Complying with the 2008 national patient safety goals

AORN Journal,  March, 2008  by Kathleen Catalano,  Kevin Fickenscher

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GOAL 9--REDUCE THE RISK OF PATIENT HARM RESULTING FROM FALLS

The NPSG 9 is to "Reduce the risk of patient harm resulting from falls." (11) Requirement 9B of this goal requires each health care organization to implement a fall-reduction program and to conduct an evaluation of the effectiveness of the program. Both clinical IT systems and manual methods can be used to collect the information necessary for this evaluation.

GOAL 11--REDUCE THE RISK OF SURGICAL FIRES

Although NPSG 11, "Reduce the risk of surgical fires," (21) currently is applicable only to the Joint Commission's ambulatory care and office-based surgery accreditation programs, it certainly is a valuable guideline for hospitals and perioperative settings as well. This is evidenced by perioperative resources such as AORN's "Fire Safety Tool Kit." (22)

Requirement 11A of this NPSG states that the organization should educate all applicable staff members, including licensed independent practitioners and anesthesia care providers, in how to control heat sources, manage fuels, and provide enough time for patient preparation. In addition, organizations are instructed to establish guidelines to minimize oxygen concentration under drapes. Information technology solutions can be used to address this goal by facilitating the education of staff members to the risks and safety measures associated with surgical fires.

GOAL 13--ENCOURAGE PATIENTS' ACTIVE INVOLVEMENT IN THEIR OWN CARE AS A PATIENT SAFETY STRATEGY

Goal 13 is to "Encourage patients' active involvement in their own care as a patient safety strategy." (11) This goal requires health care organizations to define and communicate the means for patients and their family members to report any concerns they have about safety. According to the Joint Commission, patients should be encouraged to report such concerns. When a patient or family member voices a concern, follow-up actions must be taken when warranted. Information technology also can be used to address this goal by providing a system of reporting in a non-threatening environment.

GOAL 15--THE ORGANIZATION IDENTIFIES SAFETY RISKS INHERENT IN THE PATIENT POPULATION

The intent of NPSG 15 is that "The organization identifies safety risks inherent in the patient population." (11) This goal addresses a health care organization's patient safety program. Requirement 15A specifically addresses the need to identify patients at risk for suicide and is applicable to patients in psychiatric hospitals and those being treated for emotional or behavioral disorders in general hospitals. Tracking this information also can be facilitated through the use of the appropriate technology.

GOAL 16--IMPROVE RECOGNITION AND RESPONSE TO CHANGES IN A PATIENT'S CONDITION

Goal 16, "Improve recognition and response to changes in a patient's condition," (11) is a new NPSG for 2008. This goal also will be subject to a one-year phase-in period. This NPSG requires a health care organization to enable staff members to request additional assistance from specially trained individuals when a patient's condition appears to be worsening. This goal addresses, in part, the "rapid response team" approach fostered by the Institute for Healthcare Improvement during its "100,000 Lives Campaign," (23) launched in 2004, which evolved into the current campaign, "Protecting 5 Million Lives From Harm: Some Is Not a Number. Soon Is Not a Time." (24) This directive is meant to help organizations identify and prepare individuals with specific knowledge and training who can be available to respond when a patient's condition deteriorates.