CASE

Failure to Document Drug Wastage

The nurse in Matthias v. Iowa Board of Nursing 8 failed to conform to minimum standards of practice by neglecting to document the loss or wastage of controlled substances. The minimum standard of acceptable practice requires nurses to count controlled substances each shift, to document all loss or wastage of controlled substances, and to obtain the signature of a witness to the disposal of controlled substances. Iowa Code section 147 55(2) allows a professional license to be suspended or revoked when the licensee engages in professional incompetency. Iowa Administrative Code section 655 4. 19(2)(c), which regulates the actions of the board, defines professional incompetency as including [w]illful or repeated departure from or failure to conform to the minimum standards of acceptable and prevailing practice of nursing in the state of Iowa. Matthias argued that the board erred as a matter of law because it failed to find that she knowingly or willfully failed to conform to the minimum standards of practice regarding documentation of loss or wastage of controlled substances. The Iowa Court of Appeals found that there was substantial evidence supporting the boards finding that Matthias engaged in repeated departures from the minimum standards of nursing. The board, therefore, did not need to find that the departure was also willful.

QUESTIONS

Describe the legal and ethical issues involved. Who is responsible? (List all potential parties.) In what way(s) did the quality of the interrelationships among the health professionals involved in the case affect the organizations outcomes? Explain. Analyze the legal and ethical aspects of the case and how they are related. How might ignorance of legal and ethical standards affect the accreditation or licensure of a healthcare organization?