Nursing

Experts offer advice on how to comply with JCAHO's patient safety goals

Nurse Leader Weekly, February 21, 2003

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The patient safety goals of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) went into effect January 1, 2003. Surveyors will ask what your facility measures to prove compliance, says a source close to the JCAHO. "They will want to see that you are monitoring and complying with the goals," the source says.

Goals compliance is also a focus of the random unannounced survey. Consider the following compliance tips (for goals one through four) from a source close to the JCAHO observer.

Goal #1: The accuracy of patient identification- By taking a "time-out" in the operating suite when the patient is on the table but before the surgical or invasive procedure has begun, employees must verify for the last time the correct patient, procedure, and surgical site.

TIP: The JCAHO expects you to document that you took this pause.

Goal #2: The effectiveness of communication among caregivers-Whoever takes verbal or telephone orders must verify them by reading back the complete order.

TIP: It is acceptable to repeat back the order and then write it down, but surveyors prefer that you write down the order and then read it back.

Goal #3: The safety of using high-alert medications-Remove concentrated electrolytes (including potassium chloride [KCL]) from patient units.

TIP: It's okay to have KCL in certain key areas, but only if you first perform a risk assessment and take additional fail-safe steps to alert others that KCL is a high-risk drug.

Goal #4: Eliminate wrong-site, wrong-patient, and wrong-procedure surgery-Create a preoperative verification process, such as a checklist.

TIP: While printed information suggests using a checklist, the JCAHO wants to see you use a checklist that starts when a patient comes in for the initial assessment. The expectation is to mark the site, not the nonoperative site. Some organizations mark "no" for the wrong site, but depending on where a staff member stands, it could appear as "on."

Adapted from: Briefings on JCAHO, www.hcmarketplace.com/Prod.cfm?id=16&S=ENMW.



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