Karla Bitz, PhD, RN, FRE North Dakota Board of Nursing
Mar 27, 2015
Karla Bitz, PhD, RN, FRE
North Dakota Board of Nursing
WHAT IS PBR @ NDBON?
OBJECTIVE
Provide an overview of the
implementation process used by the NDBON to incorporate the elements of TERCAP into its investigative process
Patient
Boards of Nursing
InvestigatorsResearch
Enhance the effectiveness of the investigative process
Consistent, standardized, and comprehensive data collection
Track case elements and recurring themes
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
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
2006 – Strategic Plan 2007 – Implemented TERCAP !
INTERNAL OPERATIONS
Potential Violation Report Response Form Investigative Case Interview Investigative Case Summary Disciplinary Review Panel Discipline Statistics
LESSONS LEARNED Commitment Shifts focus from name,
shame, and blame Culture Change - will take time Don’t have to recreate the
process
LESSONS LEARNED (cont’d)
Opportunity for comprehensive review of investigative process
HELP is available, Use it! TERCAP Committee NCSBN staff Protocol Webinars
JUST TRY IT!
Kathy Chastain, RN, MSNCarol Walker, RN, MS
TERCAP IMPLEMENTATION:North Carolina BON ProcessTERCAP IMPLEMENTATION:North Carolina BON Process
Project ValueProject Value
Patient safety Nursing education Nursing regulation Advancement of nursing profession Research for Healthcare Community NCBON
Project ChallengesProject Challenges
Harness magnitude of project Relevance to expanse of practice User friendly for 50+ BONs Board staff acceptance
NCBON Staff AcceptanceNCBON Staff Acceptance
Value to each Investigator Incorporate into current process
- Current system flaws identified
Needed Facilitator CharacteristicsNeeded Facilitator Characteristics
Perceive project value Energy Enthusiasm Commitment Perseverance Endurance Creativity
Needed Facilitator CharacteristicsNeeded Facilitator Characteristics
Maintain vision Patience Accept little immediate satisfaction Appreciate each step in process
NCBON Current Investigation ProcessNCBON Current Investigation Process
No Investigation tool Inconsistent documentation format New computer documentation
system
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
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
TERCAP Data EntryTERCAP Data Entry
Realization:
*Additional time needed to enter data
Resolution:
*Incorporate into case
documentation process
TERCAP Data EntryTERCAP Data Entry
Realization:
Need to revise internal Inquiry/
Investigation documentation
Resolution:
Opportunity to initiate uniform documentation
TERCAP is NOT a
Short Term Project!!