This is from JCHO....

How many of you are taking the temps of each and every visitor to your unit? My friend just emailed me and told me that they, and several other hospitals, were asked this! You've got to be kidding me.

So, are you doing this during RSV season?

And what do you do if you have a visitor with a very high temp? Now you have begun physical treatment and are responsible for their care. What if they had some raging infection and went home and died? You bet the family would have mentioned that an RN had evaluated him just before.

I've had family members ask if we could take their BS or BP-and some techs have done it. But, once you get a reading that is out of the norm, now you are responsible for it.

No way would I begin treatment on someone who is not a pt in the hospital. It's dangerous territory...

You'd have to post a link to the JCAHO site that says that. On its face, that's simply not credible. You would be creating pt/nurse relationships with EVERY visitor, a liability issue beyond compare.

Now, throw in the necessary HIPAA protections and documentation for the healthcare you are initiating. Throw in follow-up care: at your hospital's dime due to EMTALA.

Throw in legal challenges to refusing to allow somebody to see a family member.

Throw in EBP challenges that a temp alone is NOT enough to ensure contagious free access: what OTHER measures are you going to use in tandem with temps: and what liability entails for failure to appropriately screen?

What about workers? Do you send somebody home? Everybody they were exposed to BEFORE you temp'd them?: because they are now potential 'carriers' in a latent period.

Shoot, every nurse that takes a temp and notes a fever NOW becomes a 'latent' germ carrier. . .

No, I doubt it.

~faith,

Timothy.

If this is a coming thing, it's just another example of someone feeling they are way more powerful than they are. And we need to "just say no" to this silliness.

I suspect it might be your management who is wanting this, but saying it's from JCAHO. Recently we were given a form to sign stating that said it was a JCAHO requirement to give a reason why you didn't want a flu shot if you didn't take it. Excuse me? When did JCAHO start making laws? And what about the privacy of nurses as individuals?

Someone needs to take them down a peg or three and let them know they need to get back to the real world.

Sure why not, all we do in the NICU is hold and rock and feed babies anyway. We have all the time in teh world to perform a MSE on every single visitor that comes in.

This smacks of urban legend to me.

Perhaps certain facilities are doing it since it's the cold/flu/RSV season?

But I haven't come across that in any of the JCAHO standards.

This is a copy of the letter she sent to me...It didn't come from our management, and it isn't an urban legend. I left the hospital name on it and took off the people's names. Gee, I can't wait until they come to us! I'd like to know where they come up with this stuff!

Hello Everyone,

I thought I would give you an update on our JCAHO visit so we can all benefit from each other. Here is what they focused on. They spent an entire day with us on our floor (LDRP and NICU). They asked to be paged when we did a c/s so they could observe, they observed a circumcision, followed a patient who came in to the ED s/p mva but pregnant and followed her to our floor (tracer). One thing I learned-don't offer any information they don't ask, only answer what they asked. The surveyor asked a nurse about our relationship with other departments like the ICU when we had critical patients like DIC and the nurse thought she was being helpful and told her about a past patient and the surveyor asked for the patient's name and went to medical records and pulled her chart to see what was documented, etc. Sorry for the long email but I was very surprised by how much time they spent on our floor.

--Hand hygiene-washing your hands when you enter any room and when you leave

--They watched a circ-wanted the betadine and water labeled on the sterile field (they asked the nurse how she knew the difference between betadine and water -her answer that betadine is brown didn't work)

--Time outs before circ and c-section observed

--They observed a c/s-watched for circulator not wearing gloves when documented in computer

--no chairs next to COW'S in the hallway (no unattended COW's for >30min)

--Bring kardex with you to the bedside with you when you give meds, use two identifiers

--they questioned staff on other floors/departments about infant abduction drills and what there role was

--asked how we screen for child abuse

--follow up documentation for temperature outliers

--no mixing meds even if pharmacy closed

--every nurse or doctor they questioned they took her name down and went to HR and looked up their credentials, competencies, expiration dates on CPR, NRP, etc

--focused on hand offs (nurse-nurse AND physician-physician)

--specimens labeled at bedside prior to sending

--VERY focused on teaching; asked to watch a nurse give bath demo, discharge teaching, watched LC give breastfeeding teaching; wanted to see pt response to teaching documented in computer; asked to see labor teachings-kept asking "how do you know your patient understood what you taught her"

--Liked the alarms for FHR in OBTV

--asked about backups of system, wanted to see downtime policy

--asked how we screen visitors for the flu, RSV season, etc. Wanted to know if we took every visitors temperature before being allowed in OB/NICU (anyone doing that??)

--asked about calling kidney-1 and organ donation for demises

--asked staff who shuts off the main medical gas valves

--documentation of immunizations for patients (flu vaccine, pneumococcal etc)

--reassessment of pain after giving pain medication

--All PRN meds had a PRN reason listed

--No range orders (i.e. 1-2 Percocets for pain, 2-4mg MSO4 for pain) (said the nurse is prescribing meds)

--asked about how we handle the two systems (meditech and OBTV) not being interfaced, asked if there were plans for this to happen in the future, what we did about pharmacy needing access to allergies, ht/wt for dispensing meds .

--wanted to see auto generated consults to SS if the patient asked for more advance directive information, gest diabetics and dietary consults.

Sorry for the long list. All in all we did well. Most of the stuff they said "were recommendations"

Perinatal Information Nursing Systems Administrator

Maternal Child Services

PA

Our visititation policy allows siblings of the baby to visit, regardless of age, (personally I don't agree with that but that is for another thread) and we take their temps all year round but no adult temps.

What is a COW??

Computer On Wheels (at least by us)