Lifting a Regulatory Burden Could Create Dangerous Consequences

Leaders of acute care facilities are welcoming a Centers for Medicare & Medicaid Services proposal to relax some Medicare conditions of participation. But the added workload and risks to staff and patients could outweigh any benefit.

1 comments on "Lifting a Regulatory Burden Could Create Dangerous Consequences"
Mark Dominesey (11/30/2011 at 8:32 AM)

There clearly two very important sides to this issue. One issue is the patient is trusted to administer the medication (or have someone else administer it for them) while they are out of the hospital, and allowing them to continue that practice can help alleviate some of their anxiety and promote a sense of partial independence. The other issue is that now the hosptal and the clinicians may be required to take responsibility for something that they did not do, or have little control over. The article takes a negative tone for allowing patient administered medications after it does a wonderful job of laying out how clinicians and hospitals can alleviate some culpability. The CMS guidelines appear to be vague enough to allow the hospitals some flexibility in creating policies (in consultation with their Risk Management Dept) that will delineate when this pratice should be allowed and when it should not be. Patient and caregiver education is key to this practice and patient education was not mentioned in the article. Yes, there are very real possibilities of patient harm if certain medications are administered more than what is therapeutically efficacious, but hospitals can craft policies and procedures to mitigate those risks. At no time should patient self-administration be implemented to alleviate some burden on clinicians or for clinician convenience, but only as a vehicle to promote patient independence and wellness. I am in favor of this proposal by CMS. Patient self-administration does occur now, though not widespread, in many hospitals, with a properly [INVALID]d physician order and patient education. Many medications are not suitable for this proposal and it would behoove the hospitals to include such language in their ploicies and procedures along with assistance from their pharmacy staff.


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