Joint Commission?

There is absolutely no way in heck this would fly with us. Joint commission? Nonsense. I work a 12-hour shift, meaning I come in halfway through the evening shift. Most of the time I get report fast and furious as the nurse leaving from 12 hour day shift is tired and trying to get last-minute things done and chart. Then I run out the door and begin checking for what needs to be done right now (and sometimes, that last nurse is also getting a last-minute thing done then too). Who has time to walk around introducing the next shift and looking at IVFs together?? Waste of precious time, and if there IS a fluid wrong or running low or who knows what, nothing is corrected with two people that one could do.

The nurse leaving lets the pts know she's going off soon and the next nurse will be on soon. If she knows, she'll give that nurse's name to the pts. Beyond that, forget it.

Does your hospital make you go in the patient room with the oncoming nurse at shift change, introduce yourself, check IVF, etc. etc? The floor I work on just started making us do this, they are 'blaming' it on Joint Commission, which I don't buy. I can't find anything at the Joint website about this being a Joint requirement. A few smaller floors have been doing this for a while, but not the large floor I work on, then suddenly we are made to do this. It doesn't work well in pediatrics and is unnecessarily interruptive.

Two hospitals that I worked at required this. One was where it was "re-instated" called them walking rounds or walking report of shift or something. I think they did claim it was Joint commission but, don't really remember.

Thing is, no one went into the room to check things, the nurses ended up just standing in the hallway to give the report!

Gen

This sounds to me like your hospital's answer to the "hand off", JC's push for better communication between health care providers. It sounds like quite a luxury that most of us don't have - to have the time to do bedside report for all of your patients. I can see that being a good way for report in an ICU when you have one or two patients, or when you are one on one with a labor or PTL patient, but not when you have 5-15 patients.

Good luck. I would imagine the hospital will get tired of paying the overtime necessary to make this work and the complaints they will start getting from patients. If I have to wake up a patient in the middle of the night, I only want to do it once if possible; once to do report and once to do my assessment in one too many times.

It's JCAHO's National Patient Safety Goals. It's Goal #2E; improve the effectiveness of communication among caregivers; implement a standard "hand off".

How your hospital interprets how to accomplish this goal is individual but has to make JCAHO happy when they come to visit.

I hatehatehate!!! when a manager/charge nurse spouts off "It's JCAHO's fault" and it really isn't; it's just a hospital rule. But they know that we can argue hospitals regs but we all know we can't argue or debate if it's a "Joint Commission thing".

But this issue seems to actually have some basis. No; it doesn't say you have to make walking rounds; but this is how your hospital is interpreting it, perhaps how a consultant advised them JCAHO likes to see it done.

Here's the link to JCAHO's National Patient Safety Goals for Hospitals:

http://www.jointcommission.org/PatientSafety/NationalPatientSafetyGoals/07_hap_cah_npsgs.htm

What JCAHO is requiring is improved communications. The method you described is not feasible unless every off-going nurse was handing over patients to ONE on-coming nurse. Otherwise, somebody has to wait for report while the correct nurse is in a patient room. Waste of time. I can see where this would actually SLOW DOWN patient care.

We have this hand off tool. I hate it. On the other hand ER loves it because they fill it out and fax it to the floor- if we don't call in 15 minutes to ask questions, they send the patient up!:angryfire

It is so ironic that were are having this discussion, because just this morning while waiting for my father to be seen in the ER, the doctors that were going home made "rounds" with the doctors that were just starting their shift. And this is at a hospital in NYC.