Modalities of Nursing Care This refers to the manner in which nursing care is organized and provided.

It depends on the philosophy of the organization, nurse staffing and client population. Case Method/Total Patient Care In case method, the nurse cares for one patient whom the nurse cares for exclusively. The Case Method evolved into what we now call private duty nursing. It was the first type of nursing care delivery system. In Total Patient Care, the nurse is responsible for the total care of the patient during the nurses working shift. The RN is responsible for several patients. Advantages:  Consistency in carrying out the nursing care plan  Patient needs are quickly met as high number of RN hours are spent on the patient  Relationship based on trust is developed between the RN and the patients family Disadvantage:  It can be very costly Functional Nursing It is a task-oriented method wherein a particular nursing function is assigned to each staff member. The medication nurse, treatment nurse and bedside nurse are all products of this system. For efficiency, nursing was essentially divided into tasks, a model that proved very beneficial when staffing was poor. The key idea was for nurses to be assigned to tasks, not to patients. Advantages:  A very efficient way to delivery care.  Could accomplish a lot of tasks in a small amount of time  Staff members do only what they are capable of doing  Least costly as fewer RNs are required Disadvantages:  Care of patients become fragmented and depersonalized  Patients do not have one identifiable nurse  Very narrow scope of practice for RNs  Leads to patient and nurse dissatisfaction Team Nursing This is the most commonly used model and is still in use today. It was developed in the 1950s in order to somewhat ameliorate the fragmentation that was inherent in the functional model. The goal of team nursing is for a team to work democratically. In the ideal team, an RN is assigned as a Team Leader for a group of patients. The Team Leader has a core of staff reporting to her, and together they work to disseminate the care activities. The team member possessing the skill needed by the individual patient is assigned to that patient, but the Team Leader still has accountability for all of the care. Team conferences occur in which the expertise of every staff member is used to plan the care. Advantages:  Each members capabilities are maximized so job satisfaction should be high  Patients have one nurse (the Team Leader) with immediate access to other health providers Disadvantages:  Requires a team spirit and commitment to succeed

RN may be the Team Leader one day and a team member the next, thus continuity of patient care may suffer  Care is still fragmented with only 8 or 12 hour accountability Primary Nursing The hallmark of this modality is that one nurse cares for one group of patients with a 24-hour accountability for planning their care. In other words, a Primary Nurse (PN) cares for her primary patients every time she works and for as long as the patient remains on her unit. An Associate Nurse cares for the patient in the PNs absence and follows the PNs individualized plan of care. This is a decentralized delivery model: more responsibility and authority is placed with each staff nurse. Advantages:  Increased satisfaction for patients and nurses  More professional system: RN plans and communicates with all healthcare members. RNs are seen as more knowledgeable and responsible.  RNs more satisfied because they continue to learn as as part of the in-depth care they are required to deliver to their patient Disadvantage:  Only confines a nurses talents to a limited number of patients, so other patients cannot benefit if the RN is competitive  Can be intimidating for RNs who are less skilled and knowledgeable Modular Nursing (District Nursing) This is a modification of team and primary nursing. It is a geographical assignment of patient that encourages continuity of care by organizing a group of staff to work with a group of patients in the same locale. Advantages:  Useful when there are a few Rns  RNs plan their care Disadvantage:  Paraprofessionals do technical aspects of nursing care


Types of Nursing Modalities Nursing modalities are ways care is organized and delivered to patients. They have to do with arranging staff members and assigning patients. Care delivery methods take into account the total number of patients and tasks needed to be accomplished as well as how many nurses are needed. Most importantly, they are concerned with meeting patient's needs and continuity of care. "The purpose of any delivery system is to provide high quality care, efficiently and effectively," according to Kaiser Permanente Institute for Health Policy. 1. Team Nursing
o

Team nursing involves having a head nurse supervise and coordinate a team of nurses. The head nurse assigns each individual nurse a group of patients. Each nurse is responsible for most of each patient's care. Some of the duties may be delegated to other nurses or assistant personnel such as nursing assistants. The head nurse is typically a registered nurse who assigns patients primarily according to the abilities or expertise of each nurse. The team nursing modality includes nurses at all levels of knowledge: registered nurses, practical nurses and nursing assistants, orderlies and aides.

Primary Nursing
o

Primary nursing generally requires all nurses on staff be registered nurses. Each nurse is assigned to a small group of patients according to expertise but is not just responsible for the time she is on duty. The nurse is accountable for each patient's total care continuously until discharge even when technically off duty. She must be responsible for care of her patients all of the time but is assisted by an associate nurse with whom patient information is communicated. The associate nurse provides care when the primary nurse is off duty, but the primary nurse is contacted if needed. The primary nursing modality was thought to not be cost-effective because of the exclusive use of registered nurses. Today this model is still used in hospitals, but may use practical nurses as associate nurses. Nursing Case Management

Case management is a more recent development as the health care establishment began to explore more efficient, but cost-effective, ways to deliver patient care. This model utilizes the role of a nurse case manager, typically a registered nurse who advocates, manages and coordinates care for patients. It is used in hospitals and clinics as well as in the community. The focus of case management is on a specified population. Private Duty Nursing

Private duty nursing refers to a delivery method of care in which one nurse is responsible for the complete care of one individual patient typically in the home. This is how nursing was done when first established as a profession in the U.S. It was used briefly in the hospital setting during the depression but was too difficult to coordinate because of the large numbers of patients and not enough nurses. Functional nursing was the main modality used in hospitals at that time. The group nursing and total patient care modalities were created in an effort to try and adapt private duty nursing to the hospital setting. In group nursing, a group of nurses care for a group of patients. With total patient care, the nurse assumes complete responsibility of one patient or a group of patients only for the duration of her shift. Total care nurses can either be registered or practical nurses. Private duty nursing and total patient care are still used today. Group nursing is no longer being used. Functional Nursing

With this approach, nurses are assigned a specific task and do only that duty. The nurse performs the task for every patient on the ward or hospital unit. There is a medication nurse, an IV nurse, a dressings nurse and so on. For each task that needs to be done, one nurse handles it for all the patients. According to "Leadership and Nursing Care Management," the functional nursing modality was the principle method of care delivery back in the old days from around the 1800's to the end of WWII. It was instituted in response to the situation of not having enough nurses but lots of patients to care for, particularly during war times. Functional nursing is still being used today.

Read more: Types of Nursing Modalities |

eHow.com http://www.ehow.com/info_8520558_types-nursingmodalities.html#ixzz1REgKxED3

Force majeure (French for "superior force"), also known as cas fortuit (French) or casus fortuitus(Latin),[1] is a common clause in contracts that essentially frees both parties from liability or obligation when an extraordinary event or circumstance beyond the control of the parties, such as a war, strike, riot, crime, or an event described by the legal term "act of God" (such as flooding, earthquake, or volcanic eruption), prevents one or both parties from fulfilling their obligations under the contract.[2] However, force majeure is not intended to excuse negligence or other malfeasance of a party, as where non-performance is caused by the usual and natural consequences of external forces (for example, predicted rain stops an outdoor event), or where the intervening circumstances are specifically contemplated. Purpose Time-critical and other sensitive contracts may be drafted to limit the shield of this clause where a party does not take reasonable steps (or specific precautions) to prevent or limit the effects of the outside interference, either when they become likely or when they actually occur. A force majeure may work to excuse all or part of the obligations of one or both parties. For example, a strike might prevent timely delivery of goods, but not timely payment for the portion delivered. Similarly, a widespread power outage would not be a force majeure excuse if the contract requires the provision of backup power or other contingency plans for continuity. A force majeure may also be the overpowering force itself, which prevents the fulfillment of a contract. In that instance, it is actually the impossibility or impracticability defenses. In the military, force majeure has a slightly different meaning. It refers to an event, either external or internal, that happens to a vessel or aircraft that allows it to enter normally restricted areas without penalty. An example would be the Hainan Island incident where a U.S. Navy aircraft landed at a Chinese military airbase after a collision with a Chinese fighter in April 2001. Under the principle of force majeure, the aircraft must be allowed to land without interference. [edit]Importance The importance of the force majeure clause in a contract, particularly one of any length in time, cannot be overstated as it relieves a party from an obligation under the contract (or suspends that

obligation). What is permitted to be a force majeure event or circumstance can be the source of much controversy in the negotiation of a contract and a party should generally resist any attempt by the other party to include something that should, fundamentally, be at the risk of that other party. For example, in a coal-supply agreement, the mining company may seek to have "geological risk" included as a force majeure event; however, the mining company should be doing extensive exploration and analysis of its geological reserves and should not even be negotiating a coal-supply agreement if it cannot take the risk that there may be a geological limit to its coal supply from time to time. The outcome of that negotiation, of course, depends on the relative bargaining power of the parties and there will be cases where force majeureclauses can be used by a party effectively to escape liability for bad performance. In Hackney Borough Council v. Dore (1922) 1 KB 431 it was held that "The expression means some physical or material restraint and does not include a reasonable fear or apprehension of such a restraint". The expression bears more extensive meaning than "act of God" or vis major. As to delay due to breakdown of machinery, it comes within the words "force majeure", which certainly cover accidents to machinery. The term cannot, however, be extended to cover bad weather, football matches, or a funeral. Matsoukis v. Priestman & Co (1915) 1 KB 681. The expression is undoubtedly a term of wider import than vis major. Judges have agreed that strikes, breakdown of machinery, which though normally not included in vis major, are included in force majeure. In re Dharnrajmal Gobindram v. Shamji Kalidas [All India Reporter 1961 Supreme Court (of India) 1285] it was held that "An analysis of ruling on the subject shows that reference to the expression is made where the intention is to save the defaulting party from the consequences of anything over which he had no control". Under international law it refers to an irresistible force or unforeseen event beyond the control of a State making it materially impossible to fulfil an international obligation. Force majeure precludes an international act from being wrongful where it otherwise would have been. [edit]Elements The understanding of force majeure in French law is similar to that of international law and vis major as defined above. For a defendant to invoke force majeure in French law, the event proposed as force majeure must pass three tests: Externality The defendant must have nothing to do with the event's happening.

Unpredictability If the event could be foreseen, the defendant is obligated to have prepared for it.[3] Being unprepared for a foreseeable event leaves the defendant culpable. This standard is very strictly applied:


CE 9 April 1962, "Chais dArmagnac": The Conseil d'Etat adjudged that, since a flood had occurred 69 years before the one that caused the damage at issue, the latter flood was predictable.

Administrative tribunal of Grenoble, 19 June 1974, "Dame Bosvy": An avalanche was judged to be predictable since another had occurred around 50 years before. Irresistibility


The consequences of the event must have been unpreventable. Other events that are candidates for force majeure in French law are hurricanes and earthquakes. Force majeure is a cause of relief from responsibility that is applicable throughout French law. On the other hand, the German understanding goes under the German translation of vis major (hhere Gewalt) but seems conceptually synonymous with the common law interpretation of force majeure, comprehending both natural disasters and events such as strikes, civil unrest, and war. However, even in the event of force majeure, liability persists in the face of default by a debtor (Schuldnerverzug, cf. BGB287 (in German)) or deprivation of property (Sachentziehung, cf. BGB 848 (in German)). Force Majeure in areas prone to natural disaster requires a definition of the magnitude of the event for which Force Majeure could be considered as such in a contract. As an example in a highly seismic area a technical definition of the amplitude of motion at the site could be established on the contract base for example on probability of occurrence studies. This parameter or parameters can later be monitored at the construction site (with a commonly agreed procedure). An earthquake could be a small shaking or damaging event. The occurrence of an earthquake does not imply the occurrence of damage or disruption. For small and moderate events it is reasonable to establish requirements for the contract processes; for large events it is not always feasible or economical to do so. Concepts such as 'damaging earthquake' in force majeure clauses does not help to clarify disruption, especially in areas where there are no other reference structures or most structures are not seismically safe.[4]

Force majeure and cas fortuit are distinct notions in French Law. [edit]Sample clause The following is an example of how force majeure might be described in a specific contract. Clause 18. Force Majeure A party is not liable for failure to perform the party's obligations if such failure is as a result of Acts of God (including fire, flood, earthquake, storm, hurricane or other natural disaster), war, invasion, act of foreign enemies, hostilities (regardless of whether war is declared), civil war, rebellion, revolution, insurrection, military or usurped power or confiscation, terrorist activities, nationalisation, government sanction, blockage, embargo, labor dispute, strike, lockout or interruption or failure of electricity or telephone service. No party is entitled to terminate this Agreement under Clause 19 (Termination) in such circumstances. If a party asserts Force Majeure as an excuse for failure to perform the party's obligation, then the nonperforming party must prove that the party took reasonable steps to minimize delay or damages caused by foreseeable events, that the party substantially fulfilled all non-excused obligations, and that the other party was timely notified of the likelihood or actual occurrence of an event described in Clause 18 (Force Majeure). [edit]

http://www.scribd.com/doc/17224886/Nursing-Jurisprudence

Professional Negligence refers to the commission or omission of an act, pursuant to a duty, that a reasonably person in the same or similar circumstance would or would not do, and acting or the non-acting of which is the proximate cause of injury to another person or his property Elements of Professional Negligence
   
Existence of a duty on the part of the person charged to use due care under circumstances Failure to meet the standard of due care The foreseeability of harm resulting from failure to meet standard

The fact that the breach of this standard resulted in an injury to the plaintiff Specific Examples of Negligence 1. Failure to report observations to attending physicians. 2. Failure to exercise the degree of diligence which the circumstances of the particular case demands. 3. 4. 5. 6. Mistaken identity. Wrong medicine, wrong concentration, wrong route, wrong dose. Defects in equipments that may result in injuring the patients. Errors due to family assistance.

7. 1. 2. 3.

Administration of medicine without a doctor prescription. The thing speaks for itself. It means that the nature of the wrongful act or injury is suggestive of negligence Three conditions are required to establish a defendants negligence without proving specific conduct.  That the injury was of such nature that it would not normally occur unless there was a negligent act on the

The Doctrine of Res Ipsa Loquitor

 

part of someone. That the injury was caused by an agency within the control of the defendant That the plaintiff himself did not engage in any manner that would tend to bring about the injury.

Malpractice
         
you do things beyond your scope of practice also denotes stepping beyond ones authority with serious consequences. It means an irresistible force, one that is unforeseen or inevitable. you cannot stop it from happening circumstances such as floods, fire, earthquakes and accidents fall under this doctrine let the master answer for the acts of the subordinate the liability is expanded to include the master as well as the employee and not a shift of liability from the subordinate to the master this doctrine applies only to those actions performed by the employee within the scope of his employment is the lack of ability, legal qualifications or fitness to discharge the required duty. Although a nurse is registered, if in the performance of her duty she manifests incompetency, there is ground for revocation or suspension of her certificates of registration. Nursing aides perform selected nursing activities under the direct supervision of nurses. Nurses should not delegate their functions to nursing aides since the Philippine Nursing Act specifies the scope of nursing practice of professional nurses. If a nurse delegates, he is responsible. Under the Philippine Nursing Act of 2002, nursing students do not perform professional nursing duties. They are to be supervised by their Clinical Instructors. A nurse cannot bring suit against the patient if she gets hurt or contacts the disease since upon accepting the case, the nurse agreed to assume the risk of harm or infection. Is defined as a free and rational act that presupposes knowledge of the thing which consent is being given by a person who is legally capable to give consent. It is the NURSE who actually secures the consent of the patient upon admission. it is established principle of law that every human being of adult years and sound mind has the right to determine what shall be done with his on body Essential elements of Informed Consent 1. Diagnosis and explanation of the condition 2. A fair explanation of the procedures to be done and used and the consequences 3. A description of alternative treatment or procedures

Doctrine of Force Majeure

Doctrine of Respondeat Superior

Incompetence

Liability of Nurses for the Work of Nursing Aides

     

Liability for the Work of Nursing Students

Assumption of Risk

Consent
   

Informed Consent

4. 5. 6.

A description of benefits to be expected Material rights if any The prognosis, if the recommended care, procedure, is refused.

Proof of Consent
   
A written consent should be signed to show that the procedure is the one consented to and that the person understands the nature of procedure A signed special consent is necessary before any medical or surgical treatment is don such as x-rays etc. Normally the patient himself is the one who gives the consent, If he is incompetent (minors or mentally ill) or physically unable, consent must be taken from another who is authorized to give it in his behalf.

Who Must Consent

Consent of Minors
   
Parents, or someone standing in their behalf If emancipated minor consent is signed by them. They cannot legally give consent. Parents or guardians. When an emergency situation exists, no consent is necessary because inaction at such time may cause greater injury. Patients other than those who are incompetent to give consent can refuse consent. If refuses to sign, this should be noted in his chart Is the termination of the ability to produce offspring. The husband and wife must consent to the procedure if the operation is primarily to accomplish sterilization. If its medically necessary or an incidental result, the patient alone is sufficient. As a record of illness and treatment, it saves duplication in future cases and aids in prompt treatment It serves as a legal protection for the hospital, doctor, and nurse by reflecting the disease or condition of patient and its management. If it was not charted, it was not observed or done. Nurses have the responsibility of keeping the patients right to confidentiality. Permission has to be taken from the Medical Records Division of the Hospital. nurse may be held liable for intentional wrongs is a legal wrong, committed against a person or property, independent of a contract which renders the person who commits it liable for damages in a civil action. The person who has been wronged seeks compensation for injury or wrong he has suffered Assault and Battery Assault is the imminent threat of harmful or offensive bodily contact; banta Battery is an intentional, unconsented touching of another person. False Imprisonment or Illegal Detention Unjustifiable detention of a person without legal warrant within the boundaries fixed by the defendant by an act or violation of duty intended to result in such confinement Invasion of Right to Privacy and Breach of Confidentiality.

Consent of Mentally Ill Emergency Situation

Refusal to Consent
            
1.

Consent for Sterilization

Medical Records

Intentional Wrongs Torts

Examples of Torts are:

 
1.


1.


1.

The right to privacy is the right to be left alone, the right to be free from unwarranted publicity and exposure to public view Defamation Character assassination, be in written or spoken Slander is oral defamation of a person by speaking unprivileged or false words by which his reputation is damaged. Libel is defamation by written words, cartoons or such representations that cause a person to be avoided, ridiculed or held in contempt or tend to injure him in his work.

  

Advance Directives and Do Not Resuscitate Orders

What is an advance directive?
An advance directive tells your doctor what kind of care you would like to have if you become unable to make medical decisions (if you are in a coma, for example). If you are admitted to the hospital, the hospital staff will probably talk to you about advance directives. A good advance directive describes the kind of treatment you would want depending on how sick you are. For example, the directives would describe what kind of care you want if you have an illness that you are unlikely to recover from, or if you are permanently unconscious. Advance directives usually tell your doctor that you don't want certain kinds of treatment. However, they can also say that you want a certain treatment no matter how ill you are. Advance directives can take many forms. Laws about advance directives are different in each state. You should be aware of the laws in your state. Return to top

What is a living will?

A living will is one type of advance directive. It is a written, legal document that describes the kind of medical treatments or life-sustaining treatments you would want if you were seriously or terminally ill. A living will doesn't let you select someone to make decisions for you. Return to top

What is a durable power of attorney for health care?

A durable power of attorney (DPA) for health care is another kind of advance directive. A DPA states whom you have chosen to make health care decisions for you. It becomes active any time you are unconscious or unable to make medical decisions. A DPA is generally more useful than a living will. But a DPA may not be a good choice if you don't have another person you trust to make these decisions for you. Living wills and DPAs are legal in most states. Even if they aren't officially recognized by the law in your state, they can still guide your loved ones and doctor if you are unable to make decisions about your medical care. Ask your doctor, lawyer or state representative about the law in your state. Return to top

What is a do not resuscitate order?

A do not resuscitate (DNR) order is another kind of advance directive. A DNR is a request not to have cardiopulmonary resuscitation (CPR) if your heart stops or if you stop breathing. (Unless given other instructions, hospital staff will try to help all patients whose heart has stopped or who have stopped breathing.) You can use an advance directive form or tell your doctor that you don't want to be resuscitated. In this case, a DNR order is put in your medical chart by your doctor. DNR orders are accepted by doctors and hospitals in all states. Return to top

Should I have an advance directive?

By creating an advance directive, you are making your preferences about medical care known before you're faced with a serious injury or illness. This will spare your loved ones the stress of making decisions about your care while you are sick. Any person 18 years of age or older can prepare an advance directive. People who are seriously or terminally ill are more likely to have an advance directive. For example, someone who has terminal cancer might write that she does not want to be put on a respirator if she stops breathing. This action can reduce her suffering, increase her peace of mind and increase her control over her death. However, even if you are in good health, you might want to consider writing an advance directive. An accident or serious illness can happen suddenly, and if you already have a signed advance directive, your wishes are more likely to be followed. Return to top

How can I write an advance directive?

You can write an advance directive in several ways: y y y y y Use a form provided by your doctor. Write your wishes down by yourself. Call your health department or state department on aging to get a form. Call a lawyer. Use a computer software package for legal documents.

Advance directives and living wills do not have to be complicated legal documents. They can be short, simple statements about what you want done or not done if you can't speak for yourself. Remember, anything you write by yourself or with a computer software package should follow your state laws. You may also want to have what you have written reviewed by your doctor or a lawyer to make sure your directives are understood exactly as you intended. When you are satisfied with your directives, the orders should be notarized if possible, and copies should be given to your family and your doctor. Return to top

Can I change my advance directive?

You may change or cancel your advance directive at any time, as long as you are considered of sound mind to do so. Being of sound mind means that you are still able to think rationally and communicate your wishes in a clear manner. Again, your changes must be made, signed and notarized according to the laws in your state. Make sure that your doctor and any family members who knew about your directives

are also aware that you have changed them. If you do not have time to put your changes in writing, you can make them known while you are in the hospital. Tell your doctor and any family or friends present exactly what you want to happen. Usually, wishes that are made in person will be followed in place of the ones made earlier in writing. Be sure your instructions are clearly understood by everyone you have told.

Roles & Responsibilities of a Nurse

       
1. Caregiver/ Care provider the traditional and most essential role functions as nurturer, comforter, provider mothering actions of the nurse provides direct care and promotes comfort of client activities involves knowledge and sensitivity to what matters and what is important to clients shows concern for client welfare and acceptance of the client as a person 2. Teacher provides information and helps the client to learn or acquire new knowledge and technical skills

encourages compliance with prescribed therapy. promotes healthy lifestyle interprets information to the client 3. Counselor- helps client to recognize and cope with stressful psychologic or social problems; to develop an improve interpersonal relationships and to promote personal growth  provides emotional, intellectual to and psychologic support  focuses on helping a client to develop new attitudes, feelings and behaviors rather than promoting intellectual growth.  encourages the client to look at alternative behaviors recognize the choices and develop a sense of control. 4. Change agent- initiate changes or assist clients to make modifications in themselves or in the system of care. 5. Client advocate- involves concern for and actions in behalf of the client to bring about a change.  promotes what is best for the client, ensuring that the clients needs are met and protecting the clients right.  provides explanation in clients language and support clients decisions. 6. Manager makes decisions, coordinates activities of others, allocate resources, evaluate care and personnel  plans, give direction, develop staff, monitors operations, give the rewards fairly and represents both staff and administrations as needed . 7. Researcher participates in identifying significant researchable problems  participates in scientific investigation and must be a consumer of research findings  must be aware of the research process, language of research, a sensitive to issues related to protecting the rights of human subjects. Expanded role of the nurse: 1 Clinical Specialists- is a nurse who has completed a masters degree in specialty and has considerable clinical expertise in that specialty. She provides expert care to individuals, participates in educating health care professionals and ancillary, acts as a clinical consultant and participates in research. 2. Nurse Practitioner- is a nurse who has completed either as certificate program or a masters degree in a specialty and is also certified by the appropriate specialty organization. She is skilled at making nursing assessments, performing P. E., counseling, teaching and treating minor and self- limiting illness. 3. Nurse-midwife- a nurse who has completed a program in midwifery; provides prenatal and postnatal care and delivers babies to woman with uncomplicated pregnancies. 4. Nurse anesthetist- a nurse who completed the course of study in an anesthesia school and carries out preoperative status of clients.

5. Nurse Educator- A nurse usually with advanced degree, who beaches in clinical or educational settings, teaches theoretical knowledge, clinical skills and conduct research. 6. Nurse Entrepreneur- a nurse who has an advanced degree, and manages health-related business. 7. Nurse administrator- a nurse who functions at various levels of management in health settings; responsible for the management and administration of resources and personnel involved in giving patient care.

What is an Incident Report

Definition Despite the most careful precaution of medical personnel, medico-legal accidents still occur. In all cases of accidents nurses caring for the client during the time of incident and those who saw or heard the unusual event should write an incident report. The nurse in charge of the department should also write an incident report in cases of accident. An incident report is a form that filled up in order to record the details of accidents, patient injury and other unusual events that occur in a health care facility such as a hospital or nursing home. It is also called an accident report which documents the exact details of the accident or unusual event while the information is still fresh in the minds of those who witness the event. Purpose of an Incident Report People often regard an incident report as a black mark against the nursing staff who wrote it. This should not be the case because an informed consent is a legal document of an incident that took place. The purposes of an incident report are the following: 1. To document the exact detail of an accident or unusual incident that occurred in a health-care institution. 2. To be used in the future when dealing with liability issues stemming from the incident. 3. To protect the nursing staff against unjust accusation. 4. To protect and safeguard the client in case of negligence on the part of the nurse. 5. Helps in the evaluation of nursing care to ensure safe care to all patients. Incident Report Written at the first opportunity after the incident so that the details are not blurry or forgotten. Written with a pen (ink) not pencil. Information written using a pencil can be erased. Details should be complete and accurate. The patient should be identified with the following details: 1. Full name 2. Hospital bed number 3. Hospital ID 4. Patients diagnosis 5. Patients condition before and after the incident Other details included are: 1. Details of ward or clinical area 2. Date, time and place of incident 3. Details of equipments used including the serial number or asset tag identification (if appropriate)  Written as statement of facts without interpretation or opinion. Descriptive adjectives should not be used. For example instead of writing: Mr. Dimaano would not listen when I told him to stay in bed. He is very difficult to care for. It is his fault why he fell on the floor. You should write: I heard a loud crash, and immediately went to the ward. I found Mr. Dimaano on the floor.  Events should be written in sequence that they occurred.

  

    

Proper technical terms should be used. For example instead of using the word bottle specify that it is a urinal. Identifies the witnesses. Identifies the medications given before the incident (if applicable) Identifies the equipment that is involved or used. Signed legibly with the correct designation.

http://www.scribd.com/doc/25102504/Staffing-in-Nursing-Management?vm=r