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Holly,
Have you tried taking it back to your nurses?
Get them together and explain the issue and then ask-how do
you guys propose that we can fix this problem?- they are the ones who need to be
more responsible-give them the problem and expect them to come to a conclusion
on how to fix it.
Most times, I find that if I figure out a solution they will
find ways to gripe and complain about it-so, turn it on them to figure out and
fix.
Just an idea.
Lisa
----- Original Message -----
Sent: Monday, April 05, 2004 6:44
PM
Subject: Re: ?Regulation re Shift Change
MAR Review
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
----- Original Message -----
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?
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 -----
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.
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
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