JCAHO Visit

[nurserynurse55]

What is it like when JCAHO visits? They are expected to be here in a few days (or might be there now). I forgot to do something small ( I am sorry too). When we got critical lab values on patients, we tell the doctors and chart it in two places. Usually the lab calls us about critical lab results, and that is our reminder about charting. The lab forgot to call, and I forgot to chart it in one of the two places. The patient was treated quickly and is fine, but I feel nervious about it. Of all the times to forget.

Thanks.

[wooh, BSN, RN]

Just do your job. Keep in mind, it's not YOU that Joint Commission is out to get. It's the hospital. Management wants you to be all on pins and needles because if something comes out, they'll get in trouble. Just remember, you're a good nurse. And the standards a good nurse has for herself are far higher than any standards a bureaucratic agency can have for her.:)

[interleukin]

"The lab forgot to call, and I forgot to chart it in one of the two places"

As long as you are a nurse you will forget to do things...it's in the nature of the beast and it will only get worse as you are required to chart yet one more thing, fill out yet one more sheet, or perform yet one more task.

Do not, I repeat, do not take that on yourself. When a sufficient number of nurses say, "enough is enough" then the system may finally be reevaluated. Until then, prioritize your care and make no excuses for missing something.

[wooh, BSN, RN]

"the lab forgot to call, and i forgot to chart it in one of the two places"

as long as you are a nurse you will forget to do things...it's in the nature of the beast and it will only get worse as you are required to chart yet one more thing, fill out yet one more sheet, or perform yet one more task.

do not, i repeat, do not take that on yourself. when a sufficient number of nurses say, "enough is enough" then the system may finally be reevaluated. until then, prioritize your care and make no excuses for missing something.

the beauty of joint commission is that to fulfill every rule, the hospitals decide the best idea is to double chart. because if we make joint commission actually look in the chart for what they want, they might find something else wrong. instead we double chart so they have a nice little solitary form they can look at. so what if it makes it harder for the nursing staff?

nurses have got to start sticking together and refusing this double charting garbage. at work we have a spot to chart in the computer the results of an accucheck. of course, before i can get it in the computer, the machine has gone on the base and already sent the result to the computer. it's idiotic, and i refuse to double chart. if the machine is down for some reason, i'll chart it, but otherwise, i'm letting the machine do the work.

[litbitblack, ASN, RN]

When they come and even the months before they come admin is in a uproar for everyone to fix everything. even when its stuff that should have already and continually been in progress. If you are so lucky to be pulled in to review a chart with them they will probably ask how is your staffing and is it like this all the time and what kind of things does the hospital do for the staff and crap like that in addition to finding things in the chart and what do you do if you find this. What all is documented on an admit and how do you know when your pt has went for a procedure. where are the policies and procedures for the unit and facility. Where are the chemical emergency policies. Just know where everything is located or how to find it/answer. They just want to know that the policies they want for pt safety are on board or the process is started. I was a lucky one(yuck) to get called in to the little room and oh admin goes with you (I guess so you don't tell the truth)lol. When I went they had 6rns on the floor for 17 pts and he asked me if this was the normal staffing for this floor. Of course I said NO.....The facility I used to work at failed jhaco the first time with 17 disciplines and most of them were doctors things.

[pagandeva2000, LPN]

Joint Commission scares the pants off of every one of us. They look for minimal safety standards. It may be that they don't make it to your floor at all, or even pull the chart where you omitted to document in the two areas instructed.

They usually make rounds, randomly interview anyone they choose and most of the time, they are supposed to ask things that should have been reviewed in policy and procedure manuals; and they want to see if everything correlates. I hate when they come as well. Most facilities attempt to have meetings with staff to prepare them, give them pamplets and give a general heads up on what questions are asked. My facility is so crazy that we usually call the other floors and warn them of what they asked us. Fortunately, I have not been confronted by them, but I am sure my day will come, eventually. What is generally more stressful these days is one; the managers are usually more nervous than we are (because most of the problems discovered are mostly system problems that they are responsible for) and also, now that visits are supposed to be unannounced, we are on our toes much longer than what we would care to do.

[wooh, BSN, RN]

Joint Commission scares the pants off of every one of us.

But there's no reason for it to scare us! After all, it's system issues they're after, not individual nurses. I love JC visits. Staffing is good. They'll actually spend MONEY to make sure enough people are there! Supplies and equipment are there when you need them. Linen is never short. I'd love it if every single day was a JC visit!

[Okami_CCRN, BSN, RN]

Jchao is funny. My hospital just passed flyers and required a mandatory in service for all employees, it was hilarious.

Last time they were here they came to my unit pulled a chart and asked the RN some questions. Usually they look to make sure everything is in order, however in 2003 we were fined for not listing the Emergency Number to call codes on the little tag we get to put in with our ID's so that we know what each code means.

[interleukin]

"It's idiotic, and I refuse to double chart."

Absolutely...if more nurses refused to duplicate their work there'd be changes made.

If I chart in the computer, then it's done. If the particular program wants duplicate input for billing reasons or other access reasons, then next time have some nurses there for program design in the first place rather than those who have no idea what we do.

[ICRN2008, BSN, RN]

The Joint Commission used to sit in a board room looking at charts and policies during their visits. Now, they spend at least half the time interviewing nurses, patients and other employees to make sure that everyone has a basic understanding of the standards of safe care. They do not have time, nor are they interested in completing, a chart audit on every single patient.

Regulatory compliance is important, but it is only one part of the picture when evaluating the quality of care in a facility. The most important priority is ALWAYS the patient. When I speak to other nurses about improving the quality of documentation surrounding infections, I want them to always keep in mind that this does not mean that they are exhaustively charting while their patients need their attention.

[pagandeva2000, LPN]

But there's no reason for it to scare us! After all, it's system issues they're after, not individual nurses. I love JC visits. Staffing is good. They'll actually spend MONEY to make sure enough people are there! Supplies and equipment are there when you need them. Linen is never short. I'd love it if every single day was a JC visit!

You are correct there. I think what happens is that hysteria is catching...the managers look like fools, harassing us every few minutes, sweating, even crying. Usually, the systemic problems are issues that those fools created in the first place.

[wooh, BSN, RN]

You are correct there. I think what happens is that hysteria is catching...the managers look like fools, harassing us every few minutes, sweating, even crying. Usually, the systemic problems are issues that those fools created in the first place.

Last year, management FREAKED out when JC come around. It was hilarious. And since I was used to our understaffing so actually had 2 patients less than usual and had a tech that day (which had become rare) I was calm and cool as a cucumber since it was one of the few days I wasn't wondering when the inevitable killing of a patient was going to happen. Greatest day at work ever. People always want to take vacation time when JC is due to come around. Me, I'll volunteer for the days. Because they are pure bliss. The people that cause me stress actually have the stress themselves for a change.:)