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Hi Y'all,
What fun it has been to stir up all this zest for improvement in the
system! I still don't have an answer to my most basic question.... Can I
teach the PSA technique that is approved in my 24 hour class, or do I
need to submit to the PPD of the 40/Bridge/skillsheet set? Peter, are
you out there??
I don't believe the answer is as simple as some of you may imply-
stating legal issues and Nurse Practice Act. I was taught a lot of
things in nursing school which I now do different, and better- that is
called progress and evolution. And, at one time women couldn't vote and
black people couldn't eat in certain restaurants, but the legal issues
have changed for the better. Since I am convinced that PSA decreases med
errors, and ethically I don't consider it predocumenting, and there is a
definate division of thought on the subject, I will need something more
concrete to go on .....Darryl
-----Original Message-----
From: owner-beas-crma@lists.state.me.us
[mailto:owner-beas-crma@lists.state.me.us] On Behalf Of Davis, Carol A
Sent: Monday, March 01, 2004 12:50 PM
To: 'Ham Robbins'; dpoulton@eaaa.org; Davis, Carol A
Cc: beas-crma@lists.state.me.us; leapoh@tds.net
Subject: RE: beas-crma Med Administration Techniques
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Ham,
I agree with Darryl, things are often under debate if two practices are
similar. Future changes in nursing practice and procedure happen when
statistics don't support a substantial degree of error. Until this has
been statistically proven, nursing practice will maintain the same
practice. I don't have a source for you. I like Shirley only remember
from when I was trained in nursing school. Carol Davis HSC
-----Original Message-----
From: Ham Robbins [mailto:hrobbins@GINNE.ORG]
Sent: Monday, March 01, 2004 7:59 AM
To: dpoulton@eaaa.org; Carol.A.Davis@maine.gov
Cc: beas-crma@lists.state.me.us; leapoh@tds.net
Subject: RE: beas-crma Med Administration Techniques
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Hi Carol,
I am not wed to PDA or PAD, in a life or death fashion. BUT, I would
like to take this question beyond the opinion phase, mine, your's, and
even Don Johnson's. So I ask: where is, and what is, the legal document
that demands all of nursing do this one way or the other, and which
method does it site? If there is no document, let's all agree that some
of us may disagree.
Otherwise this issue could distract us from the important issues of our
time: war, politics, religion, abortion, and gay marriage.
Thanks,
Ham
Ham Robbins, RN/Paramedic
Goodwill Industries of Northern New England
243 Leighton Road
Augusta, Maine 04330
(207) 626-0170 ex 262
FAX (207) 622-3517
>>> "Davis, Carol A" <Carol.A.Davis@maine.gov> 2/27/04 10:02:18 AM >>>
I would like to say that PSA may be quicker and appear to reduce
medication errors but in reality this practice reduces the amount of
time the medication certified person has to reflect upon their
administration and practice procedure.When the person signs after
administration, they are indicating they have poured, passed,
administered, and are sure they have done their best practice. There
will most certainly be less errors, as the person whether they have
administered or not, will have signed they have completed the process.
Because of the large numbers of medications in a facility, time
constraints, and a desire to keep the amount of staff to a minimum for
business purposes, we sometimes find ways that are not always best
practice. We have got to continually try to examine what may be other
alternatives than to compromise what is best practice.
-----Original Message-----
From: dpoulton@eaaa.org [mailto:dpoulton@eaaa.org]
Sent: Thursday, February 26, 2004 7:13 PM
To: Ham Robbins
Cc: beas-crma@lists.state.me.us; leapoh@tds.net
Subject: Re: beas-crma Med Administration Techniques
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>
How nice to have this dialog with providers out there.... Having been
involved in the medication administration practice from a regulatory
standpoint (20 years ago and over a 10 year period), and then in
developing our own agency curriculum, we have never accepted signing off
medication administration until after one has observed the individual
actually taking the medication - To sign off earlier makes the statement
that the process is complete, and there is always the moment when a
provider (CRMA) is interrupted, the resident is not available, or some
other disruption to the process can occur, and the record would then
indicate that a medication has been administered, when perhaps it has
not.... It is interesting to learn that others do the process
differently.
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> list]
>
> Hi Darryl,
> My agency's policies, Goodwill Industries, also calls for the PSA
> method. It has been the method of choice in every hospital and
nursing
> home I have been associated with in the past 20 years. While the
check
> list calls for the PAS method, there is a statement in the 40 hr
CRMA
> book that documentation of the med admin should follow agency
practices.
> I use that as the relief to teach PSA. I don't have my book with
me
> tonight at home, but I will site the page for you soon.
>
> PSA PSA PSA
>
> Ham Robbins
>
> Ham Robbins, RN/Paramedic
> Goodwill Industries of Northern New England
> 243 Leighton Road
> Augusta, Maine 04330
> (207) 626-0170 ex 262
> FAX (207) 622-3517
>>>> "Darryl" <leapoh@tds.net> 02/26/04 4:27 PM >>>
>
> Hi everybody,
>
> I am looking for some feedback..... I have always taught the Pour,
Sign,
> Administer technique method of medication delivery (in my approved
24
> CRMA class). I honestly believe this method provides the lowest med
> error rate.
>
> The 40 course and the Bridge/Refresher teach the Pour, Pass,
Document
> technique, as does the Skills checklist.
>
> 1) My approved curriculum has the PSA method but is used in
conjunction
> with the skills checklists. To me the most important thing is
knowledge,
> clean and accurate technique, and complete and objective
documentation,
> not necessarily a slight difference in technique.
>
> 2) Many people have been trained in the PSA technique and have very
> comfortable with it. To make them change for the Bridge/refresher
may
> increase the liklihood of errors for them.
>
> Are any of you running into this out there? How are you handling it?
>
> Do others agree in the PSA method as a preferred technique?
>
> Thanks in advance for the feedback..... Darryl Wood, RN @ LEAP,
Inc.
> leapoh@tds.net
>
>
>
>
>
>
>
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