The Daily Adventures of Managing Surgery

Tag: regulatory

My top 10 infection control survey blunders…they may be yours too!

My top 10 infection control survey blunders…they may be yours too!

I have the privilege of assisting surgical facilities prepare for surveys.  I have seen countless wonderful, clean, well prepared centers where I would feel confident in having surgery or taking a loved one for surgery. Even in the most pristine facilities, there is sometimes an […]

Hospital transfers and the new Medicare rules…

Hospital transfers and the new Medicare rules…

When we have to facilitate a hospital transfer, we have to shift into high gear.  Not only do we have to ensure a safe and smooth patient transition, we have to re-route other facility operations as we shift focus, all while being concerned for our […]

Feed your hungry in-service binder

Feed your hungry in-service binder

Binder

In-services.  We all know the importance of training our staff, keeping them updated and communicating regularly.  If you are like me,

You swear you just had an in-service recently, go back to your records, and time has flown by.  Could that last documented in-service really have been that long ago?

How can you make your in-service documentation better? (more…)

Sharing the Hats: Delegating those non-patient care tasks.

Sharing the Hats: Delegating those non-patient care tasks.

  We have all heard it before: The key to effective management is delegation. But, if you are like me, sometimes it’s hard to let go. What if the ball gets dropped? The problem is that either can’t get it all done well, or worse, we trust […]

Nursing school lessons that stuck…if it’s not charted…

Nursing school lessons that stuck…if it’s not charted…

  One of the first things I learned in nursing school, after I put on that embarrassing apron thing over my crisp new white uniform, and after learning bed making (do they still teach that?) and hand washing, was that if its not documented, it’s […]

Banding together…Looking for better ways to identify our patients.

Banding together…Looking for better ways to identify our patients.

 

I recently worked with a facility that used red allergy bands they had

sharpie markered with each patient’s allergies. They get kudos for patient

safety, but it was definitely not the most efficient practice.

I could just see the staff going through each chart, writing the list of

allergies on each band, and placing it on the chart to later place on the

patient for surgery.

The process offered an opportunity to consider patient identification in

general.

We all know to use two identifiers to check to make sure we have the

right patient. However, is the person who places the identification band

on the patient requesting that the patient verify the information is correct

prior to placement? It is much easier and safer to correct before placing

the band on the patient.

Are staff are remembering to look at the identification band and having the

patient state the information? We all know how agreeable patients can be

after a little Versed. Check out the process in your facility. The result of

the observation can provide a nice quality study to boot.

Where do you look to verify allergies? Since allergies need to be part

of the pre-operative assessment, it is a good idea to have one common

space in the medical record that everyone references to verify allergies.

Paper records often allow for several locations where allergies are

documented, and updates may get missed.

In case you were wondering, the facility that was using the sharpie the

red band method has updated their process to use color coded bands with

patient identification stickers. Those without allergies get white bands,

and those with get red bands. Everyone gets asked about allergies, but

the red band provides an alert.

They also use a yellow band on extremities that cannot be used (ie:

mastectomy, shunt), so that there is a clear indication not to use the

limb for interventions. I loved this idea. The process adds to the

patient’s safety and clearly identifies the issue if missed in hand-off

communication.

Take a quick second look at your policy, make sure it matches your

process by doing an observation, and document the task as a quality study

to report to your board. You’ll either have confidence that everyone is

doing a great job, or you may shore up your processes. You may even

retire a sharpie or two.

Safety Data Sheets….who is keeping up the book, what needs to be included, and what happened to the “M”??

Safety Data Sheets….who is keeping up the book, what needs to be included, and what happened to the “M”??

  We have always called it the MSDS book.  It typically lives somewhere in the facility where all can reference it, right? Did you know the “M” went away? Yup.  No more MSDS.  I guess we can call it the “SDS” book, or the Safety […]

CMS Quality Reporting.  No, it was not created just to add one more thing to our plates.

CMS Quality Reporting. No, it was not created just to add one more thing to our plates.

  CMS describes it as a way to promote more efficient health care for Medicare beneficiaries. It can be overwhelming. Between registering for access, understanding what, how, and when to report, it is stressful. Especially considering that, if not done right, reimbursement may be affected.