The Centers for Medicare and Medicaid Services (CMS) issued a proposed rule in the October 24 Federal Register that changes the requirements (also known as Conditions of Participation (CoPs). In this proposed rule hospitals and critical access hospitals must meet to participate in the Medicare and Medicaid Programs.
CoPs are intended to protect patient health and safety and make certain of quality of care. However at-times this can limit or prohibit nurses from practicing to the full extent of their education and training. CMS is considering changes in the CoPs which will effect nursing practice and patient care within these hospitals – and possibly throughout health care.
The proposed changes could break down barriers that can limit nursing practice. The proposed rule changes requirements related to many of the things nurses do every day – use of restraints and seclusion, hospital privileging and APRN practice, nursing care plans, standing orders, and verbal order review and authentication.
| Standard: Organization |
| It is essential for the hospital to have a well-organized service with a plan of administrative authority and delineation of responsibilities for patient care. The director of the nursing service has to be a licensed registered nurse. The individual is responsible for the carrying out operations of all services, which include formulating the types and numbers of nursing personnel and staff necessary to provide nursing care for all capacities of the hospital. |
| Standard: Staffing and delivery of care |
| The nursing service should include adequate numbers of licensed registered nurses, licensed practical (vocational) nurses, and other personnel to provide nursing care to all patients in-need. There should be supervisory and staff personnel for every department or nursing unit to ensure, when needed, the immediate availability of a registered nurse for bedside care of any patient. |
| Standard: Preparation and administration of drugs |
| Drugs and biologicals must be prepared and administered asper the Federal and State laws, the orders of the practitioner or practitioners responsible for the patient’s care as specified under § 482.12(c), and accepted standards of practice. |
| All drugs and biologicals must be administered by, or under supervision of, nursing or other personnel in accordance with Federal and State laws and regulations, including applicable licensing requirements, and in accordance with the approved medical staff policies and procedures. |
| Blood transfusions and intravenous medications must be administered in accordance with State law and approved medical staff policies and procedures. |
| There must be a hospital procedure for reporting transfusion reactions, adverse drug reactions, and errors in administration of drugs. |
| The hospital may allow a patient (or his or her caregiver/support person where appropriate) to self-administer both hospital-issued medications and the patient’s own medications brought into the hospital, as defined and specified in the hospital’s policies and procedures. |
To get the Latest Updates for 2017 on the CMS Nursing CoP Standards for Hospitals join expert speaker Sue Dill Calloway, RN, MSN, JD, is a must attend for any clinical nurse or nurse leader. During this session, sue will cover the nursing services section in the hospital CoP manual.
Source: CMS CoP Standards for nursing personnel in hospitals and patient administration
