We have just discovered some staff members have shared their codes for the computers we use. This is the same of forging signatures. I am an educator, and will be dealing with P&P and such, trying to correct this from an educational standpoint (the administration is dealing with corrective actions and disciplinary actions).

Most of the offenses have been done by pct's. I'm wondering if they don't value the serious nature of medical/legal fraud/forgery because they haven't been through nursing school and had the wits scared out of them about charting, etc.

I'm looking for any ideas on how to approach this subject with the staff. I will be using our standards to teach(P&P, etc), and will be trying to impress upon them a zero tolerance of such matters.

How does one motivate people in a subject like this?

Thanks!

Robert,
What do nurses learn about the importance of accurate charting in nursing school? Because we have a serious problem in my unit with inaccruate charting. I check my run sheet each and every tx and its riddled with errors. The amount of heparin is recorded wrong, the sodium is often wrong, bps, info such as which arm a graft is located in, who one's surgeon is, the dry weight is not changed for months, same with blood flow, wgt. gain is incorrect, temps are sometimes faked, assessment figures are fraudulent almost everytime.

We have spoken with the Admin. RN about it and he has responded that its just errors, or some figures are not important. This makes me really angry, because it prevents me from accurately perusing my tx. so that I can make adjustments for the following tx. Is there anyway our nurses could not know this is fraudulent if they do in fact learn this in nursing school?

quote:

Originally posted by Edward D.:
Robert,
What do nurses learn about the importance of accurate charting in nursing school? Because we have a serious problem in my unit with inaccruate charting. I check my run sheet each and every tx and its riddled with errors. The amount of heparin is recorded wrong, the sodium is often wrong, bps, info such as which arm a graft is located in, who one's surgeon is, the dry weight is not changed for months, same with blood flow, wgt. gain is incorrect, temps are sometimes faked, assessment figures are fraudulent almost everytime.

We have spoken with the Admin. RN about it and he has responded that its just errors, or some figures are not important. This makes me really angry, because it prevents me from accurately perusing my tx. so that I can make adjustments for the following tx. Is there anyway our nurses could not know this is fraudulent if they do in fact learn this in nursing school?

Why is dialysis the only field I have seen inaccurate charting run so rampant? We have that problem also. I have been a nurse for 11 years, and have mostly worked in hospitals. I am befuddled as to why this is so common in dialysis and not in other nursing fields. Perhaps the routineness breeds complacency and selfishness?

Last treatment, a new tech recorded my blood pressure on my neighbor's treatment sheet, and my neighbor's blood pressure on my treatment sheet! It was just laughed off and wasn't corrected. I've got to wonder how many times this happens, if techs can just laugh it off.

quote:

Originally posted by DialyzinDar:
Last treatment, a new tech recorded my blood pressure on my neighbor's treatment sheet, and my neighbor's blood pressure on my treatment sheet! It was just laughed off and wasn't corrected. I've got to wonder how many times this happens, if techs can just laugh it off.

I'm sorry to hear that. Would it be possible for you to hold him/her accountable? I'm not implying be mean or anything like that, but to stress to the tech the serious nature of this, and to use assertiveness to state you want your pressure accurate.

I say this, because I wonder why no one (patients, staff, etc) are raising (in a nice professional manner) the standard and expectations we have of each other. When I worked in hospitals for eight years, such behavior would have NEVER been tolerated.

I've been in dialysis 3.5 years now, and still get stunned at how we just seem to be blind of the high standards taught in nursing school.

My social worker confided in me once that all the record keeping is just a hassle that keeps staff from doing their job???

quote:

Originally posted by Dave R.:
My social worker confided in me once that all the record keeping is just a hassle that keeps staff from doing their job???

sorry to hear that. Some systems of charting are not geared towards supporting nursing staff, and actually drown them and slow them down. I have experienced such. It seems to me that dialysis is that way with charting.

However, I have worked in locations where charting was lean and mean, and very supportive of those who are busy by not burdening them down with double and triple charting, etc.

Robert,
Anyone in my unit who assertively asked for the records to be kept accurately would be scorned for rocking the boat and being "picky". This is the way the staff view those who ask for professionalism and accountability. I think it comes down to the management of a unit. If they are honest, they will have and enforce standards. If not, you can forget it. The only way they could be forced to have standards is if there were governing agencies that acted when these type units broke the rules of professionalism. Many patients report they have made complaints to the ESRD networks and their State Depts of Health and could get no enforcement. Without enforcement the units have all the power.

quote:

Originally posted by Brad Kendall:
Robert,
Anyone in my unit who assertively asked for the records to be kept accurately would be scorned for rocking the boat and being "picky". This is the way the staff view those who ask for professionalism and accountability. I think it comes down to the management of a unit. If they are honest, they will have and enforce standards. If not, you can forget it. The only way they could be forced to have standards is if there were governing agencies that acted when these type units broke the rules of professionalism. Many patients report they have made complaints to the ESRD networks and their State Depts of Health and could get no enforcement. Without enforcement the units have all the power.

We are beginning a top down training program of DON's, and all staff. I am personally visiting all units in the next three weeks. I will be reviewing P&P's, appropriate standards, etc. The DON's have agreed to be the enforcers of the policies. All staff will be signing a paper that says they will be dismissed immediately upon any legal documentation issue.

I am hoping to hear some encouragement out there. Anyone have any success stories? What made them success stories?