Other 2006 changes will potentially impact EDs
While the two new requirements involving hand-offs and medication labeling are the most obvious changes in the 2006 National Patient Safety Goals just released by the Joint Commission on Accreditation of Healthcare Organizations, there are other, more subtle changes that also are critically important for nurse managers to know about.
For example, there is a change in Goal No. 9 regarding falls, says Richard J. Croteau, MD, executive director of patient safety initiatives for the Joint Commission. "In 2005, there was a requirement to do a risk assessment as to the potential of patients falling and hurting themselves and to take action based on that assessment. Now, there is actually a less prescriptive requirement just to have a fall reduction program."
In some settings that requirement may create a need for intake assessment and periodic reassessment, says Croteau, but this requirement has been questioned in certain settings, including the ED. "It’s not clear whether it is appropriate to have every patient that comes in screened for fall risk," he concedes. "Now, we say there must be a program in place that considers how best to minimize the harm of falling. How that’s done is left largely to the organization."
Goal No. 8, which deals with the reconciliation of medications, was a 2005 requirement to plan a process, develop it, test it, and get ready for full implementation by the beginning of 2006. Now, the surveyors expect full implementation by Jan. 1, 2006, says Croteau.
The specific requirements are that for each patient, you should obtain a list of all the medications they have been using prior to entry into the organization, he says. "That list should be used to compare against anything being ordered for the patient and, if it is a continuing care situation, that list should be maintained," Croteau says. "Finally, upon discharge, that list again needs to be checked against discharge medications and then communicated to the next provider of care."
He says the Joint Commission fully expects this information to be communicated to the practitioner who will be providing continuing care for the patient — even if that is the primary care physician. Is this also the ED’s responsibility? "How that is done is up to the organization," says Croteau.
The purpose of the requirement is to avoid giving two meds for same purpose, to avoid omitting a drug intended for the patient, and to avoid drug/drug interactions, he says. The list should include herbal medications, over-the-counter drugs, alternative therapies, and vitamins, he says.
While the two new requirements involving hand-offs and medication labeling are the most obvious changes in the 2006 National Patient Safety Goals just released by the Joint Commission on Accreditation of Healthcare Organizations, there are other, more subtle changes that also are critically important for nurse managers to know 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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