Nurses may find themselves in various situations where a resident’s safety has been jeopardized. There, too, may be ethical or legal obligations for a nurse to report an incident. It may be confusing at times to understand ethical or legal requirements and obligations as well as which resources may be available to assist nurses in protecting their residents. Nurses are in fact, obligated to report specific behaviors they observe including, but not limited to, fire, serious criminal acts, suicide, pending or actual labor strikes, and serious physical injuries resulting from accidents or unknown causes. Such behaviors also include abuse, neglect, exploitation or mistreatment, and any other event that may seriously affect the physical and psychological health and well-being of residents.
Important Clarifications
It is critical to know the difference between a serious injury and an accident. It is equally important to know the difference between a reportable incident and a non-reportable incident. A serious injury refers to an injury that is life-threatening, results in death, or requires a resident to undergo significant diagnostic treatment measures. An accident, on the other hand, includes actions including falls, burns, being electrocuted and other dangerous behaviors not related to the care of the resident. Examples of serious injuries and accidents include poisoning, reportable infectious disease outbreaks, equipment malfunction, medication errors, an employee makes errors using equipment which causes harm, and other incidents resulting in serious injury that are not anticipated during routine care and treatment of residents.
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Reportable incidents include medication errors including major IV therapy errors (e.g. wrong rate or route) that cause serious complications including coma, paralysis, permanent injury or death. Other examples include burns from hot liquids, equipment or hot packs, slips, trips or falls resulting in serious head injury, coma, permanent injury, or those resulting in significant additional therapeutic intervention or extended hospitalization. Other reportable incidents involve poisonings that occur within the care setting, criminal activity, allegations of abuse, fire, and death of a resident by suicide.
Non-reportable incidents, on the other hand, are adverse outcomes that are directly related to the natural course of the resident’s condition, disease or disorder, such as Alzheimer’s disease, diabetes, or stroke. Medication errors not resulting in serious adverse complications such as giving medications too early, too late or missing a dose are non-reportable. Other examples include minor reactions to medications, resident refusal of a treatment or procedure, dietary problems that do not affect the resident’s status, such as a food allergy, and a treatment or procedure error that results in no residual effects.
Final Statements on Reporting Major Incidents in Senior Care
Accidents will happen, especially when there are dozens of elderly residents, some very ill and frail, occupying a physical space, receiving extended care and treatment. To err is human. And while most nurses and other healthcare professionals do their very best to provide high-quality care, errors and injuries are bound to happen sometime. This is why it’s important to review exactly what constitutes serious injuries, accidents, reportable incidents and non-reportable incidents.
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