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

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
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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
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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
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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
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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
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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
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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
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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
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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
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