JCAHO Mock Survey Problems

P_RN, ADN, RN · Apr 23, 2003

Bottles of saline are easy. Use once and throw away. No way I'm using a bottle that's been opened.

Minibags....I usually kept mine in a box with an ice pack when the med carts were used. After we went to teams it was easier to keep them in the fridge. We'd have boxes in there lined up by team number and room number. The JCAHO just don't want them to be exposed to heat or pilferage. Or to curious eyes either I guess.

RN-PA, RN · Apr 24, 2003

Originally posted by P_RN
Bottles of saline are easy. Use once and throw away. No way I'm using a bottle that's been opened.

Minibags....I usually kept mine in a box with an ice pack when the med carts were used. After we went to teams it was easier to keep them in the fridge. We'd have boxes in there lined up by team number and room number. The JCAHO just don't want them to be exposed to heat or pilferage. Or to curious eyes either I guess.

These are 30 ml multidose vials of saline. I still don't understand why they can't be where we can have easy access.

As far as the refrigerated IV antibiotic piggybacks, I like to get them a little closer to room temperature before infusing them. Having all my IV piggybacks in front of me on the med cart has helped with my organization, too. JCAHO means too many regulations and not enough common sense, IMHO. :stone

altomga, ADN, BSN, MSN, DNP, RN, APRN · Apr 24, 2003

Having IV piggybacks out of the fridge breaks them down (supposedly decreases the effectiveness) It also violates HIPAA regulations. These meds have patients names on them that Passer-bys could see. Saline...it is considered a med and is supposed to be locked up.

I agree that the rules and regulations are getting to be something of a aggravation.

We recently had our official survey from JCAHO and did well (94% total "grade")

Our floor got a Type 1 for the med fridge not having the proper info on the temp required

Another for unapproved abbreviations being used ie) U instead of Units....QD instead of Qday....we just switched this policy so we expected this though.

Good luck!!

renerian, BSN, RN · Apr 24, 2003

We always used multidose saline more than once. Date it as it is opened and disgard every week. The cost of pitching a vial that is mostly full is a waste of money. Of course you and I pay for that in the form of higher bills and insurance premiums.

renerian

P_RN, ADN, RN · Apr 25, 2003

I stand by my statement. I will not use a multiuse bottle that has been opened by someone else. I have seen a nurse who stole demerol by putting it into a saline bottle. If someone "flushed" with 2-3 cc of 100mg/cc meperidine....well......

P_RN, ADN, RN · Apr 25, 2003

I stand by my statement. I will not use a multiuse bottle that has been opened by someone else. I have seen a nurse who stole demerol by putting it into a saline bottle. If someone "flushed" with 2-3 cc of 100mg/cc meperidine....well......

Home Health Columnist / Guide · Apr 25, 2003

In this day and age of liability + contamination concerns, I'd toss opened 30CC vials too.

Golden rule: Prevent harm at all costs.

We need to rethink how we do things " We always did it this way"----just like using multi-dose KCL vials and sharpening our needles for use with glass syringes.

Home Health Columnist / Guide · Apr 25, 2003

In this day and age of liability + contamination concerns, I'd toss opened 30CC vials too.

Golden rule: Prevent harm at all costs.

We need to rethink how we do things " We always did it this way"----just like using multi-dose KCL vials and sharpening our needles for use with glass syringes.

RN-PA, RN · Apr 26, 2003

I guess I've been a little naive about the multi-dose vials and will have to re-think. If they're to be single dose vials, then we need to stock smaller than 30 cc vials-- very wasteful if you're only drawing up 2 cc flushes at a time.

On another note, we are being told that *EVERY* time we give a patient a med, or do wound care or the like, we have to ask them:

*Their name

*Their birthday

Every single time (and check their name-band). So, I meet my patient at the beginning of my 8 hour shift and ask name and birthday. Then in subsequent interactions, I'm asking the same thing. I'm sorry, but this is NUTZ! If I had a nurse asking me this numerous times in a shift, I'd doubt their memory AND their competency. The two identifiers are even included in our computerized careplans. Anyone else having this same emphasis? (And please don't tell me how important identifying a patient is-- I know it's important, but this kind of "Stepford wife" nursing is creeping me out!)

RN-PA, RN · Apr 26, 2003

I guess I've been a little naive about the multi-dose vials and will have to re-think. If they're to be single dose vials, then we need to stock smaller than 30 cc vials-- very wasteful if you're only drawing up 2 cc flushes at a time.

On another note, we are being told that *EVERY* time we give a patient a med, or do wound care or the like, we have to ask them:

*Their name

*Their birthday

Every single time (and check their name-band). So, I meet my patient at the beginning of my 8 hour shift and ask name and birthday. Then in subsequent interactions, I'm asking the same thing. I'm sorry, but this is NUTZ! If I had a nurse asking me this numerous times in a shift, I'd doubt their memory AND their competency. The two identifiers are even included in our computerized careplans. Anyone else having this same emphasis? (And please don't tell me how important identifying a patient is-- I know it's important, but this kind of "Stepford wife" nursing is creeping me out!)

**canoehead, BSN, RN** · Apr 26, 2003

Most of my pts (at night) are lucky to know their name- no way they'd even know what a birthday was!