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I may be wrong, but I seem to recall that Chapter 6 regulations of the
BON were put into place due to the increasing number of RCF's hiring
R.N.'s as Resident Care Director's (supervisory capacity). Due to the
stipulation in Section 2.B.6, "Ensure that the unlicensed assistive
personnel assigned to that nurse's patient reports directly to the nurse
for the performance of nursing tasks," I feel that an R.N. Consultant
with limited hours at the facility & no supervisory responsibility
should hesitate to teach this procedure, unless there is also an R.N. on
staff. Also of note, "consistent with patient safety" is mentioned
twice in Chapter 6 (anti-coagulant injections require specific injection
technique & have higher risk of hematoma & necrosis). Lois Bourque,
R.N.
________________________________
From: owner-beas-crma@lists.state.me.us
[mailto:owner-beas-crma@lists.state.me.us] On Behalf Of Mauro, Peter
Sent: Thursday, June 02, 2005 2:42 PM
To: 'ConsultingRN@aol.com'; beas-crma@lists.state.me.us
Subject: RE: beas-crma Injections
-----Original Message-----
From: owner-beas-crma@lists.state.me.us
[mailto:owner-beas-crma@lists.state.me.us]On Behalf Of
ConsultingRN@aol.com
Sent: Thursday, June 02, 2005 8:11 AM
To: beas-crma@lists.state.me.us
Subject: beas-crma Injections
Good morning,
My name is Linda Reed and I am an RN consultant for several
assisted living facilities in the Lewiston area. I am in the midst of
trying to resolve a dilemma that I hope someone can help with. I
understand that in the past, some of you may have had some discussion
with the board of nursing in regards to training and supervising direct
care workers &/or CRMAs in regards to performing nursing tasks.
Currently, I consult (training only) for an agency who serves an
individual who needs daily anticoagulant injections. Maine care will no
longer pay for home health and wants the staff to give the injection.
(Thus, the agency would like me to train the staff.) Licensing has
stated that the agency can request a waiver from the regulation that a
CRMA may not [Mauro, Peter] There is no waiver in place for this type
of medication administration. I am not sure who in licensing told you
this. If this is a SC medication, then under 7.16 (in Level IV, may be
different in other levels) the regulations give an RN permission to
teach techniques, methods that are under Chapter 6 of the BON rules.
The board of nursing does not regulate CRMA, but by putting in Chapter
6, is where they authorize RNs to do this coordination and oversight
administer injections except bee sting kits and insulin (after
additional training). Everyone at the licensing level seems OK with all
of this????? I seem to be the only one who is apprehensive. Licensing
suggests that there are several facilities who are currently doing these
types of injections.[Mauro, Peter] What we do recommend under this 7/16
is as long as the RN feels that the person being taught is competent
enough to be taught and competent enough to carry through once being
taught. We also recognize that no all nurses are willing to do this
teaching.
My question is, has anyone been in this situation? How was it
handled? Did the State Board of nursing address this issue? If so, what
was their recommendation? I appreciate any feedback you have.
Linda Reed, RN
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