Jcaho

traumarns · Sep 6, 2002

so what are they looking for this year.

2 years ago it was documentation of restraints.

those restraint flowsheets work soooo well for icu pts who are vented/sedated/foley/rectal tube/ tf's/ miv....

a few years before that it was documentation of iv's.

what is it this year, something really stupid like

date and time ett is retaped ON THE TAPE.

i just hate it after jcaho comes. we always wind up with a new flowsheet to chart on.

zudy · Sep 6, 2002

We are getting ready for JACHO. The newest thing: Did you ask the pt if they are having any problems with nutrition? Granted, that is important for some pts, but not every single pt!! And every time Iask an overwt pt that, they always say, "Do I LOOK like I have a problem with nutrition?"

Nurse Ratched, RN · Sep 6, 2002

"Pain" is the problem du jour.....

And they always crawl us about restraints. It's to the point that our bosses question every time we have to put someone in. Yes, when a patient goes ballistic at 3 am with a skeleton staff on, and meds are obviously not working, I WILL tie them down for the safety of staff and other patients. And if the doc who is supposed to come in and visualize the pt within an hour of said tie down doesn't like it, he/she can take it up with the regulatory body that created that rule.

JustMe · Sep 7, 2002

Our new restraint policy states if all 4 bedrails are up, that is a form of restraint and we need a Dr order. In our ICU, all 4 rails are always up--does that mean we have to get restraint orders on ALL our patients??? Admin hasn't responded to our inquiries. They better hurry--JCAHO's almost here!

deespoohbear · Sep 7, 2002

Cheri P- I think you do need a dr's order even if every pt's 4 rails are up according to the JCAHO gods. In our med/surg dept we have had pts REQUEST that all 4 rails up at night for their sense of security and safety and we still had to get a blasted order.

This year is the pain thing. We had JCAHO last Aug and yeah we got a new flow sheet after they were through. I think now the big push will be the HIPPA and privacy laws. It is always something. Do you know how much money the hospitals pay these clowns to come and tell us how lousy we are? The staff could all have a nice raise if the money wasn't going to pad some healthcare managers pockets who have no idea what it is like in the real world. Maybe if these clowns would have to come and work under their own rules and regs for about 6 months maybe they would have a different prospective on things. That should be mandatory to be a JCAHO employee!! They should be required to work AT THE BEDSIDE for 3 months a year before passing judgement. Just my .02.

Nurse Ratched, RN · Sep 7, 2002

Originally posted by CheriP.
Our new restraint policy states if all 4 bedrails are up, that is a form of restraint and we need a Dr order. In our ICU, all 4 rails are always up--does that mean we have to get restraint orders on ALL our patients???

Yes. HOWEVER, 3 side rails and a strategically placed large sturdy chair do NOT equal a restraint .

teeituptom, BSN, RN · Sep 7, 2002

Howdy yall

from deep in the heat of texas

we just went thru it. This time it was restraints, concious sedation, pain control, we have 4 different pain scales that we use, and several LOC scales too.

Plus they came out on night shift and watched triage and how confidentiality was handled. And asked people on nights who various suits on dayshift were as if we really ever get to see or know them.

Doo wah ditty

JustMe · Sep 7, 2002

Confidentiality is a good point--do these inspectors sign a confidentiality statement, like we have to, before they review charts?? I remember when some of our students nurses were approached by BRN inspectors for the college. The inspectors asked the students to tell them about their patients and the students refused based on confidentiality. The inspectors were indignant, but the faculty was very proud of their convictions.

nell · Sep 7, 2002

Originally posted by traumarns
...what is it this year, something really stupid like
date and time ett is retaped ON THE TAPE...

I wouldn't put it past them! And I can just see this being universally applied without any common sense. Imagine how small the tape is on a 2.0 ETT in a premie!

traumarns · Sep 7, 2002

lmao, great replies

glad to know WE who work at the bedside think so highly of the people who accredidate our hospitals.

our inspection is the end of the month. will update you all on what new paperwork we have.

Home Health Columnist / Guide · Sep 9, 2002

Found JCAHO update at Alaska Nurses association:

JCAHO Update - June 2002

http://www.aknurse.org/

sjoe · Sep 9, 2002

JCAHO exists to serve the health care facilities, just as 1.800-DENTIST exists to serve the particular dentists who pay it a fee to recommend THEM. These are both just professional organizations which attempt to create an "in group" of their members who are willing to pay them to join and to be "screened" by them, in exchange for promotional work and the opportunity to claim "special status." Think "country club."

(disclaimer: I am not employed by, own no stock in, and do not profit from 1.800-DENTIST, nor from any of the dentists who pay them. Nor am I a member of any country club.)