Simulation and the Second Victim
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A series of simulation scenarios that had the potential for practice errors to occur were developed and implemented with registered nurse residents. High risk procedures and reported medication errors were reviewed and topics for simulation were selected from this list. The series of simulations began with a blood administration scenario. The scenario was created where 2 patients had the same name and date of birth, but different middle initials. If nurses did not follow the safety processes then they could make an error, much like an error might happen in the practice setting. The second simulation in the series was a simulated nurse peer review. The nurses who made a blood administration error, were the nurses whose practice was reviewed. The other nurse residents served on the peer review committee. The committee was provided with copies of the hospital’s Nurse Peer Review policy, the Texas board of nursing rules regarding minor incidents (217.16), standards of nursing practice (217.11) and unprofessional conduct (217.12). The simulation included certified letters delivered to the nurses who made the errors. As per policy confidentiality agreements were distributed and explained to the committee and signed. Next the nurses under review came in and were questioned by the committee. After questioning and much discussion between the nurses and the committee a determination regarding the nurses practice was made by the committee. During the debriefing the nurses were asked to write emotions, how do they think the nurses who made the errors felt, and how did they feel judging a peer. Coping skills were discussed.