More Stupid Joint Commission Tricks (sent in by a reader)
I am an anesthesiologist, and JCAHO makes us label our propofol syringes, ‘propofol’. Like there are any other milky white liquids on an anesthesiologist’s cart? We are also supposed to write the date, our initials, and the name of the drug and the concentration of each drug in each syringe. In cardiac anesthesia I have 20 syringes going in the morning. Sure, I’ll come in 1/2 hour early for that. The fact is that NOBODY does this crap, except when the JCAHO idiots are in the hospital for their ‘surprise’ inspections that they tell you you’re going to have.
Every year they add more BS hoops to jump through. Just recently, they added that we have to now individually wrap our laryngoscope blades in clear packaging. This is like saying all silverware at a restaurant must be individually wrapped. The blade is clean and going in your MOUTH!!! Your DIRTY MOUTH!! For almost 100 years blades have been stored clean! There are no infections attributed to laryngoscope blades! They don’t want them sterile; they just want them in a wrapper! If they are not in a pretty wrapper, we get cited! I am sure every medical professional has some Joint Commission crap that they have to do that makes no sense. There are many more in the OR.
We were told that our bottles of rubbing alcohol had to be labelled once they were opened, and whatever was left after 28 days had to be thrown out. Rubbing alcohol. Because it becomes a culture medium on day 29?
Pennsylvania’s lawmakers have been kind enough to define “moderate sedation” for us: it’s sedation reasonably expected to result in the loss of protective airway reflexes. That’s actually the definition of general anesthesia. General anesthesia, however, is not allowed in some ambulatory facilities. Only moderate sedation. Which, in reality, is general anesthesia.
So I lie on every anesthesia record for my endoscopy anesthetics, and call my iv general anesthetics “moderate sedation”. You know, if they passed a law that all 4 legged animals were cats, my puppy still wouldn’t meow.
These rules can’t even be called well-intentioned. They are bureaucratic bullying. Try this line out on your administrator some time in response to stupid rules that cannot be proved to improve efficacy or safety in health care:
“Gee, I sure disavow his methods, but I am certainly beginning to understand Timothy McVey’s anger!”
The powers that be made us install a password on our PACS computer…the one *in the nursing station,* where there are *constantly multiple physicians and nurses.* This was to prevent unauthorized people from looking at images!
Seems like to me wrapping the thing in plastic might take up too much extra time in an emergency. Do they REALLY require time-outs for labor epidurals? Maybe they should have the Joint inspector stand real close to the labor bed, like you know, within, um, anatomy grabbing range when that time out takes place….
I like how you’re not allowed to keep anything under a sink. Anything. I get not wanting patient care items, meds, etc. down there, but we got yelled at, er … “cited” for keeping a bottle of Palmolive under the sink in our break room.
How about the incredibly asinine practice of putting all the equipment normally in the hallway into on OR while they are “inspecting” and getting back to normal when they leave. Or locking the emergency drugs in a cart “to be safe”. Or having a “time-out” before a labor epidural to ensure the screaming pregnant patient want her epidural in her back as opposed to doing a crani or hip replacement or putting the epidural in her eye. endless hassles