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CMS's Proposed Hospital Staffing Revisions Get Cool Reception

Margaret Dick Tocknell, for HealthLeaders Media, January 3, 2012

Stephanie Hutchins, an RN in California, opposes allowing the patient or a support person to administer medications in the hospital setting. She notes that studies have shown that 30% to 50% of patients ignore or otherwise compromise instructions concerning their medication. "If a person other than the nurse administers medications in the hospital, the potential for lack of adherence and therefore lack of crucial therapeutic benefit from the prescribed meds in the hospital is high. Also, if nurses are required to monitor meds given by a person other than the nurse to ensure adherence, it would create a time backlog for the nurse, negating much of the benefit of having them given by another person."

The proposal to allow hospitals to develop their own tracking systems for infection incidents is not a good idea according to the National Nurses Union, which represents 170,000 members. "There is no empirical evidence cited supporting this. The change…is being made solely on the basis of providing flexibility to the industry. Hospitals know their reimbursement, quality data, and public perceptions will be affected by infection rates, so they have a vested interest in eliminating this requirement or rendering the data meaningless …by a lack of uniformity and transparency in recording and reporting."

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2 comments on "CMS's Proposed Hospital Staffing Revisions Get Cool Reception"


S Bork (1/9/2012 at 7:23 PM)
Amazing in one article it's all about value based purchasing and quality initiatives, then the next article with the real bottom line[INVALID]it's all about expecting better outcomes, but doing with less. Wanting higher quality but then maybe we can pull this off with untrained staff, or u-do-it medicine... Do you really think that eliminating an infection control log already in place is really in the patient's best interest? Or do you think maybe the hospitals "own tracking system" might just turn up different outcomes? Allowing hospitals to develop a "stand alone" nursing care plan is nice that way everyone can have the very same one. Saves money for sure as we won't really have to individualize the care. Why appoint medical staff to the the hospital when we can just throw open the doors and just let everybody operate when they get here? Same with credentialing[INVALID]toss it. You have a license right? Finally I must admit this one tops it all. One million lives lost, the previous focus on medication errors, thousands of articles, regulations, and rules and now just let the patients manage their own medications. I can just wait as they manage the pain medications. Do patients on the vent have to have a family member adjust the settings? Wow, what an amazing bunch of "proposals".

Jenise McGovern-Lowe (1/6/2012 at 10:35 AM)
I am an RN and a risk manager of an acute care hospital. I am opposed to allowing the patient or support person to administer medications. It would be a dangerous practice. A patients stay in the hospital is based off of an illness or event that requires medical intervention. A treatment plan for his illness is individually developed and based off of current illness/injury and concurrent medical history. Alot of information is collected and reported between medical disciplines licensed to make assessmnets. The assessmnet includes the pts. current condition and his reponse to the treatment provided. This requires a controlled environment that includes all of the consistent routines and any variables. Medication administration has to be a consistent routine and the patients response has a large role in the resolution of the illness, the discharge plan and hospital length of stay. There is a safety risk to the patient and the nurse if she/he were asked to make these medical assessments based off of only half of what she/he is sure of.