Need help with inservice for CMA's

[Donna Jo]

Hi, I have been asked to give an inservice to the CMA's at the LTC facility that I work at. In the past year there has been an increase in med errors.The DON wants me to review the basics. They know the basics, how do I get through to them in this inservice the importance of following them all the time and not just when someone is watching. I also want this to be interesting enough to get and keep their attention. In this state the CMA's take a refresher class every 2 years. I think the facility needs to give them regular inservices on new meds, review info on frequently used meds, and other updates in the space of time between updates. I think they need to take their job more seriously, be more responsible and take pride in their position. Anyone with any ideas on content or ideas for future inservices I would love to hear from you.

Thanks Donna

[nursesaideBen]

I would inquire about what time of med errors they're making as in, are they no getting them on time, giving wrong dose, wrong drug etc. Then I would look to see if there is a particular drug of drug class that they are making the errors with and see if maybe information about this drug and administering it should be provided. I would also focus on the prevention of med errors, the importance of reporting and error when one occurs, and maybe go over some of the common drugs that require one to gather additional data about the patient before administering, AP before Dig and other common dysrythmics, B/P before antihypertensives, BS before insulin, etc. Hope this helps!

[nightmare, RN]

I came across,on Allnurses,some very good excel spreadsheets on drugs.I think it was to do with NCLEX but I can't find them again.Sheets like these printed out with the drugs you use in your facility,nursing considerations etc may help to highlight some of the basic errors they are making.We have all got to guard against complacency in LTC.I always recheck drug sheets if I have been off for a few days to check for changes.

[Daytonite, BSN, RN]

this inservice should be something for you to learn as well as the cmas. allnurses has a newer forum call med savvy that you should check out: https://allnurses.com/forums/f279/. you should also check with your state agency that does your surveys and tell them that you are doing an inservice on med errors and ask if they have any information on the most common medication errors made in nursing homes and/or specifically by cmas. do they know of any studies that are being done on this? another group to check with is that dreaded jcaho. i know we all shake in our shoes when these agencies come around to survey, but they also have an education function and initiative as part of their role, did you know that? next time they come around, your don can point out that as preparation for your inservice you contacted their agencies for some references and assistance. i would also call the state agency that certifies your cmas (state board of nursing?) to see if they are compiling any statistics on medication errors made by cmas in your state as well as any disciplinary actions. i wouldn't limit myself to your state. look at other state cmas and see if any studies are being done or published by state boards of nursing. it would be interesting to present those as well. it would be current information, newsworthy and informative. there are currently a couple of agencies that are tracking med errors (some of this stuff is on the med savvy site already, but i may have some links they don't). you should be able to accomplish most of this stuff on the internet.

• http://www.fda.gov/cder/drug/mederrors/default.htm
  
• http://www.usp.org/patientsafety/mer/
  
• http://www.webmm.ahrq.gov/ - click the "case archives" link on the menu bar under their page logo to get to the case files of med errors
  
• http://www.ismp.org/default.asp (this site i know is listed on med savvy) they publish a monthly newsletter that is free to nurses and available on line. you can view back issues free here: http://www.ismp.org/newsletters/nursing/backissues.asp but you'd have to pull up each issue to see what specific drugs are addressed. hold onto your socks when you read some of the stuff in these newsletters!
  
• http://www.fda.gov/medwatch/safety.htm

you'll probably have to sort through a lot of the information looking for drugs that are more commonly given in the ltc area. make sure your inservice concludes with a review of your facility's policy on how to deal with a medication error. after doing this, you may find yourself being a bit of an expert on the subject! if you find some really good stuff you might consider posting it on the med savvy forum or here. if you need websites for medication information pm me.

good luck! have fun!

[nightmare, RN]

Found that link with the excell drug sheets it's here:

https://allnurses.com/forums/f50/those-wanted-drug-lists-224467.html

hope that helps.

[Summer69]

Our pharmacy comes in quarterly and offers a CMA inservice. Since they are in our facility monthly they see what our errors are, what new meds we are using and what interactions(such as TF to be turned off 1 hour and 1 hour after Dilantin admin.) are occuring CMA'S enjoy this and are more receptive to this forum rather than me talking to them. Also we make it fun -have cookies or doughnuts and pharmasist always brings in pens, paper etc for the drug classifiacation she is going to talk about. In Oregon CMA's are required to have CEU's for med pass and this also helps meet that criteria. The pharmacy also provides supervised med pass if we ask for it.(which we usually do for new CMA's even tho they have passed their boards)