New NCCHC standards for jails

[Crawsu]

Just wondering if anyone else has addressed this yet.

New NCCHC standards require 3x a week assessment by medical and once a week for psych. According to new standards, lockdown units require 3x per week face to face interaction with a health care provider, and documentation of same. Those allowed out and able to interract will still require at least once a week face to face verbal interaction documented in chart. How are your facilities going to deal with this. We have at least one unit that houses close to 200 and will require a nurse to walk through and stop and talk with each person housed there and document same, regardless of healthcare problems. That means that if an inmate is there for some admin. reason, ie disciplinary, they will still need documentation of one on one interface.

'Anyone else dealing with the new standard for jails yet? And if so, how are you doing it, kardex for each pt. or.... We are trying to figure out the most expeditious way of handling, though so far it is looking like at least a flow sheet for each and every inmate will have to be generated to be in compliance and maintain accreditation.

Would appreciate any input as standards will be in efect by January.

Thanks in advance for any advice

[CCHP-RN]

We use a flow sheet on each inmate. We created it in excel. It pretty much looks like a regular nurses note. It has a column for: date, time, comments, signature. So far it has worked for NCCHC. One of our Jails is having an onsite inspection in November, so I will be sure by then.

If you have any other questions let me know & I will try & help!

[Crawsu]

Thanks for the input.

How many inmates do you have to do, and how long does it take you to do it? Just wondering about the logistics of staffing, etc. to cover the time it will take.

[CCHP-RN]

I am the director of nurses over several different prisons and jails. Most of our facilities have a small Segregation unit (less than 50), but since you have a larger one, I would recommend splitting the seg unit in half and documenting on them every other day. This would be 100 (more realistic). Or you could even split them up more on each shift and have days do 50 and nights do 50, etc. How you approach the inmate will determine how long it will take you. I DO NOT recommend your staff letting the inmates know that this is a requirement. Do not ask the I/M if he has any problems. Just look in on him/her and tell him you are checking on him/her. I'm sure you are aware if you ask them if they have any problems, they always do. If they are sick, they WILL let you know when you do your walk through. And I would still stick with your normal routines for sick call. So if one says he has a cold, your answer would be an instruction on the sick call process.

If all of your nurses will be consistent and not have this be a sick call walk through, it shouldn't take very long.

I try and schedule this kind of routine walk through on night shift. If you develop a good flowsheet, it shouldn't take too long to document it. None of the nurses will be happy to do it, but it is a requirement.

Hope this helps!