Quality & Patient Safety

Joint Commission rescinds interim rule on MM.4.10

Patient Safety Monitor Alert, April 18, 2007

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The Joint Commission has rescinded the interim rule on Medication Management standard 4.10, element of performance 1 (MM.4.10, EP 1). The change means the rule as written takes effect, and a pharmacist must check first-dose medication for all patients in the emergency department, according to a Joint Commission memorandum published by the American College of Emergency Physicians (ACEP).

 

Instituted on January 1, the interim rule had allowed hospitals to use a retrospective examination of first-dose medications. The change requires pharmacists to review all orders unless "unless a licensed independent practitioner controls the ordering, preparation, and administration of the medication; or in urgent situations when the resulting delay would harm the patient, including situations in which the patient experiences a sudden change in clinical status."

 

The ACEP opposes the change, saying it puts an unreasonable onus on emergency department personnel and will slow patient care, leading to bad outcomes. The ACEP has been in contact with The Joint Commission about the change and has been told the accrediting body will review the standard and the criticisms against it in the next several weeks.



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