The Science Journal of the American Association for Respiratory Care

2009 OPEN FORUM Abstracts

MOVING THE MOUNTAIN, A STATE SOCIETY’S LESSONS IN REGULATIONS AND CHANGE

Terrence F. Smith1, Bill Kiger2, Connie Paladenech2, Jill Saye2, Daniel Grady1, Susan Rinaldo Gallo3, John Riggs1; 1Respiratory Care, Mission Health System, Asheville, NC; 2Respiratory Care, Novant Health, Winston Salem, NC; 3Respiratory Care, Duke University Health System, Durham, NC

Problem: Last year,the NC Society notified AARC about a problem with the CMS survey of hospitals in NC.The issue involved surveyors citing a facility for failing to administer inhaled meds within the standard administration schedule(30-minute rule)even though the hospital had a written policy that permitted an extension of the timeframe. Method:The AARC conducted a survey of RT’s across the country with respect to their hospitals policies and learned that the majority of those who responded had a written policy that permitted the delivery of inhaled meds up to 60 min.before or after the scheduled due time.Next,the AARC laid out the issues in a formal written paper to CMS,emphasizing that the 60-min.schedule was a generally accepted standard for the profession.CMS suggested that AARC develop a position statement.The position statement was approved by it’s Board of Directors and endorsed by it’s Board of Medical Advisors(BOMA).The statement stresses the need for facilities to establish policies for the safe and timely administration of inhaled meds for the individual facility and approved by the medical staff.The policies may differ from the standard meds schedule and time frames,but they may not exceed 60 mins before or after the scheduled meds delivery due time for meds prescribed at an interval greater than or equal to four hours.Last November,CMS had a conference call with its regional survey and certification staff responsible for the oversight of state surveyors.CMS indicated on the call that it found the AARC’s position to be an acceptable standard of practice for the delivery of inhaled meds by RT’s. A copy of the position statement and a list of BOMA were provided to regional staff,who in turn informed state surveyors during their monthly conference calls of CMS’s acceptance of the standard. Results:RC departments now have a position statement on meds delivery procedures that are unique and requires different rules.It is essential that hospitals have their own policy/procedure on the books to support the AARC position paper.The position statement should be used as a reference for backing up the hospitals policy.Policy development should be proactive with involvement from physicians and medical directors with approval from the appropriate hospital committees.The paper issued by the AARC presents an argument as to why inhaled meds administered by RTs are delivered in a period that is often different from a hospital’s standard administration schedule. Sponsored Research - None

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