Employer Complaint Information
The majority of nurses are competent and caring individuals who provide a satisfactory level of care. North Carolina is a mandatory reporting state requiring nurses and others to report when they suspect a nurse is in violation of the Nursing Practice Act. When a problem is experienced with a nurse and you believe that the nurse’s performance may be a violation, you are required to submit a complaint to the Board of Nursing.
The Board has made concerted efforts to move from the traditional regulatory culture of blame and shame to a culture of quality improvement and patient safety. All complaints are taken very seriously. The Board can only take formal action if there is clear and convincing evidence that the nurse violated state nursing laws or rules.
The Board has adopted a “Just Culture” which promotes a learning culture that supports patient safety while assigning accountability for behavioral choices. The Board uses “Just Culture” concepts when reviewing practice events or errors and when identifying appropriate resolutions that promote practice enhancement and patient safety.
The Complaint Evaluation Tool (CET) was developed by the Board of Nursing to identify and clarify when practice events require a report to the Board. The CET serves as a framework through which employers, nursing leaders, and the Board of Nursing can evaluate and analyze practice events or errors with consistency and fairness. The CET is designed for use only when evaluating clinical practice events or issues involving nurses.
Use of the CET and consultation with Board staff guide the employer and nurse leaders to evaluate whether the practice event/issue was the result of human error, at-risk behavior, or reckless behavior, and further determines whether the behavioral choices warrant consoling, counseling, remediation, or discipline.
Human Error – nurse inadvertently, unintentionally did something other than intended or other than what should have been done; a slip, a lapse, or an honest mistake. Human errors are not reportable events.
At Risk Behavior – nurse makes a behavioral choice that increases risk; mistakenly believed risk to be justified; nurse does not appreciate risk; or unintentional risk taking; At Risk Behaviors may or may not be reportable events. Consultation with an NCBON Practice Consultant assists employers and nurse leaders in determining the need for a Board report.
Reckless Behavior – nurse makes the choice to consciously disregard a substantial and unjustifiable risk. The nurse’s action or inaction is intentional and purposeful. The nurse puts own self/personal interest above that of the client, organization, or others. Reckless Behaviors require mandatory report to the Board.
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Definitely Reportable Conduct Events
- Sexual misconduct
- Mental/physical impairment
- Inappropriate prescribing
- Fraudulent prescription for non-controlled/non-abuseable substances
- Criminal charges/convictions (all misdemeanors, felonies and DWIs)
Drug related issues
- Drug abuse
- Impairment on duty
- Drug diversion
- Positive drug screen
- Fraudulent prescription for controlled or abuseable substances
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Potential Reportable Events
Breech of Confidentiality
Inappropriate Delegation &/or Assignment
Failure to Maintain Accurate Documentation
Exceeding Scope of Practice
Failure to Maintain Standards of Care
Failure to Supervise
Inappropriate Interaction with Client (verbal/physical)
Neglect - includes sleeping on duty
Failure to Report Crucial Healthcare Information
The NCBON Complaint Evaluation Tool (CET) will assist you in determining the reportability of these events.
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Common Non-reportable Events (List is not all inclusive of non-reportable events)
No call-no show
Failure to complete a resignation notice or abrupt termination
Refusal to accept an assignment
Rudeness or non-threatening verbal interactions with patient or staff
"Nodding" or momentary unintentional falling asleep, unless this is a pattern of behavior, or results in patient neglect or risk
Falsification of employment application (except when falsification relates to licensure status)
Failure to follow agency policy (unless there is ALSO a violation of the Nursing Practice Act)
Information related to mental or physical conditions of a nurse, obtained while providing care for the nurse (protected information)
Systems Issues, including but not limited to:
Staffing/work hour issues
Physician/nurse communication barriers
Outdated policies/procedures (does not reflect current evidence based practice)
Inappropriate assignment practices
Employer would address non-reportable events per agency policy.
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