Is Joint Commission more hindrance than help?

Nurses General Nursing

Published

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

I think that when Joint Commission was originally theorized it was meant to help improve patient care and it really did change some things in patient care for the better. On the other hand, the current day Joint Commission needs to take a long hike off of a short bridge. It's so much more of hindrance in nursing today than it is helpful anymore. We literally spend more time during our shift documenting and filling out endless forms.

I'd like to pose a question: How does current day Joint Commission improve patient care? I'm just dying to know. It seems as though each year between The Joint and CMS patients are being stripped of what their in the hospital for....nursing care.

Just my .02

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The paperwork is out of control. Period. The joint commission continues to mandate so much that we are drowning in paper. It is absolutely laughable how much responsibility is placed on the nurses to not only abide by these mandates but to also take care of their patients in their SPARE time. I'm sorry but this really irks me.........

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I fail to see where JCAHO has actually improved patient care. They require that numerous issues be fixed but they do not hold facilities accountable to do a root cause analysis. Thus the facilities make up yet another ridiculous rule and/or documentation sheet for us to follow but the bottom line is that the problem still exists it is merely hidden in paperwork. The majority of the issues that JCAHO is supposed to be "fixing" would be corrected easily if the facilities were willing to provide proper training and proper staffing, proper equipment.

I am afraid for the future with the newest round of regs coming from CMS about what they won't pay for in their bid to ensure quality care. The facilities are going to get even less money and nursing services is going to take the brunt of the backlash. Nurses are going to be required to spend 3 hours performing a physical exam on every admit and documenting every odd looking area of skin just to cover the hospital's butt so they can say that the decub started outside the hospital. It is going to be ugly.

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Specializes in Ortho, Neuro, Detox, Tele.

It's that huge step to magnet...or whatever....

Personally, I think that my job(I'm a tech now) is meant to be focused on patient CARE, not on making sure x drawer is stocked. I barely have enough time to do what I need to do by 11PM, and I dang sure am not waking people up at 2AM to stock their supply box in the room....there is time on days where patients are having lunch, out to rehab, out for tests, etc.....and you can't stock then why, exactly?

I also have a problem with all the extra duties I'm supposed to do in addition to my patient care....they go down to the bottom when I'm spending extra time caring about patients. Oh, well, can't do a thing about it, so worst case? fire me for violating a minor JACHO policy. Not even the hospital's policy yet!

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I think that the commission has worn out its welcome. The new "mandates" that they come up with are basic nursing care. Is it possible that now it's just a matter of justifying their own existence? Every mandate comes with more paperwork, and the hospital powers that be are on our tails about overtime for charting. So which comes first, the patient or the paper?

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In the hospital ICU that I work at, our crash cart was not always in direct observation of staff. I is locked, but JACHO made us put it behind a locked door. To get into the closet you need a 4 digit code to punch in. Since I work all over the hospital, I only have about 25 codes to remember. It really slows us down. They said it was for the saftey of visitors and in case someone wanted to steal the meds in the crash cart. :banghead:

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In the hospital ICU that I work at, our crash cart was not always in direct observation of staff. I is locked, but JACHO made us put it behind a locked door. To get into the closet you need a 4 digit code to punch in. Since I work all over the hospital, I only have about 25 codes to remember. It really slows us down. They said it was for the saftey of visitors and in case someone wanted to steal the meds in the crash cart. :banghead:

Oh, yeah, let's get high on the atropine/epi/narcan/amiodarone in the crash cart! Whoo!

Common sense seems to be in short supply at Joint Commission.

Another one that just slays me, is the "2 types of id" when medicating. Now, this is a great idea, but when I have had the same patient for many days straight, and he/she gets meds every few hours, hopefully I have figured out who they are by then. I'm not saying to skimp on identification, but again, common sense!

Oldiebutgoodie

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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.

But they have to do something to justify their existence, so if they don't come up with more paperwork, guidelines, and hoops to jump through, they'll become unemployed and we surely don't want that.

What always fascinates me is that they can make change upon change, and have the power to basically shut down a noncompliant hospital all in the name of improving patient care, yet not once have they mandated minimum ratios...has research not justified this change to improve patient care? I'd love to know why they haven't championed such a cause?

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Specializes in Rehab, Med Surg, Home Care.
In the hospital ICU that I work at, our crash cart was not always in direct observation of staff. I is locked, but JACHO made us put it behind a locked door. To get into the closet you need a 4 digit code to punch in. Since I work all over the hospital, I only have about 25 codes to remember. It really slows us down. They said it was for the saftey of visitors and in case someone wanted to steal the meds in the crash cart. :banghead:

Yep, primo example of where JCHAO goes wrong. Does anyone else find it COUNTERPRODUCTIVE to make the Code Cart less accessible in an emergency?? (JMHO...)

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Specializes in UR/PA, Hematology/Oncology, Med Surg, Psych.

I was truly shocked a few years ago when I found out that they are not a government run group, but a private company (in fairness I will add that they are non-profit) that has now progressed to holding health facilities hostage. I know for Medicare reimbursement one most be JACHO approved. I was also surprised that health facilities pay them for inspection/approval. How did a private company get so much power?

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I think it's a hindrance too.

I had the unique perspective of actually being a patient at my own hospital while JCAHO was there!! I had my c-section and I was stalled getting placed into a room because the poor nurse had to finish this special charting just for JCAHO before sending me on my way. Then there were other people who wanted to see my chart while my nurse was trying to hurry through her paperwork. It was a mess.

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Specializes in Tele, Renal, ICU, CIU, ER, Home Health..

In my opinion many of the JCAHO directives are very useful to patient care. The problem is that most of the directives / deficits are "Physician problems". Since administration couldn't possibly make the physicians accountable, they try to make the nurses fix the problem by filling out a new form. Example: signing orders, Medication reconciliation, Core Measures. These are all things that Physicians need to do, but the responsibility is given to the nurses. The problems will never be fixed by doing this...and patient care continues to suffer.

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