Nursing

Get in line with JCAHO abuse-prevention rules

Nurse Leader Weekly, October 3, 2005

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Statistics have shown that an estimated 1 million to 2 million people age 65 or older in the United States have been injured, exploited, or mistreated by a caregiver. Between birth and age three, infants and toddlers are victimized at a rate of 16.4 per 1,000 children in the same age group.

Therefore, it is no surprise to healthcare organizations that the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) continues to drill down on hospitals' abuse and neglect procedures. The JCAHO expects hospitals to have processes in place to identify victims of abuse.

JCAHO guards against abuse

Ethics, rights, and responsibilities standard RI.2.150 defines the patient's right to be free from mental, physical, sexual, and verbal abuse; neglect; and exploitation.

The two elements of performance under this standard require hospitals to protect patients from these forms of abuse by other patients, staff, volunteers, students, and others with access to them. The hospital also is required to investigate all allegations, suspicions, or observations of abuse.

Develop abuse criteria

The provision of care standard PC.3.10 discusses the assessment of the patient who may be a victim of abuse and includes seven elements of performance with which hospitals must comply.

Develop criteria to identify the victim. Such criteria may include the following:

  • Injuries inconsistent with what the patient reports to have happened (e.g., burns, welts, bites, and scratches)
  • Unusual patterns of injury (e.g., hairbrush, rope, or belt marks
  • Poor hygiene
  • Malnourishment
  • Fear of parent or caregiver
  • Being withdrawn or tearful

Obtain a referral list of private and public agencies to use as resources. Educate your staff about them and other reporting mechanisms, including appropriate law enforcement agencies and child or adult protective services. Immediately notify hospital personnel of any suspected abuse within the hospital itself. 

Source: This article is adapted from Briefings on JCAHO, September 2005, HCPro, Inc.



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