I am not sure if this is the proper forum, but any assistance would be appreciated.
I have recently accepted a position as a CNO for a LTACH hospital. They have a practice here that i believe is no longer acceptable according to JCAHO/CMS.
Pharmacy is in house about 10 hours a day and on call the remaining 14 hours or so. Probelm #1. A patient who is admitted after hours: They want the charge nurse to review all medications for appropriateness, interactions, allergies and so forth. Problem #2. Charge nurses have access to a mini pharmacy where they are suppose to mix antibiotics, obtain medications and so forth. This is all without pharmacy verification.
I have managed other LTach Hospitals who did not have 24 hour pharmacy coverage and we did have policy that did allow a one time dose of certain medications to be administered.
So any help would be appreciated. Also if you could provide a link to literature supporting my disagreement with this practice i would appreciate it. I do have a call into the Board of Nursing.
Thanks for your help and assistance.
Jan 18, '10
What you describe is precisely what happens at our hospital.