RNchat Transcript April 2, 2010

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Transcript of #RNchat, a Twitter chat for registered nurses, for Friday April 2, 2010. Follow @RNchat on Twitter - http://Twitter.com/RNchat

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T1 If health care professnal makes accidental yet fatal med error what should resulting action be? Terminate? Suspend? Revoke? Jail?

T2 Should ea facility develop & implement their own nursing care standards or should there be internat'l standards of nursing care?

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RNchat Transcript April 2, 2010

  1. 1. http://printyourtweets.com/tweets.html andrewspong: Health tweeple - pls add your personal YouTube or Vimeo channel to this directory: http://bit.ly/dbdngA #hcsmeu #hcsm #socpharm #rnchat 4/2/2010 01:43 EllenRichter: Interesting reading for today's #RNchat >> Report: Systemic problems at St. Mary's set stage for nurse's fatal drug error http://i.cx/1jt 4/2/2010 08:24 EllenRichter: Interesting reading for today's #RNchat >> a pharmacist who was jailed for being involved in accidental fatal med error http://i.cx/1ju 4/2/2010 08:25 EllenRichter: Interesting reading for today's #RNchat >> S. Florida mother died from massive overdose given by Broward General ER nurse http://i.cx/1js 4/2/2010 08:25 philbaumann: Join #RNchat with @EllenRichter today 12pm EST #nurses 4/2/2010 08:45 rnchat: Join #RNchat with @EllenRichter today 12pm EST #nurses 4/2/2010 08:45 EllenRichter: #RNchat is where nurses can meet & share ideas in an effort to strive at raising the bar on #nursing care & #patient #safety 4/2/2010 09:46 Tweror: Twitter RNs! Come join us today at 12 PM EST to discuss how to deal w/ hc professionals who accidentally make a fatal med error #RNchat 4/2/2010 09:47 EllenRichter: What should be done when the best health care professional inadvertently makes a med error that ends up in a fatality? #RNchat at 12 PM EST 4/2/2010 09:53 rnchat: RT @EllenRichter: #RNchat is where nurses can meet & share ideas in an effort to strive at raising the bar on #nursing care & #patient #safety 4/2/2010 09:54 rnchat: Twitter RNs! Come join us today at 12 PM EST to discuss how to deal w/ hc professionals who accidentally make a fatal med error #RNchat 4/2/2010 09:54 rnchat: RT @EllenRichter What to do when the best hc professional inadvertently makes a med error that ends up in a fatality? #RNchat at 12 PM EST 4/2/2010 09:56 HealthGlobal: RNs join us today 12 PM EST discuss how to deal w/ hc professionals who accidentally make fatal med error #RNchat (via @EllenRichter) 4/2/2010 09:56 VickiZLauter: RT @EllenRichter: #RNchat is where nurses can meet & share ideas in an effort to strive at raising the bar on #nursing care #patient #safety 4/2/2010 10:01 1 of 9 4/2/10 3:25 PM
  2. 2. http://printyourtweets.com/tweets.html ColoradoHealth: RT @EllenRichter: What should be done when healthcare pro inadvertently makes med error that ends up in a fatality? #RNchat at 12 PM EST 4/2/2010 10:02 amednews: RT @EllenRichter: What should be done when healthcare pro inadvertently makes med error that ends up in a fatality? #RNchat at 12 PM EST 4/2/2010 10:06 memorialcareers: RT @philbaumann: Join #RNchat with @EllenRichter today 12pm EST #nurses 4/2/2010 10:07 MGHAcademy: RT @RNchat Join #RNchat with @EllenRichter today 12pm EST #nurses 4/2/2010 10:07 lperk: RT @EllenRichter #RNchat is where nurses can meet & share ideas in an effort to strive at raising the bar on #nursing care& #patient #safety 4/2/2010 11:02 EllenRichter: Twitter #Nurses Come join us @ #RNchat in 1 hour to discuss repercussions of fatal med errors & how to prevent future occurrences! 4/2/2010 11:02 EllenRichter: Well-worded!! >> RT @EdBennett A cardiologist chronicles his shift from Twitter skeptic to Twitter advocate http://ebennett.org/oje #RNchat 4/2/2010 11:27 EllenRichter: In 30 minutes! #RNchat is where nurses can meet & share ideas in an effort to strive at raising the bar on #nursing care & #patient #safety 4/2/2010 11:28 rnchat: RT @EllenRichter: In 30 minutes! #RNchat is where nurses can meet & share ideas in an effort to strive at raising the bar on #nursing care & #patient #safety 4/2/2010 11:30 Aggiern95: RT @EllenRichter: 30 mins! #RNchat is whr RN cn meet & share ideas in an effort 2 strive at raising the bar on #nsg care & #patient #safety 4/2/2010 11:37 DermNursing: RT @AmbulatoryNurse: Passing the word along - #RNchat (Twitter chat for nurses) with @EllenRichter today at 12pm EST (via @RNchat) 4/2/2010 11:37 rnchat: Hello & welcome to the TGIF edition of #RNchat, a Twitter chat for any health care folks & of course for RNs! We're a place to share ideas 4/2/2010 11:59 rnchat: I know its Good Friday & Spring Break so our numbers may be low at #RNchat! @philbaumann cant be with us so @EllenRichter is filling in! 4/2/2010 12:01 rnchat: Lets take a few minutes to seeing who is joining in. Introduce yourselves & tell us in 140 or less a little bit about what U do #RNchat 4/2/2010 12:03 grimalkinrn: Hi! JoAnne here, med surg RN from Colorado. Hi there on this chilly morning!! #rnchat 4/2/2010 12:06 2 of 9 4/2/10 3:25 PM
  3. 3. http://printyourtweets.com/tweets.html ocdgirl2000: recommend VERY COOL #RNCHAT "Index A" ( http://bit.ly/ajXMEE ) 4/2/2010 12:08 ocdgirl2000: #rnchat T1 Lynne Siegel Community health Maryland Government,Addictions,mental yeah...computer not doing well 4/2/2010 12:10 ONSmark: I'm here too :) Mark at Oncology Nursing Society. Info pro & RNchat semi-regular. Hitting 80 degrees today in Pittsburgh :) #rnchat 4/2/2010 12:11 rnchat: The topics will be labeled T1, T2, etc. Please remember to add topic label & hashtag #RNchat to ea tweet so we can track your responses! 4/2/2010 12:12 rnchat: Welcome @ocdgirl2000 & @ONSmark ~Warm holiday wishes to everyone~ #RNchat 4/2/2010 12:13 hashtager: # The topics will be labeled T1, T2, etc. Please remember to add topic label & hashtag #RNchat to ea tweet so we can track your responses! 4/2/2010 12:13 rnchat: T1 If health care professnal makes accidental yet fatal med error what should resulting action be? Terminate? Suspend? Revoke? Jail? #RNchat 4/2/2010 12:13 ocdgirl2000: #rnchat busy on FF! twitter has so many tweeters here now! 4/2/2010 12:14 grimalkinrn: T1 the cause of the fatal error needs to be determined before action, leave of absence, education, & support. #rnchat 4/2/2010 12:16 rnchat: @ocdgirl2000 Yes its not an easy chat today...lots of "noise"...people understandably distracted this weekend! :) #RNchat 4/2/2010 12:17 grimalkinrn: T1 I would not recommend jail unless it could be proven that the fatal error was caused by negligence. #rnchat 4/2/2010 12:17 ONSmark: T1 Abstract 3678 from 2009 #ONS Congress: "POLICY FOR ACCIDENTAL CHEMOTHERAPY OVERDOSE" http://bit.ly/8Jgpg #rnchat 4/2/2010 12:18 rnchat: @grimalkinrn T1 Many times, analysis of the facts points to major flaws in the system's medication administration protocols #RNchat 4/2/2010 12:18 rnchat: @ONSmark T1 That link was 80 pgs! Can you summarize it in 140 characters? :) #RNchat 4/2/2010 12:19 grimalkinrn: @rnchat Exactly. What else was happening at the time of the error? What led to it? What does not need to happen is abandoning the RN #rnchat 4/2/2010 12:20 3 of 9 4/2/10 3:25 PM
  4. 4. http://printyourtweets.com/tweets.html rnchat: T1 Medication administration times are always filled with dozens of unending distractions! The role needs to be taken seriously! #RNchat 4/2/2010 12:22 grimalkinrn: RT @rnchat: T1 Medication administration times are always filled with dozens of unending distractions! The role needs to be taken seriously! #RNchat 4/2/2010 12:23 ocdgirl2000: #rnchat T1 jail won't solve issue, would hope nurse would have malpractice insurance that would cover,then facility would send her 2 classes 4/2/2010 12:24 ONSmark: @rnchat T1 Sorry, that's why I gave abstract #3678, for Edit/Find in PDF :) "a chemo overdose policy provides a level of safety" etc #rnchat 4/2/2010 12:24 grimalkinrn: Yesterday, I was interrupted 5 times during one AM assessment/med pass. It makes it hard to stay focused on your IV pushes, boluses #rnchat 4/2/2010 12:25 ocdgirl2000: #rnchat T1 we just accepted pt transfer from clinic inappropriately by new Therapist manager,director trusts my peer to be manager,Dr.doses. 4/2/2010 12:27 rnchat: T1 Do health care professionals get more than one chance to make a serious #patientsafety error? How many chances? #RNchat 4/2/2010 12:27 ocdgirl2000: #rnchat T1 we have no one to ask appropriate questions such as "where's the admission urinalysis".pt has 3 different drugs in UA! 4/2/2010 12:28 ONSmark: @rnchat T1 Notify appropriate personnel, Responsibility 4 patient & family disclosure, Micromedex & state Poison Control Cent etc. #rnchat 4/2/2010 12:28 rnchat: @grimalkinrn T1 Yes, yesterday I was interrupted nearly every time I was drawing up IV meds. Its so important to focus! Concentrate! #RNchat 4/2/2010 12:28 grimalkinrn: t1 Serious #patientsafety errors don't just involve meds: unsafe restraints, understaffing, it's more than just meds. #rnchat 4/2/2010 12:30 rnchat: @ONSmark T1 Yes, great information! So important to have procedures to follow when hospital med errors occur, including pt awareness #RNchat 4/2/2010 12:31 ocdgirl2000: #rnchat T1 Nurse is responsible 4 screening patient before Doctor accepts for dosing & transfer from another clinic.She was told by who? 4/2/2010 12:31 rnchat: @grimalkinrn T1 Absolutely agree abt the # of different types of patient safety issues there are! This is why #RNchat will live on! :) 4/2/2010 12:32 4 of 9 4/2/10 3:25 PM
  5. 5. http://printyourtweets.com/tweets.html rnchat: T1 But serious med errors continue to occur. How can we reduce this statistic forever? #RNchat 4/2/2010 12:33 grimalkinrn: T1 So often, the RN or Pharmacist falls on the sword for the facility. Errors don't "just happen," so we need to do RCAs to find why #rnchat 4/2/2010 12:34 grimalkinrn: @rnchat t1 I would love to see a rule at my hospital re: interrupting RNs during med administration. This is why we have charge RNs #rnchat 4/2/2010 12:35 rnchat: @ocdgirl2000 T1 Sometimes it seems like the nurse is responsible for coordinating almost everything related to patient care! #RNchat 4/2/2010 12:35 ocdgirl2000: #rnchat T1 and following safe policies & protocols of the clinic itself!where is the documentation?someone needs to ask for the right info! 4/2/2010 12:35 rnchat: 3 more minutes until next topic :) #RNchat 4/2/2010 12:37 ONSmark: T1 The 5 Million Lives campaign raised awareness of nurses' and heathcare professionals' role in #patientsafety #rnchat 4/2/2010 12:37 ocdgirl2000: #rnchat T1 we have pt's sign ROI's to 5 surrounding treatment clinics & we immediately fax those asking 2 see if they R "double dipping"! 4/2/2010 12:38 ONSmark: T1 As did the Joint Commission 2010 National Patient Safety Goals #rnchat 4/2/2010 12:38 rnchat: RT @grimalkinrn: T1 So often, the RN or Pharmacist falls on the sword for the facility. Errors don't "just happen"--we need find why #RNchat 4/2/2010 12:38 rnchat: @ONSmark T1 Yes, raising awareness is always a tactic we need to utilize more & more when addressing patient safety issues #RNchat 4/2/2010 12:40 rnchat: Great feedback on T1 from a small group today! This is terrific! Going on to T2 now~ #RNchat 4/2/2010 12:41 ONSmark: T1 Good point about "falling on the sword" - I seem to recall that happening years ago with nurses & a chemo death (@ Dana Farber?) #rnchat 4/2/2010 12:41 grimalkinrn: @rnchat thanks. I haven't even had coffee yet. #rnchat 4/2/2010 12:43 rnchat: T2 Should ea facility develop & implement their own nursing care standards or should there be internat'l standards of nursing care? #RNchat 4/2/2010 12:43 5 of 9 4/2/10 3:25 PM
  6. 6. http://printyourtweets.com/tweets.html ocdgirl2000: #rnchat monitoring what patients even do at the dosing window..diversion is a serious safety safety issue! 4/2/2010 12:43 rnchat: T1 Speaking of "falling on the sword" I shared this link earlier about a pharmacist who took the blow for his tech http://i.cx/1ju #RNchat 4/2/2010 12:44 grimalkinrn: T2 International Standards of Nursing Care would mean we respond alike to many situations. Would be good for disaster relief. #rnchat 4/2/2010 12:44 rnchat: @grimalkinrn ~OMG, I am on cup 3 ;) I couldn't do this role without coffee!! #RNchat 4/2/2010 12:45 grimalkinrn: Well, I had a gingerale. I havent managed to get out of bed yet.@rnchat #RNchat 4/2/2010 12:46 rnchat: @MHabershamSB Welcome! "Late" is if you stopped by after we all left! ;) #RNchat 4/2/2010 12:46 ONSmark: @rnchat Thanks for that link. Wow, jail time for the pharmacist. #rnchat 4/2/2010 12:46 ocdgirl2000: @MHabershamSB #rnchat welcome!my twitter home page is wearing out.getting slowwwwwwww, 4/2/2010 12:47 MHabershamSB: I too am tweeting from bed, coffeeless. Let's party. #rnchat 4/2/2010 12:47 grimalkinrn: @MHabershamSB Partay time. #rnchat 4/2/2010 12:48 rnchat: T2 @grimalkinrn Yes, I agree, if we all followed international standards, we could REALLY raise the bar on delivery of nursing care! #RNchat 4/2/2010 12:48 ONSmark: T2 GREAT ? whether standards should be "universal" or institutional So many posts/comments @ forums like http://allnurses.com (cont) #rnchat 4/2/2010 12:49 MHabershamSB: T2 I've heard from int'l doc friends that nsg isn't as expansive in other countries though-I worry it would be hard to standardize #rnchat 4/2/2010 12:50 ONSmark: T2 (cont.) ...when I see ?s on say verbal orders, some say to check state board/practice acts, others say it's institution-specific #rnchat 4/2/2010 12:50 MHabershamSB: T2 Expansive meaning the nrses don't do as much, aren't responsible for as much.. #rnchat 4/2/2010 12:50 ocdgirl2000: @RNchat #rnchat T2 Samhsa standards are all that matter & County Government "political" Standards, as far as where WE work!LOL! 4/2/2010 12:51 6 of 9 4/2/10 3:25 PM
  7. 7. http://printyourtweets.com/tweets.html rnchat: T2 Unfortunately, there are parts of the world where medical & nursing care is sparse & runs on low funds & standards cant be met #RNchat 4/2/2010 12:51 marcobucci: Hello everyone. Sorry for being more than a little late #rnchat 4/2/2010 12:52 ONSmark: @MHabershamSB I know a nurse who just returned from Egypt & she said exact opposite - nurses she met were having to do everything #rnchat 4/2/2010 12:53 rnchat: @ONSmark T2 I would venture to say that state board views preside over institutional policies, which may not be current #RNchat 4/2/2010 12:53 ocdgirl2000: #rnchat T2 our "bible" www.samhsa.gov/ 4/2/2010 12:54 ONSmark: @MHabershamSB By "everyting" I mean still within nursing, i.e., 1 nurse caring for many diff patients & no nursing "specialization" #rnchat 4/2/2010 12:54 MHabershamSB: @ONSmark That's interesting. This doc was from Ireland. Even here we see such great variability...standards are hard. #rnchat 4/2/2010 12:54 ONSmark: @rnchat Right, I guess I meant there often seems to be uncertainty whether it's something law specifically covers or not Make sense? #rnchat 4/2/2010 12:56 marcobucci: Even though organization policy exists. There is a governing body of the given province deciding best practice rules #rnchat 4/2/2010 12:56 rnchat: T2 We always tell nurses to "follow hospital policy" but if the policies are outdated & dont meet current standard, they can fail us #RNchat 4/2/2010 12:58 rnchat: @ONSmark T2 Yes, your comment makes total sense :) #RNchat 4/2/2010 12:59 rnchat: @Ezer_Nurse @marcobucci ~Welcome! #RNchat 4/2/2010 12:59 rnchat: @ocdgirl2000 Thanks, I was wondering what samhsa was! #RNchat 4/2/2010 13:00 RNconsult: #RNchat 4/2/2010 13:00 Favored1Aqua: RT @ONSmark: T1 Good point about "falling on the sword" - (@ Dana Farber?) #rnchat we talk about this in chemotherapy class and safety 4/2/2010 13:00 rnchat: @RNconsult Welcome. We are discussing universal nursing standards of care :) #RNchat 4/2/2010 13:01 7 of 9 4/2/10 3:25 PM
  8. 8. http://printyourtweets.com/tweets.html ONSmark: @Favored1Aqua Was it at Dana Farber? A good many years ago? My memory is sketchy these days, thanks. #rnchat 4/2/2010 13:02 rnchat: T2 Do we rely on individual facilities to maintain current standards of nursing care or should there B universal worldwide standards #RNchat 4/2/2010 13:02 ocdgirl2000: @rnchat #rnchat T2 the A+number 1 place to find a treatment facility locator for your patients in need!LOL! 4/2/2010 13:03 rnchat: Yesss....glad its not only ME! >> RT @ONSmark: My memory is sketchy these days, thanks. #RNchat 4/2/2010 13:03 ONSmark: T2 Are CDC, NIOSH, etc. guidelines "universal standards" (albeit not international)? Like "Dressings changed every 48 hours" etc.? #rnchat 4/2/2010 13:06 RNconsult: Universal Nursing Standards....Would certainly Help Continuity in Care #RNchat 4/2/2010 13:06 rnchat: @ONSmark T2 The problem with guidelines like CDC--not every hospital keeps up! How can we all be in synch? #RNchat 4/2/2010 13:09 ocdgirl2000: #rnchat Universal Standards apply to everyone, doctors,nurses, etc..so? what makes it it specific to Nursing? 4/2/2010 13:11 rnchat: @RNconsult T2 Yes, universal nursing standards can also raise the bar to help us achieve higher goals for the nursing profession #RNchat 4/2/2010 13:11 rnchat: T2 I work at 2 hospitals--one says IV tubing stays up for 3 days, one says 4 days! Both hospitals in same town! What do I do? :) #RNchat 4/2/2010 13:12 Favored1Aqua: RT @ONSmark: @Favored1Aqua Was it at Dana Farber? yes docs and nurses involved with wrong dose over many days #rnchat 4/2/2010 13:13 RNconsult: @ocdgirl2000 I Agree !!! #RNchat 4/2/2010 13:13 rnchat: @ocdgirl2000 @RNconsult I am not discussing Universal Precautions. I pose the question of standards of nursing care being universal #RNchat 4/2/2010 13:15 ocdgirl2000: #rnchat bottom line:we follow the Dr's orders!of course, we can ask? if they would like to follow a "standard nursing protocol"!LOL! 4/2/2010 13:16 8 of 9 4/2/10 3:25 PM
  9. 9. http://printyourtweets.com/tweets.html rnchat: I cannot believe its so late already! To the participants of today's chat I want to thank you so much for your valuable tweets! :) #RNchat 4/2/2010 13:16 rnchat: Its been so much fun filling in for @philbaumann again! Please continue the topics but before anyone left I wanted to say thanks! :) #RNchat 4/2/2010 13:17 grimalkinrn: Thanks for hosting, Ellen! Another great RN chat! #rnchat 4/2/2010 13:18 ONSmark: Agreed, thanks! RT @grimalkinrn: Thanks for hosting, Ellen! Another great RN chat! #rnchat 4/2/2010 13:18 ocdgirl2000: @rnchat #rnchat follow policy of the place u R working in.Nurse practice act. 4/2/2010 13:19 ocdgirl2000: @RNchat #rnchat thanks so much Ellen!Cheer to my otherwise dreary day!Needed it! huggs! 4/2/2010 13:23 rnchat: @ocdgirl2000 Glad that this chat brought you cheer!! YAY #RNchat :) 4/2/2010 13:24 ocdgirl2000: @RNchat T2 #rnchat You have chosen to work in a place like that, remember they will have issues that will continually arise "because" of it! 4/2/2010 13:25 rnchat: OK folks, I have a 2 PM meeting & need to head out! @EllenRichter signing off this account! xoxo Happy holidays! :) #RNchat 4/2/2010 13:26 9 of 9 4/2/10 3:25 PM

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