karla bitz, phd, rn, fre north dakota board of nursing
TRANSCRIPT
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Karla Bitz, PhD, RN, FRE
North Dakota Board of Nursing
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WHAT IS PBR @ NDBON?
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OBJECTIVE
Provide an overview of the
implementation process used by the NDBON to incorporate the elements of TERCAP into its investigative process
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Patient
Boards of Nursing
InvestigatorsResearch
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Enhance the effectiveness of the investigative process
Consistent, standardized, and comprehensive data collection
Track case elements and recurring themes
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WHY DO IT? (cont’d)
Discover characteristics of nurses at risk
Provide continuity in investigations Increase competence in addressing
Practice Breakdown Better understand why errors occur
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November 15, 2001: NDBON voted to participate in the NCSBN PBR Study
December 2002: Per the SAAG, not required to obtain consent to gather the data Board’s files are subject to ND Open
Record Law Individual identifiers are not included Analyze aggregate data
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2006 – Strategic Plan 2007 – Implemented TERCAP !
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INTERNAL OPERATIONS
Potential Violation Report Response Form Investigative Case Interview Investigative Case Summary Disciplinary Review Panel Discipline Statistics
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LESSONS LEARNED Commitment Shifts focus from name,
shame, and blame Culture Change - will take time Don’t have to recreate the
process
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LESSONS LEARNED (cont’d)
Opportunity for comprehensive review of investigative process
HELP is available, Use it! TERCAP Committee NCSBN staff Protocol Webinars
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JUST TRY IT!
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Kathy Chastain, RN, MSNCarol Walker, RN, MS
TERCAP IMPLEMENTATION:North Carolina BON ProcessTERCAP IMPLEMENTATION:North Carolina BON Process
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Project ValueProject Value
Patient safety Nursing education Nursing regulation Advancement of nursing profession Research for Healthcare Community NCBON
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Project ChallengesProject Challenges
Harness magnitude of project Relevance to expanse of practice User friendly for 50+ BONs Board staff acceptance
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NCBON Staff AcceptanceNCBON Staff Acceptance
Value to each Investigator Incorporate into current process
- Current system flaws identified
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Needed Facilitator CharacteristicsNeeded Facilitator Characteristics
Perceive project value Energy Enthusiasm Commitment Perseverance Endurance Creativity
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Needed Facilitator CharacteristicsNeeded Facilitator Characteristics
Maintain vision Patience Accept little immediate satisfaction Appreciate each step in process
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NCBON Current Investigation ProcessNCBON Current Investigation Process
No Investigation tool Inconsistent documentation format New computer documentation
system
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Feb 07 TERCAP Data EntryFeb 07 TERCAP Data Entry
Realization:
*Resistance to additional change
*TERCAP History
Decision: Restrict staff entering data
Problem: Case selection/skewed data
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TERCAP Data EntryTERCAP Data Entry
Realization: Data scattered Data not obtained
Resolution: Developed paper tool*Increased data collection*Centralized collected data
Problem: Remember to use
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TERCAP Data EntryTERCAP Data Entry
Realization:
*Additional time needed to enter data
Resolution:
*Incorporate into case
documentation process
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TERCAP Data EntryTERCAP Data Entry
Realization:
Need to revise internal Inquiry/
Investigation documentation
Resolution:
Opportunity to initiate uniform documentation
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TERCAP is NOT a
Short Term Project!!