Re: ?Regulation re Shift Change MAR Review

[Holly Sox, RN, RAC-C]

As most of you are aware, my facility has come through some unreal difficulties recently.  I believe we are on the right path, and this administrator really seems to want to make the right things better.   We have had an abysmal record with our pharmacy reviews, and the administrator, pharmacists and I spent 2 hours this am brainstorming ways to improve our compliance. One of the biggest issues is holes on the MAR and documentation errors.  What he is proposing is  a shift-to-shift compliance check off that will involve the oncoming nurse going thru the MAR books to check for any holes or missing PRN documentation, prior to accepting the keys. Hopefully, this will reduce (or eliminate???) the problem.  We do have some good nurses, but a culture of mediocrity and half-arsed compliance has developed. It's a hard attitude to overcome, but I am one determined nurse manager.   Wish me luck.    HS Holly F. Sox, RN, RAC-C  Clinical Editor, Careplans.com www.careplans.com [EMAIL PROTECTED] ----- Original Message ----- From: Thompson, Karen (Kodiak) To: '[EMAIL PROTECTED]' Sent: Monday, April 05, 2004 3:25 PM Subject: RE: ?Regulation re Shift Change MAR Review There is no regulation in regard to this policy.  It is overkill and the administrator is stomping on standards of practice.  His he or she going to require a witness as you perform each task to ensure it is complete and have the witness sign off on it?  What prompted the policy? -----Original Message----- From: Nathan Lake [mailto:[EMAIL PROTECTED] Sent: Monday, April 05, 2004 11:08 AM To: [EMAIL PROTECTED] Subject: Re: ?Regulation re Shift Change MAR Review If your administrator claims to be quoting a reg, it would be reasonable to cite the reference in the policy. Ask the Admin for the exact reference.   Nathan ----- Original Message ----- From: Wendy Connor To: [EMAIL PROTECTED] Sent: Monday, April 05, 2004 11:27 AM Subject: RE: ?Regulation re Shift Change MAR Review I don't think that there is a federal reg like that. Look at F333, under "Determining Medication Error" (pp-135.4 in the 2003 Pink Book). If he is concerned with the number of "blanks" on the MAR, it specifically addresses blank spaces. -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Holly Sox, RN, RAC-C Sent: Monday, April 05, 2004 1:55 PM To: [EMAIL PROTECTED] Subject: ?Regulation re Shift Change MAR Review Okay, Gang,   Help me out again, please. My administrator has brought me a draft policy regarding requirements for shift change MAR review and accountability.  He quoted a regulation as follows, but is uncertain as to where this is located. "At each shift change, there shall be a documented review of the MARs by outgoing staff members that they have properly administered medications in accordance with orders by physician or other authorized health care providers and have documented the administrations. Errors/omissions indicated on the MARs shall be addressed and corrective action taken at the time. The director of nursing shall be notified and other persons as set forth in the policies."     Is this from Certification Regs? Licensing?  His imagination??    Thank you in advance.   HS   Holly F. Sox, RN, RAC-C Clinical Editor   www.careplans.com   [EMAIL PROTECTED] This message is intended for the sole use of the individual to whom it is addressed, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message.