OK who else is dealing with Universal Protocol?

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:banghead:I am having a hard time dealing with the new Universal Protocol from The Joint Commission starting Jan 2009. Time out before anesthesia, time out before procedure, marking of patient by the MD only. I'm ready to get out of healthcare completely!! Does anyone feel the same, or am I just crazy? So many rules......

Specializes in OR, PACU, ICU, ER.

Hey Karnit:

Here ya go, this is the website for the new standards on universal protocol:

http://www.jointcommission.org/PatientSafety/UniversalProtocol/

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Does anyone know where I can download a Universal Protocol compliant timeout form/checklist that incorporates all aspects of the protocol? If it's not downloadable, would anyone be willing to send me a paper copy of your institution's paperwork? Thanks.

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Specializes in 2 years school nurse, 15 in the OR!.
Most of these things have been practiced by our OR for over 2-3 years now so I've come to accept it as part of every day work. We don't take our patients to the OR without consent or H&P or mark on laterality. There is also a form that needs to be signed by a surgeon. The surgeons know that it would just delay their case if they don't do that.

Not sure why these are big changes to your facility, it feels like we have been doing time-out for years now. Every surgeon, anesthesiologist and staff knows this must be done and we all stop and do it before each case starts.

I guess I would be frustrated too if others just disregard it. I do feel that doing these things will produce a safe patient outcome.

I think you are misunderstanding. We all have been doing timeouts for years now as well. We have made sure the site was marked, there was a consent and a H & P. We are not used to 10 minute timeouts...We all want our patients to be safe and that's not why we are frustrated. It is because now there are tons of things we have to ask. Not only a time out, but we have to state the position, the irrigation, the medications, the implants, the x-rays, the surgeon, etc...

We are expecting Joint Comission anyday now....Wish us luck!

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Specializes in US Army.

As usual, the default enforcer of the policy is the RN... We should get extra pay for all of those additional "law enforcement" duties. :smokin:

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Specializes in Wound care, Surgery,Infection control.
no freakin kidding i thought we were the only ones with this problem.... it is sooooooo confusing it's like every day we come to work with new sets of rules!!! i mean i have no clue what the "correct" way of doing things are anymore it seems like things change every minute!!!!!! the thing that frustrates me the most is trying to get the surgeons to comply and dealing with them when they whine and complain and then refuse to do things...... then comes all the additional paperwork they throw at us to justify our every sniffle..... for example we have always done time outs but now we have to state things like

patient name, date of birth, age

type of antibiotic what time

type of surgery, where, and if it was initialed.... not marked

any beta blockers or anticoagulants

what position

if the prep is dry

if the correct x-rays are up or images

what type of implants.... if they are available as well as instruments

blood products

safety precautions/patient history

if the surgeons have any comments

plus we have to do it while looking at the patient's arm band... as well as consent.... while at the same time making sure every eye is on you.... oy then we have to mark down the time we did the time out on the patients chart as well as fill out a whole lengthy sheet to put in the patients chart everything we said on the time out as well as who was there...... aaaaaaaaaaaaaaaaaaaaaaaaaahhhhhhhh!!!!!

to all my fellow operating room nurses who are complaining about universal protocol , i must say i am not only stunned by your comments but disappointed at your ability to adapt a standard of care that helps ensure patient safety. sammy if you are confused by this new protocol why don't you ask for help to clarify ? you seem angry that changes were implemented that might take up your time . let me ask all of the people that have posted with negative comments : if it was you or your mother , father, sister, brother or best friend on that or table don't you think it would be important that they were identified , marked and proper procedure confirmed ? and lets not forget the little things that could lead to unnecessary death : having the right instruments available , having blood ordered ,having the correct implant or suture . tell me you have never waited with the patient on the table for a drill or a tray to come out of the autoclave because it was used in another room . i have. have you ever found out the or table was the wrong one and had to move the patient intubated to the correct one? i have.

we are in the or for one reason : to ensure patient safety. you can redo paperwork , you can't redo some of the needless mistakes that have resulted in many tragic outcomes . and before you think i am some wank on a high horse , i am not. i am a nurse that had a patient die during a routine outpatient procedure due to poor planing and lack of a vital instrument tray that was out on loan and nobody noticed . please be careful with everything you do and everyone entrusted to your ( our ) care .

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Specializes in O.R., pediatrics, gynecology, surgical.

anyone, please give or provide me a copy of this new protocols... maybe i'm outdated... thank you

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