Reference no: EM133396937

Question: The monthly medication review done by the pharmacy department identified non-ordered drug removals from the PYXIS dispenser. They were all narcotics and restricted class substances. The travel nurse oversaw the PYXIS machine at the time the narcotics were removed, and no one else had any withdrawals from the PYXIS dispenser during the period in question. The travel nurse involved says she was not aware of PYXIS use. While there is compelling evidence to support termination, the CEO is pushing back on termination of the travel nurse due to a nurse shortage in the metropolitan area. The staff in the emergency department are worried that they may lose their jobs or have to work mandatory overtime due to the nursing shortage if the traveling nurse is fired.

A nurse practitioner was told by the administration to perform a specific procedure within the organization's clinic. While it is legally within the nurse practitioner's scope of practice, the nurse practitioner has no training or experience performing the procedure.

Patient satisfaction surveys (HCAHPS) over the last three months indicate inadequate patient-discharge education with an overall ranking of 3 out of 10 on the category. A recent, informal audit of the medical-surgical records supports the HCAHPS data.