2009 safety goals address site marking
The Joint Commission's 2009 National Patient Safety Goals introduce some significant changes for hospitals related to multiple drug-resistant organisms (MDROs) and more stringent standards for how operative sites should be marked to avoid wrong-site errors.
Seen by many health care providers as the gold standard for policies and procedures, the 2009 National Patient Safety Goals promote specific improvements in patient safety by providing proven solutions to persistent patient safety problems. The goals apply to the more than 15,000 Joint Commission-accredited and -certified health care organizations and programs.
Changes for 2009
Much of the patient safety goals are carried over from 2008, but there are some noteworthy additions and changes for 2009. Major changes for 2009 include three new hospital and critical access hospital requirements related to preventing deadly health care-associated infections due to MDROs, central line-associated bloodstream infections, and surgical-site infections. Those additions build on an existing National Patient Safety Goal to reduce the risk of health care- associated infections, and recognize that patients continue to acquire preventable infections at an alarming rate within hospitals.
Announcing the 2009 goals, The Joint Commission president Mark R. Chassin, MD, MPP, MPH, said the new requirements related to central line-associated bloodstream infections also will take effect for ambulatory care facilities and office-based surgery practices, home care organizations, and long-term care organizations. In addition, prevention of surgical-site infections will be a new requirement for ambulatory care facilities and office-based surgery practices. These new infection-related requirements have a one-year phase-in period that includes defined milestones, with full implementation expected by Jan. 1, 2010.
A revision of the requirements for the existing medication reconciliation goal is based on feedback obtained from a Medication Reconciliation Summit convened in late 2007 and is included in the 2009 update, Chassin says. Other changes to the National Patient Safety Goals include a requirement to eliminate transfusion errors related to patient misidentification in hospitals, critical access hospitals, ambulatory care facilities, and office-based surgery practices. New requirements for several programs focus on engaging patients in their care regarding infection control, prevention of surgical adverse events, and the patient identification process.
The requirements associated with the existing Universal Protocol, initiated to help prevent errors in surgical and noninvasive surgical procedures, also were improved for 2009. These changes, which address the topics of procedure verification, marking the procedure site, and conducting a "timeout" immediately prior to starting procedures, were based on feedback received at the Wrong Site Surgery Summit in 2007. The Universal Protocol is used by hospitals, critical access hospitals, disease-specific care organizations, ambulatory care facilities, and office-based surgery practices.
New protocols established
The Universal Protocol was changed to address some details about exactly how certain procedures are to be carried out. For instance, site-marking protocol for invasive procedures now requires that markings be performed by the licensed practitioner who will be involved directly in the procedure and who will be present at the time the procedure is performed. Such practitioners must mark surgical sites, preferably with their initials. That means it would no longer be compliant with the National Patient Safety Goals for a pre-op nurse, for example, to mark the site instead of the physician who will operate.
The goals also include additional requirements in medication reconciliation processes. Other changes include a requirement to eliminate transfusion errors related to patient misidentification in hospitals, critical access hospitals, ambulatory care facilities, and office-based surgery practices. New requirements for several programs focus on engaging patients in their care regarding infection control, prevention of surgical adverse events, and the patient identification process.
For the complete 2009 Patient Safety Goals, including details on what has changed from the 2008 goals, go to The Joint Commission's web site at www.jointcommission.org. Choose "Patient Safety" at the top of the home page and then "National Patient Safety Goals."
The Joint Commission's 2009 National Patient Safety Goals introduce some significant changes for hospitals related to multiple drug-resistant organisms (MDROs) and more stringent standards for how operative sites should be marked to avoid wrong-site errors.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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