Wrong Site Surgery, Case Study Example

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Case Study

CMS, the Centers for Medicare & Medicaid Services together with JCAHO, the Joint Commission of Accreditation on Healthcare Organizations employ accreditation and state certification means to meet quality medical care (National Council on Aging (NCOA), 2005). This paper specifically discusses the regulatory and accreditation standards that exist on patients’ wrong site surgery by CMS and JCAHO. It also discusses the CMS and JCAHO strategies by hospitals for meeting these standards and the appropriate ability of the strategies with respect to the circumstances.

Regulatory and accreditation standards that exist on patients’ wrong site surgery by JCAHO

JCAHO has set efforts to address and prevent wrong-site surgery. Those efforts manifested to the development of a wrong-site prevention initiative for easy communication and implementation within any health care systems. These efforts majorly entail the verification process where:

1) Surgical Site Verification Checklist used for every surgical procedure performed in the Main Operating Room.

2)       Two patient identifiers used to identify each patient and documented on the Surgical Verification Checklist.

3)     Extreme Surgeries like laterality, multiple structures (fingers, toes), or the spine required to have surgical site markings by the surgeon, and with documentation on the Checklist of the Surgical Site Verification

4)         Exemptions to site markings apply on the following: Single organ cases, Interventional cases where the instrument insertion site is not predetermined (Lewis et al, 2004).

5) In case of teeth, operative tooth name documented on consent, H&P, and Doctor’s Orders.

6) Exemptions on Premature infants, for whom a surgical mark causes a permanent tattoo

 

7)     The entire surgical team verify and agree to the Correct identity of the patient, Correct surgical site, Correct level, laterality, or structure, the Correct procedures to be performed, Correct patient position, and the availability of correct equipment or requirements.

8) If possible, the patient or designated representative involved in the surgical site verification process.

9)    Any discrepancy during the verification process results into an immediate halt to the surgery, until the discrepancy resolved by all members of the surgical team

Regulatory and accreditation standards that exist on patients’ wrong site surgery by CMS

CMS has it that in addition to the acceptable standards of practice, there is the employment of standard and procedures ensuring proper patient identification and surgical site. CMS summarizes the broad procedures into three approaches:

1)  A pre-procedure verification process that makes sure relevant documents inclusive of the patient’s signed informed consent and related information match the patient, correct identification, and consistent with procedure the patient and the ASC’s clinical staff expect to perform

2)      Marking of the surgical procedure site by the right physician to perform the procedure or any other member of the surgical team so that it is clear

3)    A “time out” just before the procedure; to confirm patient identity, correct site, and procedure identification of the patient. It also ensures all required documents and equipment available, and in proper working conditions, ready for use (Funk et al, 2002).

The CMS and JCAHO strategies by hospitals for meeting these standards include correct identification of the patient and following the right procedure. Wrongful surgical site majorly results from wrong identification of patient. It is upon solving the problem that other safety measures follow to work hand in hand to avoid wrong site surgery. The CMS and JCAHO regulatory, and accreditation strategies are more of the same (Funk et al, 2002).Their strategies, employed in hospitals, are particularly appropriate in ensuring no circumstances of wrong site surgery occur.

References

Funk, S. G., Tornquist, E.M., & Champagne, M.T. (2002). Key aspects of elder care: Managing falls, incontinence, and cognitive impairment. New York (NY): Springer Publishing Company.

Lewis, C. L., Moutoux, M., & Slaughter, M. (2004) Characteristics of individuals who fell while receiving home health services. Phys Theraphy, Vol 84 (1):23-32.

National Council on Aging (NCOA). (2005) Falls free: promoting a national falls prevention action plan. Washington (DC): NCOA.

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