What is the National patient safety goal 6 to improve the safety of clinical alarm systems?

Goal 1: Identify Patient Correctly: Acceptable identifiers include: the individual's name, an assigned identification number, a telephone number, or other person-specific identifiers, such as date of birth and hospital I.D. The patient's/resident's room number or physical location is not used as an identifier.(Applies to Ambulatory, Behavioral Health Care, Critical Access Hospital, Home Care, Hospital, Laboratory, Nursing Care Center, Office-Based Surgery.)

Students need to be aware of the identifiers used at their assigned health care organization.

Make sure that the correct patient gets the correct blood when they get a blood transfusion: Match the blood or blood component to the order; Match the patient to the blood or blood component; and Use a two-person verification process or a one-person verification process accompanied by automated identification technology, such as bar coding. (Applies to Ambulatory, Critical Access Hospital, Hospital, Office-Based Surgery.)

Goal 2: Improve Staff Communication:Get important test results to the right staff person on a timely basis. (Applies to Critical Access Hospital, Hospital, Laboratory.)

Goal 3: Improve the Safety of Using Medication:Label all medications, medication containers, and other solutions on and off the sterile field in perioperative and other procedural settings. Note: Medication containers include syringes, medicine cups, and basins. (Applies to Ambulatory, Critical Access Hospital, Hospital, Office-Based Surgery.)Reduce the likelihood of patient/resident harm associated with the use of anticoagulant therapy. (Applies to Ambulatory, Critical Access Hospital, Hospital, Nursing Care Center.)

Documentation of patient education and detailed discharge instructions are vital to this goal.

Record and pass along correct information about a patient’s/resident's medicines. Find out what medicines the patient/resident is taking. Compare those medicines to new medicines given to the patient/resident. Make sure the patient/resident knows which medications to take when they are at home. Tell the patient/resident it is important to bring their up-to-date list of medications every time they visit a doctor. (Applies to Ambulatory, Behavioral Health Care, Critical Access Hospital, Home Care, Hospital, Nursing Care Center, Office-Based Surgery.)

Goal 6: Reduce the Harm Associated with Clinical Alarm Systems:Make improvement to ensure that alarms on medical equipment are heard and responded to on time.(Applies to Critical Access Hospital, Hospital.)

Goal 7: Reduce the Risk of Health Care Associated Infections:

Use the hand hygiene guidelines from the Centers for Disease Control and Prevention (CDC) or the World Health Organization (WHO). Set goals for improving hand cleaning. Use the goals to improve hand cleaning. (Applies to Ambulatory, Behavioral Health Care, Critical Access Hospital, Home Care, Hospital, Laboratory, Nursing Care Center, Office-Based Surgery.)

• Implement evidence-based practices to prevent central line-associated bloodstream infections. (Applies to Critical Access Hospital, Nursing Care Center.)
• Implement evidence-based practices to prevent health care-associated infections due to multi-drug-resistant organisms in acute care hospitals. (Applies to Critical Access Hospital, Hospital.)
• Implement evidence-based practices for preventing surgical site infections. (Applies to Ambulatory, Critical Access Hospital, Hospital, Office-Based Surgery.)
• Implement evidence-based practices to prevent indwelling catheter-associated urinary tract infections. NOT APPLICABLE TO PEDIATRIC POPULATION. (Applies to Critical Access Hospital, Hospital.)

Goal 9: Prevent Residents From Falling:Reduce the risk of falls. (Applies to Home Care, Nursing Care Center.)

Goal 14: Prevent health care associated pressure ulcers (decubitus ulcers)

• :Assess and periodically reassess each resident’s risk for developing a pressure ulcer and take action to address any identified risks. (Applies to Nursing Care Center.)

Goal 15: Identify Patient/Resident Safety Risks

• Identify patients/residents at risk for suicide. APPLICABLE TO PSYCHIATRIC HOSPITALS & PATIENTS BEING TREATED FOR EMOTIONAL OR BEHAVIORAL DISORDERS IN GENERAL HOSPITALS. (Applies to Behavioral Health Care, Hospital.)
• Identify risks associated with home oxygen therapy such as home fires. (Applies to Home Care.)

Universal Protocol: The organization meets the expectations of the Universal Protocol.

• Prevent Mistakes in Surgery.
• Conduct a pre-procedure verification process. (Applies to Ambulatory, Critical Access Hospital, Hospital, Office-Based Surgery.)
• Mark the procedure site. (Applies to Ambulatory, Critical Access Hospital, Hospital, Office-Based Surgery.)
• A time out is performed before the procedure. (Applies to Ambulatory, Critical Access Hospital, Hospital, Office-Based Surgery.)

WHAT DOES A STUDENT NEED TO KNOW FOR A JOINT COMMISSION SURVEY?Occurrence Reporting

An event, regardless of the degree of seriousness at the time of occurrence should be reported per health care organization’s policy. Examples of occurrences for employees, medical staff, patients/residents, students, visitors, and volunteers include: personal injury (falls), medication error or potential error that was "caught" before it reached the patient/resident, property damage, theft, adverse drug reactions, transfusion reactions, and privacy violations. If you are involved with or become aware of an occurrence, please notify the nursing staff and your instructor immediately.

Occurrence reporting is not punitive! It is a process of identifying:

• Opportunities for improvement.
• Potential claims.
• Sentinel events.
• Peer case review.

 Sentinel Events

A sentinel event is an unexpected patient/resident occurrence that results in, or could result in, death or serious harm to the patient/resident. The purpose of reporting and investigating sentinel events is to improve the quality of patient/resident care by focusing attention on underlying causes and risk reduction and to increase the general knowledge about sentinel events, their causes and prevention. This reporting is not punitive.

Sentinel Event Alerts identify specific sentinel events, describes their common underlying causes, and suggests steps to prevent occurrences in the future. The Joint Commission uses Sentinel Event Alerts to identify potential new Safety Goals and Requirements. Examples of Sentinel Event Alerts include:

• Wrong site surgery.
• Suicide.
• Restraint deaths.
• Transfusion errors.
• Falls with injury.
• Look-alike, sound-alike and high alert medications.

 What Might Happen if a Student is Caring for a Patient/Resident Picked for a Tracer during a survey?

If a student is caring for a patient/resident selected for a tracer (patient/resident selected to be tracked and followed) they may be asked to speak with the surveyor. Surveyors are interested in learning how the student fits within the organization and its processes.

The surveyor may also take the student’s name and request to see documentation about the hospital-school affiliation agreement, orientation to the facility, and other information showing the student’s fitness for duty.

Here are some topics a student should be prepared to discuss with the surveyor:

• Knowledge about the patient/resident and care the patient/resident is receiving.
• Orientation to the facility – addressing safety, emergency codes, infection control, etc..
• Oversight of the care given by the student/supervision of the student – who, what, when, how often.

• What else might the surveyor do?
• The surveyor may ask to watch the student pass medication. If so, they are looking for infection control, medication safety, patient/resident identification and medication administration process steps.
• As part of general observation on the unit, the surveyor will also be watching for proper hand hygiene. This will be heavily scrutinized during the survey.

REFERENCE

• The Joint Commission on Accreditation of Healthcare Organizations (2015). Facts About the National Patient Safety Goals. Retrieved fromhttp://www.jointcommission.org/facts_about_the_national_patient_safety_goals/default.aspx.

• The Joint Commission on Accreditation of Healthcare Organizations. (2015). 2015 National Patient Safety Goals. Retrieved fromhttp://www.jointcommission.org/standards_information/npsgs.aspx.

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