Currently reviewing this criterion and would be interested to know how others have tackled it.
I think it is a matter to be dealt with by the clinical governance team?
A second opinion on interpretation would also be welcomed. I interpret the criterion as requiring protocols detailing which professions i.e nursing or medical and grades thereof, can prescribe specific types of equipment for inpatient treatment as well as on discharge.
Any thoughts?
Thank you.
Sue P

Ah Sue, or may I call you Sue, you pose an age old question, but you fail to give any details of your educational background, are you medical or technical, I ask because my dear, if you are of a technical existence, then it is not wise under any circumstances to prescribe the use of any medical equipment, nebulizers included, to any person as you are simply not qualified to do so. You are very right to pass this can of “estate managers” on to the godly shoulders of the clinical governance team as we all love and respect the way they have majestically appeared in our working practices and to the wonderful changes these Cosmoplast's have made to our working lives !!!

:p

Sue
there are many cross over areas between CNST and Controls Assurance.

Our clinical governance team are dealing with this issue as part of CNST and we have included it in our management and procurement policy. Prescribing of equipment is better explained in DB9801 chapter 6.

Quote "The prescription of equipment is the responsibility of the prescibing professionals, and user organisations will need to introduce and manage policies and procedures which ensure that the prescription of different types of equipment is undertaken by suitably qualified and experienced staff." Unquote

John my fellow professional, I hear what you say, but if you where to prescribe/recommend, lets say a simple nebulizer to a patient, and that nebulizer fails to deliver due to specification, would you not be responsible. I ask this because I know of many trusts that only allow clinicians to prescribe medical devices, yes, with the advice of our good selves, but at the end of the day, they take the responsibility, not us. Ask around my friend, I fib you not. I like yourself john, cringe at the current paranoia, but accountability is the key word here. I myself am a graduate both medical and technical and I would not dream of issuing a device without the written consent of a qualified, knowledgeable clinician/medic.

Kind Regards

Louis

LOUIS FOR PRESIDENT THATS WHAT I SAY :p :p

My dearest Karl, I am a mere follower in you majestical shadow, it is you who should lead us to glory.

Respect my fellow brother

Louis

My understanding of a prescription is something the Doctor writes out.

Prescribe (latin for 'to write')

The MDA are trying to improve the use of equipment, but I'm not convinced prescribing is the right word.

The prescription of equipment should mean that the device used has been issued by a professionally qualified person trained in the use of that device, and the issue has been signed off.

In our trust this happens every time a piece of equipment is issued from the EBME equipment library. All the equipment is loaned for use on a specific patient, a qualified nurse signs a request form, with the patient name/number and equipment details.

We have written it into our policy that it must be a medically qualified person requesting the device, but if a nurse were to ask me which device should be used, I would be more than happy to recommend a device, and explain my reasons.

So does this mean I am more qualified than the Nurse when it comes to prescribing equipment?

John my eminent colleague, and good friend, the term “prescribe” as defined in the Oxford dictionary is as follows:-

v. pre·scribed, pre·scrib·ing, pre·scribes
v. tr.
1. To set down as a rule or guide; enjoin..
2. To order the use of (a medicine or other treatment).
v. intr.
1. To establish rules, laws, or directions.
2. To order a medicine or other treatment.

Let me give you a popular quote from that excellent production “A day in the life of a Biomed”

Nurse:- “ It wasn't my fault your honor, that nasty biomed told me to use it”

Get my drift mate!!!

Louis

Louis
I understand your concerns, but I've been in this profession for many years and never had a nurse blame me in court (or out) of recommending the wrong equipment.

For example: If you see an infusion pump being used at very low rates less than 3mlhr, and you know a syringe driver would be more accurate at delivery, do you walk past and say "nothing to do with me" or advise the nurse of a better alternative.
Some infusion devices have an output similar to a square wave at very low rates. A flow of 3ml/hr can vary between 0.5ml/hr and 5.5ml/hr over a 5 minute period (Even though hourly accuracy is OK). The nurse would not know that and it could be detrimental to the patient with fast acting drugs.(Especially in ITU environments)

At the end of the day, the most competent person should be able to decide which equipment to use (or advise), whether that is a nurse (who usually does make the decision) an anaethetist, an ODA, a Biomed, or any other prfessional equipment user.

Sue,
As far as dealing with prescription of devices, we have a Training Policy which states equipment users are responsible for prescribing decisions and must ensure they are competent.
Also, certain types of equipment (based on a risk assessment) will require competency based training.