The Joint Commission’s latest National Patient Safety Goals for the Ambulatory Health Care Program, effective as of July, includes a few minor changes, but also emphasizes the importance of preventing mistakes in surgery and surgical site infections (SSIs).
The COVID-19 pandemic is not mentioned, but the guide provides fresh context to the accreditation organization’s emphasis on handwashing and infection prevention.
“The Joint Commission continues to require organizations to comply with the following requirements related to hand hygiene to provide protection at all times, including during the current pandemic,” says Maureen Vance, MSN, RN, clinical project director in the department of standards and survey methods for The Joint Commission.
In the first goal (NPSG.01.01.01), The Joint Commission’s refreshed recommendations focus on how to identify patients correctly. The guideline authors say surgery staff should “use at least two ways to identify patients.” One way could be the patient’s name and date of birth. Other identifiers could be the patient’s assigned identification number, phone number, or another person-specific identifier.
The guideline authors also recommend using hand-cleaning guidance from the World Health Organization. Other notable updates:
• Provide equipment and supplies, such as soap and water and hand sanitizer gel, to support infection prevention and control activities, including hand hygiene (IC.01.01.01 EP 3).
• Develop and implement written infection prevention and control goals that address prioritized risks; limit unprotected exposure to pathogens; limit the transmission of infections associated with procedures; limit the transmission of infections associated with the use of medical equipment, devices, and supplies; and improve compliance with hand hygiene guidelines (IC.01.04.01. EP 1).
• Use standard precautions, including personal protective equipment, to reduce infection risk. These precautions are general and applicable to all patients. For further information regarding standard precautions, refer to the Centers for Disease Control and Prevention (IC.02.01.01 EP 2).
• Implement methods to communicate responsibilities for preventing and controlling infection to licensed independent practitioners, staff, visitors, patients, and families. Provide information for visitors, patients, and families that includes hand and respiratory hygiene practices. Information can be communicated through different forms of media, such as posters or pamphlets (IC.02.01.01 EP 7).
The latest revision contains no new National Patient Safety goals (NPSGs), Vance says, but they do include revisions in these areas:
- NPSG.01.03.01: Transfusion errors, which is moved to PC.02.01.01;
- NPSG.03.06.01: Accurate medication information, which contains editorial changes to EPs 2 and 4;
- NPSG.07.05.01: SSIs, which was moved to IC.02.05.01 and PI.02.01.01. “The changes made to NPSG.03.06.01, accurate medication information, were limited only to editorial revision, including the removal of notes in both EP 2 and 4,” Vance says. “The intent of the requirements in NPSG.03.06.01 has not changed.”
Also, the revised version has removed the notes in EPs 2 and 4. “The notes in EPs 2 and 4 were removed to eliminate confusion and to provide clarity and consistency, based upon feedback we have received from the field,” Vance explains.