Need advice on memo to all nursing staff that contains threat - page 3
to report all medication errors to state board of nursing. A bit of background: I work in a State intermediate care facility for people with developmental disabilities. We are currently... Read More
May 2, '04Keep in mind that, according to the OP, the administration did not dream this policy up out of the blue. The facility is in trouble with the federal government for a pattern of medication errors that has not been corrected. I do this kind of inspecting for a living. When the inspectors do the first follow-up visit and find that the problem has not been corrected, there is greater pressure on the administration to fix the problem -- obviously, the original plan of correction they submitted to the feds did not fix it, so they have to "up the ante." The facility is looking at losing their license to operate and/or ability to receive Medicare/Medicaid funding. You do NOT want to have the feds (or even your state) breathing down your neck. The original inspection that identified the problem was trouble enough -- to have them come back for the follow-up and find the problem not corrected is serious trouble.
May 2, '04Quote from kmchughYeah... I'd have to agree here, too. While it DOES appear a bit harsh, I, too, believe that it has been an issue that has been going on for way too long, and not taken seriously by the nurses. Seems like this is what it had to come down to in order for it to be taken seriously. After all, the place can be closed down if the inspectors continue to find noncompliance issues.... not to mention the obvious necessities of proper documentation to prevent serious medication errors form occuring.MAR's not signed? Nursing school 101, an action not documented is an action not done. MAR's presigned? Documentation that an action has been completed when it is not done. I believe that's fraud. I hate to say this, but I'm on administration's side here (and that happens VERY rarely).
From what you have written, inspectors came in once and found documentation errors and deficiencies. Your administration put out policy to try to correct this, which by your own admission was a reasonable policy. Administration even gave you a heads up that the surveyors were going to return. When they did return, they found nurses continuing to commit the very same errors. The "reasonable policy" was ignored by the nursing staff. Were I an administrator of this facility, I'd take pretty drastic steps, too. Sounds to me like a hostile staff that would rather see the facility closed than document properly.
Whether the medication was "boost pudding" or insulin, if it is ordered, it must be administered, and the administration must be documented. If it is not administered, that must also be documented along with the justification (i.e. patient refusal). All nurses learn that in the first semester of nursing school.
Kevin McHugh, CRNA
I don't think ANY of us are perfect, but get the feeling that this is more than just an occasional omission... or they would not have gone to these extremes.
I do agree with Fergus on the " regardless of circumstances" clause, however.