Nursing

The national patient safety goals (NSPGs) for 2009 may be displayed in your break room or lunch area. You probably know most of them, and can recite some in your sleep. I thought I could use a review when preparing for the American Organization of Nurse Executives (AONE) conference in April. Locating the Joint Commission's Web site and sifting through the links was tedious, so I clicked on the link to the "Easy-to-read" documents. It turns out that these are the goals written for public use. When I compared them to the ones written for practitioners, I realized they were the same except the language was user-friendly.

I've listed the goals here, and the first 10 are for hospitals. Goals also apply to other facilities and types of care including ambulatory, behavioral health centers, critical access facilities, disease-specific care, home care, laboratory, long-term care, and office-based surgery. Each of these has a mix of the 10 goals plus others specific to the environment.

What's encouraging is that the Joint Commission will enforce the 2009 NPSGs through 2010 because they're working on new goals for 2011. The statement on the Joint Commission's site explains: "The review is being undertaken in response to concerns about the challenge some Goals represent and the need for additional information about effective approaches to addressing these challenges." I'm curious to know which goals they believe are challenging, but as you know, they can all be challenging when you're a busy nurse.

Use at least two ways to identify patients. For example, use the patient's name and date of birth.

Make sure that the correct patient gets the correct blood type when receiving a blood transfusion.

2. Improve staff communication.

Read back spoken or phone orders to the person who gave the order.

Create a list of abbreviations and symbols that are not to be used.

Quickly get important test results to the right staff person.

Manage hand-offs by creating steps for staff to follow when sending patients to the next caregiver.

3. Improve the safety of using medications.

Create a list of look-alike/sound-alike medications. Update the list every year.

Label all medicines that are not already labeled—for example, medicines in syringes, cups and basins.

Take extra care with patients receiving anticoagulation therapy.

4. Reduce the risk of healthcare-associated infections.

Meet hand hygiene guidelines.

Report Sentinel events resulting from infection.

Prevent multi-drug-resistant organism infections.

Prevent central-line-associated blood-stream infections.

Prevent surgical site infections.

5. Accurately and completely reconcile medications across the continuum of care.

Compare current and newly ordered medication for compatibility.

Give a list of the patient's medicines to the next caregiver or to his or her regular doctor before discharge.

Give a list of the patient's medicines to the patient and the family before going home. Explain the medication reconciliation list.

6. Prevent patients from falling.

Implement a fall-reduction program.

7. Help patients to be involved in their care.

Tell each patient and his or her family how to report their complaints about safety.

8. Identify patient safety risks inherent in the patient population.

Identify individuals at risk for suicide.

9. Watch patients closely for changes in their health, and respond quickly if they need help.

Request assistance for a patient with a worsening condition.

10. Prevent errors in surgery.

Create steps for staff to follow so documents needed for surgery are on hand before surgery starts.

Mark the part of the body where the surgery will be done. Involve the patient in doing this.

Universal protocols for surgery are:

Mark the procedure site.

Conduct a pre-procedure verification process.

Perform a time-out.

Goals for other settings are:

~ Reduce the risk of surgical fires (ambulatory and office-based surgery).

~ Reduce risks of influenza and pneumococcal disease in older adults (disease-specific care and long-term care).

~ Prevent healthcare-associated pressure ulcers (long-term care).

NPSGs are listed at http://www.JointCommission.org/PatientSafety/NationalPatientSafetyGoals/

What would you like to see in print or on our web site? Send an e-mail to rnmagazine@advanstar.com
.