The signature for each entry must be legible and should include the practitioner’s first and last name. Furthermore, it confirms the provider has certified the medical necessity and reasonableness for the service(s) submitted to the Medicare program for payment consideration.For clarification purposes, we recommend you include your applicable credentials (e.g., P. There are three exceptions to the above requirements: Exception 1: Facsimiles of original written or electronic signatures are acceptable for the certifications of terminal illness for hospice.Because of this, we are alerting you to the importance of these signature requirements and if changes are needed, we suggest you take immediate action.
A protocol for treating low blood sugar is an example of treating an emergency; putting silver nitrate in a newborn's eyes counts as routine.
She is the author of "Critical Care: A New Nurse Faces Death, Life, and Everything in Between." (CNN) -- My patient one day, a spry 80-year-old, started to cough and feel short of breath during a blood transfusion: classic signs of a transfusion reaction.
I stopped her IV, but she needed a steroid to bring her breathing back to normal. to authorize giving my patient this one needed drug.
The effects were remarkable -- in just this one ICU, patients had shorter hospital stays and the number of days patients spent on ventilators was reduced by 24 percent.
Ventilator-associated pneumonia is a concern anytime patients are on vents, and another reason to support weaning patients as soon as possible. Except that the vent-weaning protocol did not meet CMS's criteria for correct signing of physician orders, so the protocol got put on hold for a few months while the hospital worked to follow those rules. That bureaucratic requirement about signing orders --ostensibly used to enforce nurses' not going outside our "scope of practice" -- effectively mandated longer and more expensive hospital stays and poorer care for the patients in that ICU.
Exception 2: There are some circumstances for which an order does not need to be signed.