JCAHO Announces 2006 National Patient Safety Goals

       The Joint Commission on Accreditation of Healthcare Organizations (JCAHO, Oakbrook Terrace, Ill) announces the release of the 2006 National Patient Safety Goals and related requirements that will apply specifically to accredited long-term care facilities.
       Major additions to this fourth-annual issuance of National Patient Safety Goals, which were approved by the JCAHO’s Board of Commissioners, include a new requirement that resident “hand-offs” between caregivers be standardized with particular attention to ensure the opportunity for asking and responding to questions. This requirement is part of the “improve the effectiveness of communication among caregivers” goal. In addition, a new goal to “prevent healthcare-associated pressure ulcers (decubitus ulcers)” has been adopted and includes a specific requirement that the long-term care facility assess and periodically reassess each resident’s risk for developing a pressure ulcer and take action to address any identified risks.
       The 2006 Long-Term Care Patient Safety Goals are:
Improve the accuracy of resident identification.
• Use at least 2 resident identifiers (neither to be the resident’s room number) whenever administering medications or blood products, taking blood samples and other specimens for clinical testing, or providing any other treatments or procedures.
• Prior to the start of any invasive procedure, conduct a final verification process to confirm the correct resident, procedure, and site using active, not passive, communication techniques.
Improve the effectiveness of communication among caregivers.
• For verbal or telephone orders or for telephonic reporting of critical test results, verify the complete order or test result by having the person receiving the order or test result “read back” the complete order or test result.
• Standardize a list of abbreviations, acronyms, and symbols that are not to be used throughout the organization.
• Implement a standardized approach to “hand off” communications, including an opportunity to ask and respond to questions.
Improve the safety of using medications.
• Standardize and limit the number of drug concentrations available in the organization.
• Identify and, at a minimum, annually review a list of look-alike/sound-alike drugs used in the organization and take action to prevent errors involving the interchange of these drugs.
Reduce the risk of healthcare-associated infections.
• Comply with current US Centers for Disease Control and Prevention (CDC) hand-hygiene guidelines.
• Manage all identified cases of unanticipated death or major permanent loss of function associated with healthcare-associated infection as sentinel events.
Accurately and completely reconcile medications across the continuum of care.
• Implement a process for obtaining and documenting a complete list of the resident’s current medications upon admission to the organization and with the involvement of the resident. This process includes a comparison of the medications the organization provides to those on the list.
• A complete list of the resident’s medications is communicated to the next provider of service when it refers or transfers a resident to another setting, service, practitioner, or level of care within or outside the organization.
Reduce the risk of resident harm resulting from falls.
• Implement a fall-reduction program and evaluate the effectiveness of the program.
Reduce the risk of influenza and pneumococcal disease in institutionalized older adults.
• Develop and implement a protocol for administration and documentation of the flu and pneumococcus vaccine.
• Develop and implement a protocol to identify new cases of influenza and to manage an outbreak.
Prevent healthcare-associated pressure ulcers (decubitus ulcers).
• Assess and periodically reassess each resident’s risk for developing a pressure ulcer (decubitus ulcer) and take action to address any identified risks.
       Visit http://www.jcaho.org for more information.

MIST Therapy^TM Receives FDA Clearance for Expanded Indication

       Celleration, Inc. (Eden Prairie, Minn) announces that it has received its second clearance with expanded indications from the US Food and Drug Administration (FDA) for the MIST Therapy^TM System 5.0. The clearance was based in part on the results of its prospective, randomized, double-masked, sham-controlled, multicenter study in diabetic foot ulcers, which resulted in a statistically significant improvement in the incidence of complete wound closure and time to wound closure. The newly cleared indication for use reads, “The MIST Therapy System produces a low energy ultrasound-generated mist used to promote wound healing through wound cleansing and maintenance debridement by the removal of yellow slough, fibrin, tissue exudates, and bacteria.”
       Celleration’s proprietary noncontact MIST Technology^TM can be used on a variety of wounds including acute, traumatic, chronic, and dehisced wounds to promote wound healing. MIST Therapy is an attractive technology for healthcare professionals, since its use appears to affect multiple aspects of a chronic wound to optimize the wound bed environment thus promoting healing. The treatment takes only minutes; it is easy to use, compact, portable, and comfortable for patients with painful wounds.
       Call 952-224-8702 for more information.

Physical Therapists Identify Risk Factors for Hip Fracture Sufferers

       The likelihood of a patient experiencing the reoccurrence of a fall after a hospital stay for a hip fracture can be predicted, according to a study published in the July issue of Physical Therapy (the official journal of the American Physical Therapy Association). The study shows that the likelihood of a fall following a hip fracture can be predicted by determining the functional status of the patient prior to the hip fracture.
       Physical therapists Anne Shumway-Cook, PT, PhD, Cynthia Robinson, PT, MS, and biostatistician Marion A. Ciol, PT, PhD, from the University of Washington (Seattle, Wash) and William Gruber, MD, of Northwest Hospital (Seattle, Wash), conducted the study.
Hip fractures often lead to impaired balance and gait and loss of functional independence. “Hip fractures are a major medical problem among older adults. We wanted to examine the incidence of falls in older adults who had experienced a fall-related hip fracture and to find out what factors could predict falls in the 6 months following hospital discharge,” says Shumway-Cook.
       The researchers found that important factors for predicting post-hospitalization falls were pre-fracture use of an assisted walking device and a history of falls within the 6 months prior to the fracture.
       Researchers interviewed 100 community-dwelling older adults (65 years and older) in the first 48 hours of their hip fracture hospitalization. Interview questions included demographics, premorbid health, and functional status. Participants were followed up at 6 months following their hospitalization. Of the 100, only 90 were used for the study (due to death, out-of-area move, or unwillingness to participate).
       The study found that 53% of the patients who had fall-related hip fractures experienced another fall within 6 months following their discharge from the hospital. Of those who had fallen, 18% reported being readmitted to the hospital for their fall-related injuries.
The study showed 24% of the patients who did not fall during the 6 months following their hospital stay had used assisted walking devices before their hip fractures. Comparatively, 54% of the patients who did report post-hospitalization falls had used assisted walking devices prior to their hip fractures. In addition, at the 6-month follow-up, 71% of the patients who did not fall and 94% of those who did fall were using assisted walking devices, showing a major increase in the use of assisted walking devices for both groups.
       “The results of this study indicate that patients with hip fracture can be evaluated early in their hospital stay to determine whether they are at risk for falls following discharge. If the physical therapist finds that, prior to hip fracture, a patient had poor balance and a slow walking speed, those factors may suggest that the patient is at risk for another fall. Post-fracture care can then be focused not only on helping patients recover from the hip fracture but also on improving deficits that are likely to produce another fall,” says Shumway-Cook. “It’s gratifying to continue to find more ways to maximize patients’ potential to safely return to their pre-injury lifestyle.” Shumway-Cook and Robinson are members of the American Physical Therapy Association.
       Source: American Physical Therapy Association
       E-mail katiemoore@apta.org or call 703-706-3217 for more information.