Compliance

The following questions are intended as a guide to help you when submitting information about your complaint. It is not necessary to answer each question.

Who:

• • • • • Who committed the actions you are reporting?

        • Who was the victim(s)?

        • Who discovered the incident/behavior?

        • Who else was involved?

        • Who else witnessed the incident?

What:

• • • • • What was the violation? (see Chapter 8, Section 3 of the Board’s Rules and Wyoming Statute § 33-21-146 for a list of violations)

        • What happened?

        • What actions were performed by the nurse/nursing assistant?

        • What equipment was used or should have been used?

Where:

• • • • • Where did the incident occur?

        • Where were the witnesses during the incident?

        • Where was the item(s)/information stored or kept?

When:

• • • • • When did the incident occur?

        • When was it discovered?

        • When were the supervisors/authorities notified?

How:

• • • • • How was the incident committed?

        • How was the incident discovered?

        • How much property or money was taken?

        • How much damage was done?

Also, include supporting documentation. (i.e. copies of records, Medication Administration Records (MARs) and controlled substance records, name and/or statements of witnesses and/or persons involved, confession, applicable policies and procedures, employee handbook, staffing schedule, patient assignment, incident reports, drug test results, termination notice, names and address of all witnesses).  Other forms of evidence may include pictures, surveillance videos, and copies of text messages or social network pages.