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Comment period open on JCAHO's revised anesthesia standard, new immunization standard

Accreditation Connection, January 23, 2006

The JCAHO is accepting comment on its proposed revisions to a standard for plan of care for anesthesia and a proposed new staff influenza immunization standard.

Comment will be accepted through February 12 and may be submitted using an electronic questionnaire, accessed via the JCAHO Web site or by clicking here.

The changes to standard PC.13.20 (plan of care for anesthesia) would affect the accreditation manuals for ambulatory care, behavioral healthcare, critical access hospitals, hospitals, long-term care, and office-based surgery. The standard's Element of Performance 11 requires that a licensed independent practitioner (LIP) with appropriate clinical privileges either plan the administration or concur with the planned administration of moderate to deep sedation or general anesthesia.

A group of experts has recommended replacing the word "concur" with "agree," and stipulating in the standards that both the practitioner administering the moderate to deep sedation or general anesthesia and the practitioner performing the procedure must agree that the patient is an appropriate candidate for the planned level of sedation or general anesthesia. Proposed standards language also addresses the role of the LIP when neither the practitioner performing the procedure nor the person administering sedation or general anesthesia are LIPs (e.g., a certified nurse midwife and a certified registered nurse anesthetist in some states).

The proposed staff influenza immunization standard would affect the accreditation manuals for ambulatory care, behavioral healthcare, critical access hospitals, home care, hospitals, long-term care, and office-based surgery.

Through this field review, the JCAHO seeks comment on whether influenza vaccination should be made mandatory for caregivers in various healthcare settings, as well as what categories of individuals should receive vaccinations, whether the option to decline vaccination for legitimate or other reasons should be provided, and whether and how organizations can track how many employees decline vaccinations.

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