There is something to be said for the hard hat, that orange life jacket and a rope-secured harness. They have saved the lives of many construction workers, boaters and rock-climbers over the years. Even though it represents an extra expense and a bit of a hassle, deploying safety equipment and observing safety strategies have been shown to avert disaster. For many organizations, safety must come first.
That is surely the case with medical facilities and those who’ve taken the Hippocratic oath to “first, do no harm.” Safety comes first. And the Joint Commission (JC) clearly agrees with this safety-first mantra, as is evidenced by their recent publication of their 2023 National Patient Safety Goals (NPSGs). There are 16 of these goals, and the JC has set an effective date of July 1 of this year for these NPSGs to go into place. It might be helpful, then, to take a look at a representative few of these goals, so that hospital administrators can know what the JC expects in the area of patient safety standards in U.S. medical facilities.
Hospital staff should use at least two patient identifiers when administering medications, blood, or blood components; when collecting blood samples and other specimens for clinical testing; and when providing treatments or procedures. The patient’s room number or physical location is not used as an identifier. Staff should also label containers used for blood and other specimens in the presence of the patient.
When it comes to newborns, distinct methods of identification should be used. Examples of methods to prevent misidentification may include the following:
- Distinct naming systems could include using the mother’s first and last names and the newborn’s gender (for example, “Smith, Judy Girl” or “Smith, Judy Girl A” and “Smith, Judy Girl B” for multiples).
- Standardized practices for identification banding (for example, using two body sites and/or bar coding for identification).
- Establish communication tools among staff (for example, visually alerting staff with signage noting newborns with similar names).
It is critical to cut down on errors in patient identification, and this new JC goal implementation protocols will go a long way in achieving this priority.
The goal here is to label all medications, medication containers and other solutions on and off the sterile field in perioperative and other procedural settings. Medication containers include syringes, medicine cups and basins. Here are some specifics that the JC is looking for hospitals to accomplish in this area:
- In perioperative and other procedural settings both on and off the sterile field, label medications and solutions that are not immediately administered. This applies even if there is only one medication being used. An immediately administered medication is one that an authorized staff member prepares or obtains, takes directly to a patient, and administers to that patient without any break in the process.
- In perioperative and other procedural settings both on and off the sterile field, labeling occurs when any medication or solution is transferred from the original packaging to another container.
- In perioperative and other procedural settings both on and off the sterile field, medication or solution labels include the following:
- Medication or solution name
- Amount of medication or solution containing medication
- Diluent name and volume (if not apparent from the container)
- Expiration date when not used within 24 hours
- Expiration time when expiration occurs in less than 24 hours
Clinical Alarm Systems
While the JC acknowledges that universal solutions have yet to be identified, it is nevertheless critical for hospitals to understand their own unique situation and to develop a systematic, coordinated approach to clinical alarm system management. Standardization contributes to safe alarm system management, but it is recognized that solutions may have to be customized for specific clinical units, groups of patients, or individual patients. This NPSG focuses on managing clinical alarm systems that have the most direct relationship to patient safety.
Facility leaders should establish alarm system safety as a hospital priority by first identifying the most important alarm signals to manage based on:
- Input from the medical staff and clinical departments
- Risk to patients if the alarm signal is not attended to or if it malfunctions
- Whether specific alarm signals are needed or unnecessarily contribute to alarm noise and alarm fatigue
- Potential for patient harm based on internal incident history
- Published best practices and guidelines
After identifying the above, the hospital should then establish policies and procedures for managing the alarms.
These are just a few of the national goals that will be put into place later this year by the Joint Commission. For a look at the full list of JC goals, please click on the following link: 4900a554-af56-4b70-9988-c446385a8f12 (jointcommission.org).
With best wishes,
Senior Vice President—BPO