Recommend the following underlined phrase be retained in 12VAC5-31-1140 (Provision of patient care documentation), paragraph B:

The signature of the prescriber . . . who assumes responsibility for the patient shall be included on the prehospital patient care report . . . , except when standing orders from the OMD allows the administration of the drug or procedure

The rationale for this recommendation is that in practice, the prescriber does not know or have the time to review what he is signing; he often never sees the patient associated with the report; he is almost always deeply engaged in other cases at the time.  Often, no prescriber is willing or able to make himself available to provide such signature, and waiting for such signature delays the EMS unit's availability for other cases.

It is well established that the barrage of constant interruptions sustained by such prescribers is strongly associated with increased medical error rates.  Deleting this critical exception actually represents a higher potential for patient harm than it does a potential for patient good.

In the specific case of interventions performed under standing orders, the signature provides no prescriptive value, since the standing orders already have the OMD's signature attached.

Please retain the above underlined phrase in 12VAC5-31-1140.