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Howdy y'all,
I'm late chirping up because I was teaching a CRMA class. Imagine that!
I had of course noticed the portion of the regs that allowed the RN to
train and provide documentation for the CRMA's chart on this note:
7.16 Whenever a Registered Nurse teaches or provides in-service
training to unlicensed personnel on medical issues, treatments and/or
medical equipment not specifically outlined in these Regulations, there
must be documentation in the employee file.
I had not imagined this to refer to any other injectibles, or why would
insulin and epi-pens be specified? I also would use my judgment and
research through the BON any Rx's that I was concerned might be
overstepping the CRMA's boundaries- or my RN delegation
responsibilities. I certainly wouldn't train anything I felt was unsafe,
or required comprehensive assessment whether I was told I should or not.
I would fight it. Perhaps a list of approved treatments for CRMA's
should be identified and not left to judgment- that may help the funding
issues as well. That being said, there would be controversy in
developing that list for sure!! There are lots of controversies out
there -- see G-tubes for instance.
I think in many ways we as RN's in assisted living may get mixed
messages from our organizations, surveyors, Maine care auditors, DHHS,
etc. There are usually answers somewhere, occasionally more than one
answer to the same question! The problem is tracking down clear and
definitive answers that everybody agrees are the standard. An active and
positive discussion on a site like this can only be helpful and I
appreciate the learning process.
Darryl wood, RN LEAP Inc.
-----Original Message-----
From: owner-beas-crma@lists.state.me.us
[mailto:owner-beas-crma@lists.state.me.us] On Behalf Of Shirleyann
Davison
Sent: Monday, December 13, 2004 11:46 AM
To: Ham Robbins
Cc: Beas-crma@lists.state.me.us; voodoosgirl@midmaine.com
Subject: Re: beas-crma Fw: sub-cutaneous injections
Ham, Kathleen and all colleagues on the list:
This is probably politically incorrect to say but, as an old crone I am
known to be politically incorrect, so I will just say it:
Merry Christmas
ShirleyAnn Davison RN
Fortiter
Ham Robbins wrote:
[See the end of this message for instructions on unsubscribing from this
list]
Kathleen,
We read the regs the same way you do; and limit SC's to insulin and
Epi.
Medicaid, BDS, BEAS, DHHS, BON, and our agencies, need to come-together
to create a common set of rules for our programs. (Or at least they
should meet each other and chat!!!!!)
Please let me know if you learn anything new.
Good luck,
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
>>> "Kathleen Bernard" <voodoosgirl@midmaine.com> 12/10/04 11:59:27 PM
>>>
----- Original Message -----
From: Kathleen Bernard
To: Beas-crma@lists.st.me.us
Sent: Friday, December 10, 2004 7:50 AM
Subject: sub-cutaneous injections
Hi Everyone,
I would like to get your feedback on a recent dilemma. I cover 6 group
homes under the assisted living regs, PNMI and BDS. One home is a level
IV assisted living home but serves adults with mental illness. We have
CRMA's, one LPN that coordinates appointments and works M-F days.
We needed home health to provide evening SC lovenox which they did but
Medicaid denied their payments. The Medicaid folks feel that CRMA's can
administer this SC medication because the assisted living regs state SC
insulin is ok so the assumption is that SC anything is ok.
Is anyone aware of CRMA's giving anything but bee sting and insulin
injections? The CRMA course seems specific, as do the regulations....bee
sting and insulin with instruction from an RN and not part of the CRMA
course itself.
Through the many levels of conversations about this subject Peter
Mauro's name was mentioned. It is unclear to me at this point what
details were presented to him.
Thanks for any help and guidance.
Kathleen Bernard RN,BC
Community Health and Counseling/Bangor
947-0366 x452
the email is my home, I don't have work email
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