Federal Reports

Nuclear Power Group Standard Programs and Processes 03.21, Fatigue Rule and Work Hour Limits, includes rules regarding required average minimum days off for covered individuals, as well as overtime rules for how many hours can be worked in specific time periods. Our review of sampled employee and contract employee work hours and badging records for fiscal years 2017 and 2018 identified no violations of nuclear fatigue rule (NFR) minimum days off or overtime rules. However, we identified areas of deficiencies with Brown Ferry's performance of (1) fatigue assessments and (2) NFR compliance reviews. Additionally, we identified areas for improvement related to NFR work-schedule tracking.

The Postal Service prefers to use eBuy2 to pay for goods and services. If a purchase cannot be satisfied through eBuy2, authorized postal employees may use the purchase card. Cash can be used for emergency one-time expenses, not to exceed $25. No-fee money orders can be used for emergency one-time local expenses, not to exceed $1,000. The objective was to determine whether local purchases and payments for miscellaneous services made at the Perth Amboy, NJ, Post Office were valid and properly supported and processed.

This report presents the results of our self-initiated audit of Delivery Scanning Issues – Carmel Valley Carrier Annex, San Diego, CA. The Carmel Valley Carrier Annex is in the San Diego District of the Pacific Area. We conducted the audit to provide U.S. Postal Service management with timely information on potential operational risks at the Carmel Valley Carrier Annex.

The audit objectives were to determine whether program funds were managed in accordance with the ARC and Federal grant requirements

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The VA Office of Inspector General (OIG) conducted a healthcare inspection to address care and process issues for an Emergency Department patient and out of operating room airway management processes (OOORAM). The OIG substantiated that an advanced practice registered nurse caused airway trauma while unsuccessfully attempting intubation. However, the bleeding was minor and of no lasting impact. OIG staff determined that the other aspects of the subject patient’s emergency care were appropriate. The OIG substantiated the advanced practice registered nurse did not document the failed intubation attempts in the patient’s health record. The OIG team concluded that the advanced practice registered nurse should have personally documented the procedure in the patient’s health record. The OIG substantiated that an Emergency Department provider documented a brief normal neurological examination and determined that this was adequate given the emergent circumstances. The OIG did not substantiate that the patient was inadequately sedated prior to receiving paralytics for the intubation. The OIG concluded that the patient received a sedative medication for seizures, which is also used for intubation. Furthermore, the patient was unresponsive and therefore did not likely need additional sedatives. The OIG found the facility was not in compliance with tracking competency assessments for OOORAM providers, and leaders addressed OOORAM issues when they became aware of deficiencies and were working to implement new processes for OOORAM provider privileging. The OIG team identified that providers’ credentialing information was not consistently uploaded into VetPro and determined Cardiopulmonary Resuscitation Committee minutes were lacking in documentation of discussion related to resuscitative events, data analysis, and actions proposed for improvements. OIG inspectors made seven recommendations related to OOORAM documentation, review of OOORAM policy, OOORAM training and competency, credentialing, VHA OOORAM policy implementation, documentation in VetPro, and committee review of resuscitative events.