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I have a quick question. Can CRMA do rainbow coverage for insulin.
-------Original Message-------
From: Deb Poulton
Date: 06/03/05 11:13:38
To: 'Bourque, Lois'; 'Mauro, Peter'; ConsultingRN@AOL.com; beas-crma@lists
state.me.us
Subject: RE: beas-crma Injections
I do believe that this response is very accurate, and I couldn’t agree more.
Over the course of time, what was once an “RN Consultant” with specific,
intermittent duties in the various residential homes, has now become too
synonymous with providing nursing service.
Overseeing three Assisted Living sites with an RN Consultant who spreads
her time between the 3, (overseeing medication programs and providing
training as needed,) I would never consider her to be in a position to be
able to turn over nursing tasks to CRMA’s (great as they are!). I would
doubt that the changes allowed by statute with the BON were meant to extend
in this regard. I do hope that they stay on top of this issue, as residents
in MaineCare reimbursed homes are more and more frequently being denied
access to a visiting nurse to provide them with a nursing service. Having an
RN on staff in a residential home or assisted living sure does swing this
model away from its original social model, and one must wonder where the
expectation to provide nursing delegation will end.
Deborah A. Poulton
Director, Residential Programs
Eastern Agency on Aging
450 Essex Street
Bangor, Maine 04401
Tel. (207) 941-2865, ext 129
1-800-432-7812
Fax (207) 941-2869
dpoulton@eaaa.org
-----Original Message-----
From: owner-beas-crma@lists.state.me.us [mailto:owner-beas-crma@lists.state
me.us] On Behalf Of Bourque, Lois
Sent: Thursday, June 02, 2005 3:48 PM
To: Mauro, Peter; ConsultingRN@aol.com; beas-crma@lists.state.me.us
Subject: RE: beas-crma Injections
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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