TJC Basics
Scavenger
Emergency Emergency
Medical Record
Tracer Findings
100
Formerly known as JCAHO, name was changed to this in 2007.
What is The Joint Commission (TJC). Hard to believe the name changed happened that long ago!
100
Locate the MSDS information for Caviwipes
Name changed from MSDS to SDS (Safety Data Sheet). On the intranet on the right hand side of the screen under departments.
100
4545 or 911 in outside buildings
What number to call in case of an emergency Code Blue? These numbers are also located on the back of your badge buddy along with the emergency codes. If staff have panic buttons they need to know how to use this and who the button alerts.
100
These two patient identifiers must be verified prior to administering medications or performing and procedures
What is Name and MR # or Name and Date of Birth
100
Name two NPSG and locate the 2016 Poster.
Patient Identification, Communication among caregivers, medicines safely, uses alarms safely, Prevent infection, Identify patient safety risks and prevent mistakes in surgery. List is on the intranet under the Patient Safety Tab.
200
Doctors, Nurses and Office staff
Who are the key people the Surveyors ask questions to? Administrators will be acompaning the Surveyors, but they will want to speak to Staff that do the work!
200
Locate your units QAPI plan and hospital PI Teams
What is the QAPI Board and speak to the initiatives. Can be any of the following: Patient Experience, Falls, and Partnership for Patients
200
Run, Hide, Fight
What are the strategies for Active Shooter? (Code Silver) T
200
Discharge instructions for this diagnosis include: Diet Activity Weight Monitoring Symptoms Worsening Smoking Cessation Follow up
What is Congestive Heart Failure
200
A designated area 8"x11" identified that is used for nothing else
What is the Medication Preparation Area
300
Give short concise answers, only answer questions given-nothing more.
How to speak to Surveyors? If the answer is unknown say I don't know, or I know where to find the answer. Don't argue, ask for ideas, ask for clarification on the question if needed.
300
Locate the fire pulls & estinguishers in your area.
Know what to do in case of fire and how to evacuate. RACE- Rescue, Announce, Confine, Extinguish PASS- Pull, Aim, Squeeze, Sweep
300
PMCS and/or Managing your Safety
What is "Management of Aggressive Behavior" training? This training is provided to all direct caregivers and support staff
300
This process determines what medications the patient is taking. Compares those medicines to new medicines given to the patient. And makes sure the patient knows which medicines to take when the are at home
What is Medication Reconciliation?
300
Location of specimen labeling, and required information
What is at the bedside, with date, time, and collectors badge number
400
Surveyors analyze a hospital's systems by following individual patients through their hospitalization, evaluating multiple care units, departments, and services rendered to the patient
What is Tracer Methodology
400
Locate the Patient Rights and the Hospital's Mission Statement
Know how to loate these along with the other required signage in your areas.
400
Snowvember
What is a external disaster, Code Triage We are required to have a drill or real-time disaster event. We had a State of Emergency snow storm on this date. Lessons learned: Established protocols needed for housing and operations.
400
This is placed in the patient's medical record Upon admission, When cardiac monitoring is initiated, when a change in the rhythm, initial rhythm during a RRT or Code, Rhythm Changes and Post Rapid Response or Code.
What is a rhythm strip with the patient's name date and time and signature of the RN
400
Used for more than one patient and do not enter the immediate patient treatment area
What is Multidose Vials
500
Units must always be regulatory ready, expired food items removed from the refrigerator in the galley, mdv dated with open and expiration dates, only one days worth or bgt results, one week of Emergency Checks, clutter cleared.
We only will get a 30 minute warning the day Surveyors come. We need to always be ready! They will be visiting us anytime between now and July.
500
Locate the Patient's Advanced Directives and CARE (Caregiver Advise, Record Enable Act)
What is in the EMR under Summary- Risk Legal Under Care Activity Advanced Directives Intervention
500
Explain how Critical Test Results are communicated?
Critical labs are communicated to clinical staff in the patient care area and to the physician/provider of results and documented in pts chart.
500
Locate items in patient chart: H&P, Post op note, previous visits, ED Record, Discharge Planning Assessment, Pain Medications, Fall Risk, and Suicide Risk .
What is the EMR
500
Drawn up in the Medication Room and have a label immediately attached that contains the medication name, bar code and dose of medication
What is Insulin Administration and labeling
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