New safety goals listed for 2004 JCAHO surveys
If you’re not in full compliance with the National Safety Patient Goals for 2004 from the Oakbrook Terrace, IL-based Joint Commission on Accreditation of Healthcare Organizations, you have a lot to worry about. Surveyors will be looking for complete compliance as of Jan. 1, 2004, warns Darlene Bradley, RN, MSN, MAOM, CCRN, CEN, director of emergency/trauma services at University of California — Irvine (UCI) in Orange.
To comply, use the following strategies for each of the seven safety goals implemented at the facility’s ED:
• Goal 1: Improve the accuracy of patient identification.
ED nurses now take the order sheet to the bedside and compare the name and medical record number with the patient’s identification bracelet, reports Bradley.
The patients are asked their names, and nurses use birth dates and other verifiable personal information as identifiers. "Some staff go to the bedside and ask the patients to spell their name," she says. "This has prevented error in some cases, particularly for non-English-speaking patients."
Spontaneous audits also are being done, with observers documenting interactions with patients, says Bradley.
• Goal 2: Improve the effectiveness of communication among caregivers.
Verbal orders are not accepted at UCI’s ED, says Bradley. "All of our orders are written," she says. When a critical test result is given, the following steps are used:
— The test result is called out to a nurse or physician, and the name and spelling is read off with the results of the test.
— The name of the person receiving the results is written into the computer system.
— This result is matched with the label printout verifying the results.
• Goal 3: Improve the safety of using high-alert medications.
No concentrated electrolyte solutions at all are stocked, says Bradley. "Drugs with similar names such as morphine and hydromorphine are packaged separately and labeled in places in our storage cabinet where they cannot be confused with each other," she says.
• Goal 4: Eliminate wrong-site, wrong-patient, and wrong-procedure surgery.
If a procedure is going to be performed such as surgery or reduction, the patient will "x" the spot and initial the area that is affected, says Bradley. "We also use a checklist for verification," she adds.
• Goal 5: Improve the safety of using infusion pumps.
New free flow-protected Volumetric Infusion Pumps (Baxter Healthcare Corp., Deerfield, IL) are used in the ED, says Bradley. "They also perform some calculations, fluid volume documentations, and alarm systems," she says.
• Goal 6: Improve the effectiveness of clinical alarm systems.
Random checks are done by making alarms go off with a tachycardia, says Bradley. "We then time the responsiveness of the nurse," she says. "In almost all cases, the response has been within 10 seconds."
• Goal 7: Reduce the risk of health care-acquired infections.
To improve compliance with hand washing, a waterless soap solution is made available at many strategic areas throughout the ED, says Bradley.
Health care personnel are required to wash their hands before entering a patient’s room or going to the bedside, and again after leaving the bedside, she explains. Previously, compliance with hand washing was about 76%, she reports.
"As we worked with staff on their awareness of this patient safety issue and continued to monitor compliance, we now have successfully reached 100%," says Bradley. "This is an immense improvement from previous practice."
If youre not in full compliance with the National Safety Patient Goals for 2004 from the Oakbrook Terrace, IL-based Joint Commission on Accreditation of Healthcare Organizations, you have a lot to worry about.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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