NURSING-201 Central New Mexico Community College – As the team leader on the floor where you practice nursing, you are covering another RN’s group of patients while she is away at lunch.

QUESTION

As the team leader on the floor where you practice nursing, you are covering another RN’s group of patients while she is away at lunch. As you make your rounds, you notice her LPN (who is not certified for IV medication administration) administering a syringe of fluid via an IV line to a patient. (Learning Objectives 3, 6, 8, and 10)

a. What data in the scenario are pertinent?

b. Is there a nursing practice violation? If so, what is it?

c. What regulations and/or standards address these issues?

d. How does licensure and certification apply to this case study?

e. What purpose would an incident report play in this scenario?

ANSWER

Nursing Practice Violation: LPN Administering IV Medication Without Certification – Incident Report and Regulatory Considerations

The pertinent data in this scenario are:

• The team leader is covering another RN’s group of patients.
• The LPN, who is not certified for IV medication administration, is administering a syringe of fluid via an IV line to a patient.

Nursing practice violation

Yes, this scenario has a nursing practice violation. The LPN, who is not certified for IV medication administration, is administering a syringe of fluid via an IV line to a patient (Boehning, 2022). This action goes against the scope of practice for an LPN and violates the principle of delegation and appropriate assignment of tasks.

The regulations and/or standards that address the issues

State Nurse Practice Acts: Each state has its own Nurse Practice Act that outlines the legal scope of practice for nurses. These acts typically define the roles and responsibilities of different types of nurses and specify what tasks can be delegated to unlicensed assistive personnel.

The Joint Commission (TJC) Standards: TJC is an independent, nonprofit organization that accredits and certifies healthcare organizations (Wadhwa, 2023). They have standards in place to ensure patient safety and quality of care, including guidelines on delegation and appropriate assignment of tasks.

Nursing Board Regulations: State nursing boards establish rules and regulations governing nursing practice within their jurisdiction. These regulations often address issues related to delegation and assignment.

Licensure and certification apply to this case study as follows:

Licensure: Licensure is the process by which a nurse is granted legal authority to practice nursing in a specific state or jurisdiction. Both the RN and LPN in this scenario should be licensed by the state nursing board. Licensure ensures that nurses meet the minimum educational and competency requirements to provide safe and effective care to patients.

Certification: Certification, on the other hand, is a voluntary process that validates a nurse’s specialized knowledge and skills in a particular area of practice. In this case, the LPN is not certified for IV medication administration, which means they have not undergone the additional training and evaluation required to safely perform this task.

Incident report purpose

 An incident report would play a crucial role in this scenario. Incident reports are used to document any unexpected or adverse events that occur in a healthcare setting. In this case, the LPN’s unauthorized administration of fluid via an IV line to a patient would be considered an incident. The purpose of an incident report in this scenario includes:

Documentation: The incident report provides a formal record of the event, including details of what happened, who was involved, and any relevant observations. This documentation can serve as evidence in case of any legal or disciplinary proceedings.

Analysis and Investigation: Incident reports help identify the underlying causes of the incident. By analyzing the circumstances surrounding the unauthorized administration, the healthcare facility can determine if there were any systemic issues, such as inadequate supervision or inadequate policies and procedures, that contributed to the incident.

Quality Improvement: Incident reports are valuable tools for identifying areas where improvements can be made in healthcare delivery. By reviewing trends and patterns of incidents, healthcare organizations can implement changes to prevent similar incidents from occurring in the future.

Communication: Incident reports facilitate communication between different healthcare professionals and departments (O’Daniel, 2008). The report can be shared with the RN, LPN, and their respective supervisors, as well as with the risk management and quality improvement departments, to ensure that appropriate follow-up actions are taken.

In summary, the incident report serves as a crucial documentation and communication tool, enabling analysis, investigation, and quality improvement measures to be implemented to prevent similar incidents in the future.

References

Boehning, A. P. (2022, July 18). Nursing Practice Act. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK559012/ 

Wadhwa, R. (2023, March 16). The Joint Commission. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK557846/ 

O’Daniel, M. (2008, April 1). Professional Communication and Team Collaboration. Patient Safety and Quality – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK2637/

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