Is Joint Commission more hindrance than help?

ebear, BSN, RN · Jan 26, 2008

I agree. I also think they would be better served by not announcing their visits. Most of their "requirements" go out the window after they leave (my experience). While some of their requirements may be well founded, they DO take the staff away from nursing care by focusing on miniscule BS.

tencat · Jan 26, 2008

Definitely a hinderance and mostly a waste of time and energy that could be put into patient care instead.

oldiebutgoodie, RN · Jan 26, 2008

Definitely a hinderance and mostly a waste of time and energy that could be put into patient care instead.

I think about rating pain and reassessment of pain. Correct me if I am wrong, but aren't these Joint Commission recommendations (dicatates)?

Where it sounds great in theory, it's a nightmare in practice. On a recent shift I worked, I had 5 patients (we have pretty good ratios, but most patients are train wrecks/in isolation/total care). 2 patients were chronic pain pts with Dilaudid ordered every 2 hours. Both were also clock watchers, and one actually would ring for his next dose 15 minutes after the last dose. Pain service was on board for both patients.

So, I had to document pain, document the Dilaudid, waste leftover Dilaudid, reassess pain, and document the reassessment every 2 hours for these 2 patients. I am sure this documentationa alone took 10% of my day (it seemed like more).

My fantasy is that all hospitals refuse to join the Joint commission, and we can get back to actually taking care of our patients.

Oldiebutgoodie

Valerie Salva, BSN, RN · Jan 26, 2008

We are getting ready for Joint Commission right now- they are due any day.

Their bs just adds so many uneccesary steps, it really only serves to shift the focus away from pt care and on to document care.

twarlik · Jan 26, 2008

I agree. I also think they would be better served by not announcing their visits. Most of their "requirements" go out the window after they leave (my experience). While some of their requirements may be well founded, they DO take the staff away from nursing care by focusing on miniscule BS.

The Joint Commission no longer announces its visits. Hospitals are given a window of time in which they could be visited (usually several months). This is suppose to keep hospitals in a state of "continual readiness". Not sure how effective it will be.

Todd

Tweety, BSN, RN · Jan 26, 2008

A little of both, but I agree that it's gotten out of hand. If they come up with one more blasted form or paperwork for us to fill out I'll scream.

nici1978 · Jan 26, 2008

i agree it is a waste of time

nici

lindarn · Jan 26, 2008

I just thought I would throw this one out there:
Do you think that the activities that floor nurses must do to satisfy Joint Commission requirements are a help or a hindrance to patient care? It almost seems to me that we spend so much time documenting that a lot of patient care has gone out the window.
What do you think?
Oldiebutgoodie

As we say in Brooklyn, they are about as useful as tits on a bull.

Lindarn, RN, BSN, CCRN

Spokane, Washington

imenid37 · Jan 26, 2008

A little of both, but I agree that it's gotten out of hand. If they come up with one more blasted form or paperwork for us to fill out I'll scream.

I think much of it is carried to the ridiculous. They try to set rules to act in every possible way to every possible situation and it is just not feasible to predict and prevent every problem always. There are times when there is no "rule" and we have to use professional judgement, experience, collaboration,etc. to problem solve and we cannot necessarily respond to the problem w/ one size fits all documentation. For example, if a very large patient wants two percocet for a level 3 incisional pain, I must give him only one because we only give one for level 3. It doesn't matter if the pt. and I both know he needs two because that is what it always takes to relieve his pain. Good ole JCAHO decided we had to have very strict written guidelines to give these meds. You need to have a level 6 for 2 percocet whether you are the size of Shaquille O'Neil or Twiggy. The nurse's judgement about what would work for you is out the door. He or she would be considered to be rx'ing meds if they deviate from the policy. So said JCAHO on their last visit to us which was a surprise, BTW. All I can say now if Shaquille has level 3 pain and wants 2 perc's, it becomes a 6! The whole quality and pt. safety principal behind JCAHO is great, but it has evolved beyond that into a senseless and useless monster.

marie-francoise · Jan 26, 2008

Is some (maybe much) of the excess documentation also due to 1) fear of lawsuits and 2) having to prove to Medicare that something was done?

pagandeva2000, LPN · Jan 26, 2008

We have now entered the joint commission mode, and yes, it is true, they are no longer announcing when they will arrive; it will be a surprize. And, I am hearing that if they see three infractions, they stop the survey immediately and walk out, only to return with pages of demerits.

I think that they are definitely a hinderance rather than a help. The only good thing coming out of this is that I will probably see more policies and procedures that were kept in the dark since I became a nurse last year. In my opinion, joint commission or even magnet do nothing to improve patient care or the stress nurses experience trying to care for our clients. As another poster said (Valerie Salva to be exact) it has become "document care". A shame...