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Medication errors targeted in new JCAHO survey process
Examining the six steps of medication process
In light of so many providers having difficulty meeting the standard of care for medication administration, the Joint Commission on Accreditation of Healthcare Organizations in Oakbrook Terrace, IL, is taking action.
One its 2004 national patient safety goals is to improve the safety of using high-alert medications. In addition, newly organized medication standards from the Joint Commission focus more on medication processes as a system than on individual standards, says Michael Jarema, associate project director of the Division of Standards and Survey Methods at the Joint Commission. For all surveys that take three days or longer, surveyors will walk through the six steps of medication process:
The surveyors might pinpoint a specific medication and "walk it through" the organization, Jarema says. They may ask, "How would you determine how you’re going to use this drug in your facility? What are storage issues? How do you train staff?" For new medications, they might ask, "Does this medication require anything unique?" Surveyors might pull a patient’s chart and ask about any medications the patient is taking that are considered high risk, such as warfarin. They might ask staff, "How is the medication approved for use in your organization? How did you decide to use it? How frequently do you review the medication you’re using? How do you know providers are competent to use them?" If surveyors see a drug is administered in a specific area, such as pre-op, they may go to that area and talk to staff about storage and other safety issues, he explains.
Also, the Joint Commission requires facilities to have a regulation that provides a process for a nurse to contact a physician when an order isn’t legible or is the wrong dose, adds F. Dean Griffen, MD, FACS, surgeon at the Highland Clinic at Shreveport, LA.
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