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RESOURCE MANUAL The Impaired Nurse Prevention Identification Investigation Reporting Colorado Board of Nursing 1550 Broadway, Suite 880, Denver, CO 80202 Phone: 303-894-2430 Fax: 303-892-2821 www.dora.state.co.us/nursing

How to fill out form impaired nurse

How to fill out form impaired nurse:

1. Begin by gathering all necessary information and documents related to the impaired nurse, such as their personal details, employment history, and any relevant medical or disciplinary records.
2. Clearly indicate the purpose of the form, which is to report and document concerns about an impaired nurse.
3. Provide a section for the person filling out the form to identify themselves and their relationship to the impaired nurse, ensuring that their contact information is included for follow-up if necessary.
4. Create a detailed section for describing the specific observations or incidents that have led to concerns about the nurse's impairment. Encourage the use of clear, concise language and objective descriptions.
5. Allow space for additional supporting information, such as witness statements, photographs, or relevant documentation that can help provide a complete picture of the situation.
6. Include a section for the person filling out the form to indicate their understanding that the information provided is truthful and accurate to the best of their knowledge.
7. Finally, provide clear instructions on where to submit the completed form, whether it is an online submission, mailing address, or specific individual or department responsible for receiving and processing these forms.

Who needs form impaired nurse:

1. Employers or supervisors who have observed concerning behavior or performance from a nurse that may indicate impairment.
2. Colleagues or co-workers who have witnessed incidents or patterns of behavior that raise concerns about a nurse's impairment.
3. Patients or their family members who have experienced or observed situations where a nurse's impairment may have affected the quality of care provided.

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What is form impaired nurse?

Form impaired nurse is a document used to report a nurse who may be impaired due to substance abuse or other issues in order to protect patients and maintain the integrity of the nursing profession.

Who is required to file form impaired nurse?

Employers, colleagues, or other individuals who may have concerns about a nurse's impairment are required to file form impaired nurse.

How to fill out form impaired nurse?

Form impaired nurse can typically be filled out online or by contacting the appropriate state nursing board. The form will require detailed information about the nurse in question and the reasons for the report.

What is the purpose of form impaired nurse?

The purpose of form impaired nurse is to ensure patient safety, support the nurse in getting the help they may need, and uphold the standards of the nursing profession.

What information must be reported on form impaired nurse?

Information that must be reported on form impaired nurse includes the nurse's name, workplace, behavior of concern, and any supporting evidence.