The Failure of the Joint Commission - page 4

I want honest opinions here. I consider myself one of the many that think the Joint Commission has outlived its usefullness. Every year more National Patient Safety Goals, Sentinel Event alerts and... Read More

  1. Visit  pglick profile page
    1
    it was intended as informative...
    I was insulted by your making MRI safety seem unimportant.

    Was it the only subject you thought you could use to support your disdain for tjc?
    tjc wants to reduce medication errors... can't attack that one.
    tjc wants to improve communication among caregivers... I'd look silly attacking that.
    tjc wants to reduce medication errors...

    You see where I'm going. Was MRI safety the best argument you could point to?

    No one in the medical industry understands the uphill struggle I have and tjc isn't doing anything to help me make my workplace, my equipment, my staff or my patients safe in the most hostile environment in the hospital.
    Last year an MR tech caught a pair of scissors with his forehead... nearly lobatomized him... it did puncture his skull cavity a couple of inches. Scissors narrowly missed a 2 yr. old last year from a resp. therapist.
    A physician required emergency surgery after being struck with an e-size o2 tank. A service engineer was killed last year because she failed to follow procedures. The average cost of a large projectile is $183,000! and they actually do occur all the time.

    You just don't hear about the accidents because no on wants to talk about them. I can send you dozens of accounts and photos.

    It truely wasn't my intention to insult you or ANY caregivers. But you insulted me and I want you and every other RN to know a real danger exists everyday in my life, my patient's lives and my staff's lives.

    I'll give you one last example. Go to youtube and search "MRI oxygen tank"... it's a taped experiment to demonstrate how dangerous MR is. A 12lb. O2 tank will shoot into a 1.5-T MRI at about 40-50 mph. It shoots past the strongest point only to be pulled back again and again for about 4 sec. Once at rest it will weigh in at 2500-3000lbs. That the same as a mini Cooper.

    I apologize if in my anger, I insulted. It's just MY job and I find it more & more difficult to get people to understand how dangerous MRI is. Especially when it comes to protecting pts. from burns.

    And when someone casually brushes off something as important to me as MRI safety, I speak up...LOUDLY!
    tjc sentinel event alert was the closest thing to somebody, anybody putting safety requirements in place... and I will agree with you but not on MR safety, they've done nothing to put teeth into these "recommendations" for the 3 yrs. since the alert.
    lindarn likes this.
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  3. Visit  abbaking profile page
    1
    Quote from pglick
    it was intended as informative...
    I was insulted by your making MRI safety seem unimportant.

    Was it the only subject you thought you could use to support your disdain for tjc?
    tjc wants to reduce medication errors... can't attack that one.
    tjc wants to improve communication among caregivers... I'd look silly attacking that.
    tjc wants to reduce medication errors...

    You see where I'm going. Was MRI safety the best argument you could point to?

    No one in the medical industry understands the uphill struggle I have and tjc isn't doing anything to help me make my workplace, my equipment, my staff or my patients safe in the most hostile environment in the hospital.
    Last year an MR tech caught a pair of scissors with his forehead... nearly lobatomized him... it did puncture his skull cavity a couple of inches. Scissors narrowly missed a 2 yr. old last year from a resp. therapist.
    A physician required emergency surgery after being struck with an e-size o2 tank. A service engineer was killed last year because she failed to follow procedures. The average cost of a large projectile is $183,000! and they actually do occur all the time.

    You just don't hear about the accidents because no on wants to talk about them. I can send you dozens of accounts and photos.

    It truely wasn't my intention to insult you or ANY caregivers. But you insulted me and I want you and every other RN to know a real danger exists everyday in my life, my patient's lives and my staff's lives.

    I'll give you one last example. Go to youtube and search "MRI oxygen tank"... it's a taped experiment to demonstrate how dangerous MR is. A 12lb. O2 tank will shoot into a 1.5-T MRI at about 40-50 mph. It shoots past the strongest point only to be pulled back again and again for about 4 sec. Once at rest it will weigh in at 2500-3000lbs. That the same as a mini Cooper.

    I apologize if in my anger, I insulted. It's just MY job and I find it more & more difficult to get people to understand how dangerous MRI is. Especially when it comes to protecting pts. from burns.

    And when someone casually brushes off something as important to me as MRI safety, I speak up...LOUDLY!
    tjc sentinel event alert was the closest thing to somebody, anybody putting safety requirements in place... and I will agree with you but not on MR safety, they've done nothing to put teeth into these "recommendations" for the 3 yrs. since the alert.
    I agree with you about MRI safety and I am not mocking it or downplaying it.
    My issue is when JCAHO requires yet more banal and irritating crisis event alerts to situation that in general do not happen all that often as compared to short staffing, patient falls, suicides, staff assaults, etc.
    I think the Joint Commission would be better off and more useful if it were to mandate national nurse-patient ratio requirements for all its accredited facilities.
    That being said - MRI safety is very important but i feel that the safety information should come from the manufacturer and not this giant schpiel that JCAHO makes it out to be.
    I say relatively few MRI accidents because in my 10 years in hospital, I have yet to see a MRI related safety issue with a staff or a patient but I have seen MANY MANY MANY preventable patient falls, Infections, etc.
    Fixit likes this.
  4. Visit  myk_RN profile page
    2
    I totally agree with you. The hospital that I work in had just earned their accreditation last year after 27 years of not being accredited. I've been working as a nurse for 4 years now and it was the same timeframe when our hospital pledged to aim for JCAHO accreditation. The overwhelming amount of JCAHO mandated paperwork and charting does take away time with our patients.
    sweetnepenthe and lindarn like this.
  5. Visit  FLOBRN profile page
    1
    IMHO JCAHO is a money grab. Seriously, the state of Arizona is doing just fine without them.
    It seems similar again IMHO to Magnet. You can do the identical program using the Robert Woods Johnson foundation's quality plan and....it's F R E E (my personal favorite 4 letter word)
    lindarn likes this.
  6. Visit  Catch22Personified profile page
    1
    When I was a student they seemed to strike fear into the staff.

    There was a pen on the floor in the nurses station and the JCAHO rep was throwing a HUUUUUUUUUUUUUUUUUUUUUUUGE FIT over "workplace safety, neglect, and how this kind of thing happens in the patient rooms".

    They're worse than seeing Press-Gainey results.
    wooh likes this.
  7. Visit  forrester profile page
    5
    A pen on the floor!
    Poor nursing care pure and simple. We need a new form!
    Whew. nursing management solves another catasrophic problem.
    Mission accomplished
    salvadordolly, PatchycatRN, wooh, and 2 others like this.
  8. Visit  scaler911 profile page
    3
    Sorry to hijack a nursing site (hope it's ok, mom's a RN, mom in-law same, 80yrs between 'em). We just JCAHO rolling up in our OR (I'm a licensed AT with 22 years experience), and we got dinged for not having individually sterilized laryngoscope blades. Really? We already were soaking them in a anti-viral, anti bacterial solution, scrubbing them, rinsing with isopropyl alcohol, then Sterrading them in bulk, then passing them out to the Doc's for the day. So now some Ph.D with a big black binder with no real OR/ Anesthesia experience is riding us about this, and comes back for another visit to 'drill down' to the core problem?
    Something super clean is going in your filthy mouth, show me some evidence please that that has ever been an cause of post op SSI.
    And as an aside, the unwrapped (they don't even come sterile) oral airways were not a issue.
    These people need to quit making our lives hard, and let us get on with the business of taking care of our patients.
    wooh, monkeybug, and lindarn like this.
  9. Visit  forrester profile page
    2
    JCAHO was and is a joke, even after being spanked by CMMS.
    It's like having the airline industry regulate the FAA.
    The AHA is extremely powerful, politically, and has controlled legislation since the 1970's.
    Sort of explains the 1999 IOM report doesn't it.
    wooh and lindarn like this.
  10. Visit  Rob72 profile page
    2
    Quote from pglick
    Was it the only subject you thought you could use to support your disdain for tjc?
    tjc wants to reduce medication errors... can't attack that one.
    tjc wants to improve communication among caregivers... I'd look silly attacking that.
    tjc wants to reduce medication errors...

    You see where I'm going. Was MRI safety the best argument you could point to?
    In referencing TJC, the TJC does not "want" to reduce/rectify any of the above. Their federal funding requires that they identify unspecified problems and address them in (unspecified) ways.

    Accreditation serves the same purpose as the RN- reduction of liability. If a facility is accredited, it has met "standards", and is involved in some form of QA/QI- "We are not negligent..." RNs are the licensed caregivers between UAPs/aids, ancilliary services and physcians, then Admin. Our licensure assumes liability, we are present to ensure that policy is being followed. Without docs, the hospital closes; they can replace RNs. Cheaply.

    HIPPA, same thing. No patient has been made "safe" by HIPPA. If PHI is lost/misused, the liability is now on the individual employee/violator- who probably doesn't have $7.8 million in annual (net) revenue to go after. "Settlement caps", by any other name...

    So. A facility is accredited, it has me The Standards- it is not at fault(negligent) for your injury. A facility has an RN on the floor- it is the RN's responsibility to prevent/anticipate/minimize your injury, the facility is not responsible(negligent). You receive another patient's lab results in the mail- the lab tech/mail room gal/whatever, is fired, and the facility may pay you a couple of thousand, but certainly no more(they were not "negligent"). See a pattern...?

    Being very simplistic here, but this is the reality of the bureaucratic model. The TJC validates its existence by finding "fixables" and handing out to-do lists. They can't hold CEOs/CMOs accountable because of the layers of insulation.
    PatchycatRN and lindarn like this.
  11. Visit  BeentheredonethatRN profile page
    1
    Wow ! After being a nurse for over 20 years ,I finally decided to lookup the "Boogie Man a.k.a JCAHO "- just like so many of you have stated - A joke ! Get this ! They are supposed to be coming through our Mega Magnet hospital and its just like most times-Panic ! Then it hit me -after working in so many hospitals ( some should have been 3rd world ) all passed - why ? Oh, JCAHO is paid in full and we always have the receipt . Again-What a joke !
    lindarn likes this.
  12. Visit  stablesystole profile page
    1
    Is it just me or can we make a sincere allegation that TJC qualifies as a racketeering operation?
    wooh likes this.


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