A nurse administers medication to a patient at 0900.

Seven hours later, the nurse realizes a medication error has occurred and completes an incident report. At what time, in 24-hour clock format, did the nurse complete the incident report?

Choice A rationale
Using white out to remove incorrect documentation and writing the correct information over the white out is not an acceptable practice according to CMS guidelines. This method does not allow for the original documentation to be seen, which is a requirement for making corrections to documentation.
Choice B rationale
Using a permanent marker to eliminate all incorrect documentation from view and initialing the mistake is also not an acceptable practice according to CMS guidelines. This method completely obscures the original documentation, which goes against the CMS requirement that all original content must be clearly identifiable.
Choice C rationale
Crossing out the error with a double line so the original documentation may be seen and dating the new entry is not specifically mentioned in the CMS guidelines. While this method does allow for the original documentation to be seen, it’s not clear whether it adheres to all CMS guidelines.
Choice D rationale
According to CMS guidelines, when making corrections to documentation, the nurse should cross out the error with a single line so the original documentation can be seen and sign and date the correction. This method ensures that all original content is clearly identifiable, which is a requirement for making corrections to documentation.

Choice A rationale
This statement is more about describing the specific situation (the “D” in DESC) rather than expressing the nurse’s concerns (the “E” in DESC). It’s important to note that the DESC tool stands for Describe, Express, State, and Consequences. In this context, the nurse is merely stating what happened, not expressing how it made them feel or the impact it had on them.
Choice B rationale
This statement accurately represents the “E” component of the DESC tool, which stands for "Express your concerns"12. In this scenario, the nurse is expressing their feelings about the physician’s behavior and its impact on them. They’re stating how the physician’s actions made them feel uncomfortable, especially in front of other staff members and the patient. This is a crucial step in the DESC process as it allows the individual to express their feelings and concerns about the situation.
Choice C rationale
This statement is more aligned with the “S” component of the DESC tool, which stands for "State other alternatives"12. Here, the nurse is suggesting a different way for the physician to express their concerns in the future. While this is an important part of the DESC process, it does not represent the “E” component.
Choice D rationale
This statement represents the “C” component of the DESC tool, which stands for "Consequences stated"12. In this context, the nurse is outlining the potential outcomes if they cannot agree on an alternative approach. While this is a crucial step in the DESC process, it does not represent the “E” component.