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JCAHO patient-safety reminders
After an intensive review process of past sentinel event
recommendations, JCAHO’s Sentinel Event Advisory Group developed
National Patient Safety Goals in January 2004 and made them part
of the accreditation process to promote specific improvements in
patient safety.
Two of JCAHO’s patient-safety recommendations – the use of two
identifiers and reading back verbal orders – are highlighted here:
Goal 1- Improve the accuracy of patient identification
1a - Use at least two patient identifiers (neither identifier
should be the patient’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.
The intent is to identify the individual as the person to whom
the service or treatment is intended and match the service or
treatment to that individual. The two patient-specific
identifiers must be associated directly with the individual, and
the same two identifiers must be associated directly with the
medication, blood products or specimen. The
two-patient-identifiers process used at Texas Children’s is:
Inpatient: 1) Name on armband is compared to name on order/label
and 2) Medical record number on armband is compared to medical
record number on order/label.
Outpatient: 1) Verbalized name is compared to name on
label/order and 2) Verbalized date of birth is compared to the
date of birth on order/label.
Goal 2-Improve the effectiveness of communication among
caregivers
2a - 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.
The receiver of the order should write down the complete order
and then read it back for verification from the individual who
gave the order. The intent is to ensure that such orders are
clear to the recipient and confirmed by the individual giving
the order. All verbal or telephone reports of critical
diagnostic lab tests require a read-back. Texas Children’s
procedure requires that any health care provider who takes
verbal or telephone orders inclusive of critical test results
for clinical lab write it down and read it back.
JCAHO reviewers will evaluate our performance by interview or
observation of compliance. Your participation is appreciated as
our organization continues to incorporate these safety
recommendations into daily practice.
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