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Re: JCAHO strikes againFrom: Henry Gregor (henrygregor@yahoo.com)Tue Dec 7 16:03:25 2004
Points all well taken, and of course - and I didn't reflect on this - any md mu/min orders do get translated to cc's for the pump. Re abbreviations...it's crazy. We have a diligent staffer combing charts to find erroneous chart entries (of the kind in use for decades) to bring to committee attention, to bring to offending md for review, to consume health care dollars contributing, IMHO, no demonstrable patient benefit in return for the time and money spent. Hank ainsron <ainsron@sbcglobal.net> wrote: Most of us probably use prewritten protocols in our units that designate the dosages in both ml/hour and mu of pitocin/min. You can’t take away the ml/hour, because that is how the nurses control the pump. The problem with the pharmacy at JCAHO’s behest dictating the concentration of the pitocin, or insulin, or any other drug we use “routinely” to a dose convenient to them and unfamiliar to us is that we then have to adapt our familiar protocols to new institutional guidelines. Habits are hard enough to change without concentrated efforts if there is perceived personal benefit, as when we try to convince patients to quit smoking. On the other hand, when we see no perceived benefit, we say to ourselves, what do I have to gain from this policy dictated from on high? Perhaps some degree of safety, because in some faraway hospital, a new nurse misread an order and as a result a patient suffered an adverse outcome. But when you have been doing something for 30 years and have never seen a complication related to a misread decimal point, from cc being misread as 00, from MSO4 being misread as MgSO4, or any of the multitude of therapeutic errors they point out when we complain about these changes, it makes it hard to cooperate with institutionally mandated changes dictated by JCAHO or a hospital corporation. Ronald E. Ainsworth -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Henry Gregor Sent: Tuesday, December 07, 2004 12:31 PM To: Multiple recipients of list OB-GYN-L Subject: Re: JCAHO strikes again Re mu's and cc's per minute. Don't we already have an ACOG technical bulletin addressing that issue? Personally I haven't seen - or at least cannot recall - any colleague using cc's, tho' I accept that it happens. However, is disregard for one recommendation the creation of yet another regulation? Hank RModugno@aol.com wrote: In a message dated 12/6/2004 12:18:41 PM Eastern Standard Time, "Myer Bornstein" writes:
>I would rather see JCAHO issue guidelines that oxytocin dosage that is use I would rather not see JCAHO issue any guidelines regarding pitocin.Remember these are the same people who suggested we mark the surgical site for circumcision! Robert Modugno MD MBA FACOG Marietta, GA http://www.novaobgyn.yourmd Tired of spam? Yahoo! Mail has the best spam protection around All your favorites on one personal page – Try My Yahoo!
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