JCAHO visit

NicuGal, MSN, RN · Jul 15, 2003

Pain management and all the Do Not Use abbreviations...they scoured many of our charts for that!

tylerrose · Jul 20, 2003

Thank God! JCAHO came and everything went well in my unit. Our surveyor is a nurse and she was really nice. Took her on a quick tour of the unit then, she asked for a chart with a lot of the multidisciplinary team involved, got the chart went into the conference room with everybody concerned including our trauma surgeon. She asked him about the patient (by the way, this surgeon talks a whole lot. you ask him a question and he will give you a lecture) of course, he gave her the history, the management basically covered everything that the surveyor did not have anymore questions, that saved our day. I guess it sometimes pays if you talk a lot.. :::)

She reviewed the chart but didn't really ask anymore questions. They said the doctor and the administrator surveyors were very strict. I'm so glad it is all over....

zacarias, ASN, RN · Jul 20, 2003

Did you guys here that JCAHO is gonna start visiting hospitals unannounced starting 2006?? Scary huh!

Tweety, BSN, RN · Jul 20, 2003

Pain management, teaching and restraints seemed to be a big focus this past year. Next I hear they might be focusing on sleep. What you do to promote sleep, provide a restful atomosphere and for day/night orientation. Has anyone else heard this?

I'm glad things went well for you.

Huq · Jul 20, 2003

I have also read that JCAHO will make surprise visits in the future.

Unlike the State surveys there is a fee for JCAHO and this fee is paid by the facility.

Cannot figure out why a facility would pay for an unannounced visit.

WhiteCaps · Jul 20, 2003

JCAHO is focusing big on medication errors, pain management, and the ever dreaded new PRIVACY issues.

They have gone way overboard with some of this stuff! While they are supposed to be ensuring quality care for patients (and they do to a large extent), their never ending nit-pickings are making so much more work they are driving nurses away!

For ex. we are told we have to ask a pt their name and birthdate and check the id band with each and every med we give no matter how well we know the patient. If I was a pt, I'd start to be suspicious of a nurse who never seemed to know my name! Not to mention the annoyance when you are sick!

What kind of quality care will patients get if there is no one to do it?

I'm angry with JACHO! Dare I say that???

rileygrl11, BSN, RN · Jul 20, 2003

Our hospital had our visit last fall. They were very interested in pulling "new" RN's off the floor to question. At the time, I had just graduated that past spring and was the one she wanted because I had the least time in as an RN. The surveyor also was an RN. Lots of questions about pain mgmt, training & orientation, resources available to new grads, privacy issues, how approachable management was by staff with concerns & problems. All the while having management sit and watch you answer the questions with that look of "PLEASE don't blow this for us!" Talk about stress!

pickledpepperRN · Jul 20, 2003

Nurses at California Nurses Association hospitals ask for a Private Interview with the JCAHO team which includes the state DHS and Medical Board.

They prepare and tell the truth.

NO administrators in the room. (They are nervously outside the room.

This is one chance to tell of staffing, competency (floats & registry) equipment & supply, and other concerns.

The JCAHO results are secret because the $$$ is paid by the hospital, but they have certain rules. Many I think truly care.

Not a bad idea to give the management some stress.

Now management is MUCH more likely to listen to nurses concerns because they want the nurses to tell JCAHO about problems solved rather than problems contunuing. (or fixed for the survey). TELL THE TRUTH!

Do you get the best ever staffing?

Cleanest facility?

New IV poles and so on just for JCAHO?

AMV · Jul 20, 2003

We just had our JCAHO survey. In the weeks leading up to the survey our hospital replaced all draperies in patient rooms, the mattresses for the beds and did a lot of painting, etc. etc.

We had mandatory inservices on what questions they would likely ask. BIG one's were patient rights, privacy as well as the two ways they look for us to identify pt's when giving meds, etc - (which are asking - not verifying - pt their name and DOB). Also make sure we knew the RACE acronym for fire drills and how to call a code and where extinguishers were. Also restraints were going to be a big thing they were going to look at - as well as check charts for Dr's order renewed every 24 hours and nursing documentation every 2 hours.

We had heard from another hospital that they would lock themselves in an empty room and pull the bathroom emergency cord. Sure enough they did this on every unit. We all had our dimes ready in our pocket (this is what opens the locks on the door) when we opened it, the RN was standing in the bathroom looking at her watch as well as several people from administration standing in the dark room with anxious looks on their faces. I guess on one of the units the alarm didn't work! OPPS!!

The survey was Tues thru Thur. We found out that they would be on our floor Thur (although the bathroom thing was on Wed). I worked Tues and Wed and staffing was GREAT on those days. I work on the PCU and 4 patients is ideal, but we always have 5. On Tues and Wed we had charge plus 6 which meant we had 3 or 4 patients!! On the day they were scheduled to be there they had charge plus 8!!! Amazing... I didn't work, but heard that there was so much staff present that everyone was tripping over each other.

And guess what? The next day (Friday) staffing was so bad (I didn't work that day thank goodness) that most of the staff was there till 9pm (7a - 7p) shift. I worked yesterday - Saturday and we were one nurse and one tech short and the charge had to take patients. The night shift coming on last night was also short and had no tech and no tele tech so the charge had to be unit secretary, tele tech and stay at the desk. Surprise surprise!!

I want my hospital to do well, and of course with staffing and preparation, we did, but I sure wish instead of being so focused for this ONE EVENT - the hospital would be more focused on the needs of the patients and the staff EVERYDAY. We have a great group of people and it just stinks. Why can't they see the bigger picture?? I have heard some of our cardiologists voice concerns over the poor staffing. Don't they want a reputation of quality care and quality staff that gains experience and stays there for the long term?? I also know that if we felt they were commited to the staff and patients and were doing everything they could to MEET THEIR OBLIGATIONS, that we the staff would feel so much more loyal to our hospital - and they would find that they would keep their employees longer!! HELLO!!! I almost wished the surveryors would have come back unexpectedly on Friday or Saturday and could have seen what a mess it was - then the truth would be out!!

It is very disheartening. I love being a nurse and I really love my patients - but it is hard to care much for WHO you work for when you see this. We hear there is a shortage and that is the reason for the poor staffing. BALONEY! There are so many times we are short staffed and they either don't try to get extra staff or they have them and cancel them and the turn a deaf ear to our concerns. We were talking about this yesterday - we are professionals and we want to leave at the end of the day feeling like we did a good job and took good care of our patients - NOT that we just got by - by the skin of our teeth - and didn't get 15 minutes to sit down in the process....

Oh well, I have worked at hospitals with poorer staffing conditions and I think I am hoping for something that is never going to happen.

fedupnurse · Jul 20, 2003

If they want their surveys to mean anything they should be unannounced. I think all those organizations are a joke. Magnet, Joint, none of it means anything if you work in a facility that is poorly run and puts profits before patients. If they ask me anything I tell them the truth: "We are understaffed. I feel it is more important to take care of my ill patients than fill out some form your organization feels is important." Needless to say they schedule me off when the suits from oint are there...

fedupnurse · Jul 20, 2003

AMV, you are so right! Short staffing is purposely done by hospitals. They budget not based on number of licensed beds but on a bogus number called average daily census. In my facility we can never count more than the number of licensed beds we have. So if we start full and ship 10 out and get 10 in, the new 10 never count. It never averages out the low census days. I will never figure out how the suits sleep at night.