Jcaho 2005

TiffyRN, BSN, PhD · Apr 27, 2005

Our was last November but that wasn't all that long ago was it?

Patient safety goals; there were a good dozen of them and i don't remember all of them but one was checking 2 identifiers before doing anything (patient's name and hospital ID number for us). The other biggie was unapproved abbreviations. Terms/abbreviations they hate:

MS, U, IU, MgSO4, MSO4, QD, TIW

Also they wanted us to stop using trailing zeros and make sure to use leading zeros when appropriate; for example: Zantac 3.0 mg is not cool, it has a trailing zero. Another is Versed .4mg, it lacks a needed leading zero. These sort of things can lead to medication errors.

We got in trouble for the abbreviation thing though we did well overall otherwise so they will be back to check us again in a few weeks.

Our contention though is that if you are not writing a med order then the trailing zero/leading zero thing is silly. We finally got approval to write our ETT sizes with trailing zeros (for example, infant intubated with "3.0" ETT taped at 8cm). It also seems silly to write our labs out (we have this lab flow sheet for the docs convinience) without the trailing zeros; I think if your K+ level is reported from the lab as 4.0, then we should write it out that way to make is clear we didn't just forget to complete writing the lab. Common sense needs to be used, no one will ever confuse a K+ level of 4.0 with 40.

NancyJo · Apr 28, 2005

Today was day 2 of our survey. The big thing here has also been the unnaproved abbreviations, the zeros things also. The two pt. identifiers is being watched also and the real biggie for us is that when we take any telephone or verbal orders, we write that the orders were read back and verified. They are also checking into pain management closely, making sure that all there are follow up notes and inital assessments when pt. c/o pain, and that the acceptable level of pain was recorded on admission. Another question being asked alot is why would someone want to come to this hospital? Need to give answers that reflect a quality improvement, like decreased fall rates/decreased infection/increased pt. satisfaction scores etc and how these goals were achieved. Hasn't been to bad yet, but they haven't chose one of my charts, so I haven't had to go into the heavy interrogation.

bobnurse · Apr 28, 2005

Thank you, all of your help is greatly appreciated.. We have JCAHO in june.......How is the tracers going? are they tough?

head injury unit RN · Apr 28, 2005

we got hit hard on skin conditions/wound vac therapy.and our charting system. plus as said in above comment pain assessment/relief and abbreviations too.

zacarias, ASN, RN · Apr 30, 2005

I am so sick to my stomach that they are clamping down hard on abbreviations. Don't they realize that they are dumbifying healthcare and that removing a lot of those abbreviations are negating our healthcare training.

UM Review RN, ASN, RN · Apr 30, 2005

I am so sick to my stomach that they are clamping down hard on abbreviations. Don't they realize that they are dumbifying healthcare and that removing a lot of those abbreviations are negating our healthcare training

I don't think I agree. The result on our units have been that a lot of docs have been writing more legibly or using preprinted standing orders. Always a good thing.

allnurses Guide · Apr 30, 2005

I don't think agree. The result on our units have been that a lot of docs have been writing more legibly or using preprinted standing orders. Always a good thing.

That is my experience too - although we have one maverick doc who hates it.

steph

UM Review RN, ASN, RN · Apr 30, 2005

That is my experience too - although we have one maverick doc who hates it.
steph

Cripe, there's always one in every bunch, isn't there? In our case, the same doc who writes in boldface and underlines about 4 times, "DO NOT USE STANDING STROKE ORDERS!!!!" is also the idiot who writes "Shave patient daily!!!!" for all the males.

Ahhh....yeah sure, we'll just let that Pt. in SVT sit a few more minutes while we lather up the confused, combative guy in wrist restraints--just for you, doc. :rolleyes:

Da Monk · Apr 30, 2005

I heard that in 2006, they will be checking to see if the staff's shoe laces are tied according to the standards and if pants are the right length. All buttons also must all be buttoned. OH! And stethescopes must NOT be worn around the neck.

bobnurse · May 2, 2005

I heard that in 2006, they will be checking to see if the staff's shoe laces are tied according to the standards and if pants are the right length. All buttons also must all be buttoned. OH! And stethescopes must NOT be worn around the neck.

Well actually you have to start a process in 2006 for this with full implementation in jan 2007.

mtnmom · May 2, 2005

:confused:

I heard that in 2006, they will be checking to see if the staff's shoe laces are tied according to the standards and if pants are the right length. All buttons also must all be buttoned. OH! And stethescopes must NOT be worn around the neck.

are you serious???? is there really a certain way we are supposed to tie our shoes???? and if so what is it?

and where, pray tell, can I put my stethoscope? My pockets are full already