----- Original Message -----
Sent: Wednesday, December 17, 2003 11:39
AM
Subject: Re: Antipsychotic Med
Policy
Jeez,
I do seem to have a habit of starting a firestorm
with a lot of my emails, don't I?
Now where in my original comment did I suggest
NOT STARTING a med when the doc wrote the order. On the other hand, when
the doc wrote the order, the nurse taking it off was responsible for noting
the diagnosis on the diagnosis list. So if there wasn't a
diagnosis on the order sheet, she nailed the doc before he left, or left him a
message on the pager.
Since I started out as a midnight nurse at Henry
Ford Hospital in Detroit, we were required to contact the doc 24 hours a day,
when needed, regarding orders, especially if you couldn't read it. I had
no problem at all calling either very late or very early and reminding the
poor soul that I needed a diagnosis for the med. Never needed to call
more than once either . . . . (I wasn't really POPULAR back then, but we
got diagnoses!)
Corey
----- Original Message -----
Sent: Tuesday, December 16, 2003 7:23
PM
Subject: Re: Antipsychotic Med
Policy
I appreciate that it's not rocket science, or
brain surgery. I understand the regulations, and although I am the person
responsible for double checking the pharmacy consultant recommendations, I
am not in the position to determine policy for our facility.
I just wanted to know if other facilities have a policy of not starting
antipsychotic medications without the proper diagnosis. Our MDs have a
wonderful habit of writing orders without a dx, dictating progress notes and
it takes a month or 2 for the progress note to make it to the chart.
By that time, the resident has been receiving the potentially inappropriate
medication for a month or 2. It does not seem like witholding the med
until the physician has supplied the appropriate dx should be a problem,
but, again, I am not the one who gets to decide.
----- Original Message -----
Sent: Tuesday, December 16, 2003 6:37
PM
Subject: Re: Antipsychotic Med
Policy
Forget asking surveyors how to comply with
regulations. In Los Angeles County our biggest problem is that they
do not know the regulations. This year's survey team 'want' it one
way and next year another [or the same] team tell you it is all
wrong.
Read the regulations and develop a policy that meets
the needs of your residents and the facility. It is not brain
surgery.
Delores
Could any of you who are "lurking" surveyors (Yeah,
you, MR), send me some guidance (along with links to supporting
regulations, etc)? Also, what are other facilities doing as far
as P/P for antipsychotic meds?
Do you really
think that a surveyor is going to tell you how to fix this? It has been
my experience that the surveyors don't and won't give advice of any
kind.
Delores L. Galias, RN,
RHIT
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