The real solution, Bankowitz says, is for hospitals to have a process in place to assure efficient delivery of the medication, "so that it becomes a non- issue."
That brings us back to the proposed CMS rules. They require the hospital to meet all of the requirements specified below before allowing medication self-administration:
• Assure that a practitioner had issued an order, consistent with hospital policy, permitting self-administration of medications
• Assess patient and caregiver/support person's capacity to self-administer specific medications
• Provide patient and caregiver support person instructions regarding the safe and accurate administration of the compounds
• Ensure the security of medications for each patient
• Identify a patient's own medications and visually evaluate those medications for integrity
• Document the administration of each medication in the patient's medical record.
When all these parameters are met, CMS writes, the new rule "may provide hospitals with a means to make care more patient-centered and adaptable to patient and caregiver/support person needs."
In a commentary published this week in the Journal of the American Medical Association, CMS administrator Don Berwick, MD, and CMS chief medical officer Patrick Conway, MD, wrote that this portion of the burden-lifting proposal served to promote greater patient-centered "culture and engagement."
Surely the intention in reworking this regulation is a good one. But the added workload and risks for healthcare personnel to enable patients and their support teams to administer their medications – even if it's just supposed to be an aspirin or an eye drop – could outweigh any benefit or added convenience to the patient and their families.
Relaxing regulations to promote better patient-centered care is an admirable goal, but it shouldn’t come at the expense of patient safety.