Refusal to work additional shifts either doubles or extra shifts on days off
Floating to an unfamiliar area - correct answer Always responsible for providing safe patient care
May request training prior to having to float
May invoke safe harbor
May refuse assignment
What do I do if I question safety of assignment - correct answer1st- clear about what you are being asked to do
2nd- consider what can change during assignment
3rd- state concern to person making assignment, brainstorm ways to modify
4th- Listen to response
Disciplinary Action - correct answer Chemical Dependency
Alcohol Dependency
Mental Illness
Even some prescription drugs
Red Flags - correct answer Lack of energy
Frequent absences
Spike in pt. need for pain meds
Lateness to work
Red Eyes
No/unusual documentation
Frequently stands behind other nurses signing out meds
Unprofessional Conduct - correct answer Drug Diversion
Unsafe practice
Failure to pay student loans
Dismissal peer assistance program
Drug related actions
Criminal conduct
Board process for investigating complaints - correct answer Nurse notified of investigation and invited to respond
Investigator gathers and reviews evidence
Decision made by board
Nurses's responsibility during investigation - correct answer Respond promptly to all requests
Keep contact information current
Feel free to contact investigator
Do not ignore any mail from BON
Types of Nurse Remediation - correct answer Remedial education
-Classes specific to issue [Show Less]