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HELLO EVERYONE- I AM RESONDING TO THE BIG QUESTION ALSO BECAUSE I HAD
QUESTIONED IT MYSELF. WHAT I HAVE DETERMINED IS THAT I DON'T FEEL
COMFORTABLE SIGNING OFF ON ANYTHING UNTIL I HAVE ACTUALLY DONE IT. WHAT I
HAVE BEEN UTILIZING IS THE DOUBLE CHECK SYSTEM WHICH REFERS TO ONCE A MED IS
POURED I PUT THE FIRST INITIAL OF MY NAME AND THEN ONCE IT HAS BEEN
ADMINISTERED I COME BACK AND PUT MY SECOND INITIAL. MY REASONING BEHIND
THAT IS WHAT IF YOU POUR THE MED, SIGN OFF ON IT, AND IN ROUTE TO ADMINISTER
IT A "CRISIS" OF SOME SORT OCCURS AND YOUR ASSISTANCE IS NEEDED? IT WOULD
SEEM VERY EASY TO SET DOWN THOSE MEDS AND HAVE THEM GET LOST IN THE SUFFLE.
WHAT ARE YOUR THOUGHTS????-BECCI
----- Original Message -----
From: "Darryl" <leapoh@tds.net>
To: "'Davis, Carol A'" <Carol.A.Davis@maine.gov>; "'Ham Robbins'"
<hrobbins@GINNE.ORG>; <dpoulton@eaaa.org>
Cc: <beas-crma@lists.state.me.us>
Sent: Monday, March 01, 2004 5:00 PM
Subject: RE: beas-crma Med Administration Techniques
> [See the end of this message for instructions on unsubscribing from this
list]
>
> 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
>
>
> [See the end of this message for instructions on unsubscribing from this
> list]
>
> 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
>
>
> [See the end of this message for instructions on unsubscribing from this
> list]
>
> 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
>
>
> [See the end of this message for instructions on unsubscribing from this
> list]
>
> >
>
> 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.
>
> [See the end of this message for instructions on unsubscribing from this
> > 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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