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That is exactly what the large catholic healthcare system where I trained did.  They switched to the following agency for their accreditation.  I applauded the nuns who said, "we don't need your services anymore JCAHO."  As you can see the HFAP arm of the American Osteopathic Association is perfectly appropriate for CMS and state purposes....etc...

http://www.hfap.org/

Scott


Sent from my iPad

On Feb 17, 2012, at 4:51 PM, Marty Herman <[log in to unmask]> wrote:

> Well it is another example of beaurocratic nonsense. A parent can arrive to the Ed with a febrile child, and while waiting adminsiter their own acetaminophen or ibuprofen but a licensed and certified nurse or paramedic can't? How insane is that? It just doesn't make sense. even the densest of our patients see the absurdity in this ..Same is true for albuterol. Parents administer this all the time to their kids, paramedics as well, yet if a wheezing child arrives at the triage desk and has albuterol with them the nurse can't administer it?/ What is the fear here? that the kid will have overwhelming reaction to their own medication? What a bunch of crap!. That is why I just abhor JCAHO. Their inspectors are unyielding, autocratic robotrons. I wish the hospitals would call them on their bullying and stand up to them when patient care and common sense shold prevail. 
> 
> Marty
> Martin Herman, M.D.
> 
> Pediatric Emergency Medicine 
> Sacred Heart Children's Hospital
> FSU @ Sacred Heart, Division of Pediatrics
> 5153 N. 9th Ave, 6th Floor Nemours Bldg
> Pensacola, FL 32504
> Ph: 850 416 7658(office)
> Ph: 901 219 9202 ( cell)
> Fx: 850 416 7677
> Email: [log in to unmask]
> 
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> 
> 
>> Date: Fri, 17 Feb 2012 16:22:34 -0500
>> From: [log in to unmask]
>> Subject: Re: Preemptive Triage Guidelines
>> To: [log in to unmask]
>> 
>> You're exactly right Joe.
>> 
>> The key is that the order has to be signed by a LIP.
>> 
>> Apparently, there were some EDs operating out on the frontier where
>> nurses were actually treating patients and were talking to the doctor by
>> phone. TJC's response to this practice was this overreaction and "one
>> size fits all" approach that is clearly not relevant in large hospitals.
>> 
>> We argued with our regulatory compliance people the absurd logical
>> conclusion that if a patient arrived by ambulance with asthma and was
>> being treated "by protocol" with albuterol by the paramedics, then the
>> nurse would have to stop the treatment because she/he would be
>> prescribing medications by allowing the albuterol to continue...
>> 
>> Jim
>> 
>> James Chamberlain, MD
>> Division Chief, Emergency Medicine
>> Children's National Medical Center
>> 111 Michigan Avenue, NW
>> Washington, DC 20010
>> 
>> 202.476.3253 (O)
>> 202.476.3573 (F)
>> 202.476.5433 (Emergency Access)
>> 
>> 
>> -----Original Message-----
>> From: Zorc, Joseph [mailto:[log in to unmask]] 
>> Sent: Friday, February 17, 2012 4:12 PM
>> To: Chamberlain, Jim
>> Cc: [log in to unmask]
>> Subject: Re: Preemptive Triage Guidelines
>> 
>> The approach may differ by site, but for us this was a specifically
>> written "standing order" with a tight process for a doc/np to sign
>> afterwards as no verbal order is given at triage.
>> 
>> Joe Zorc
>> CHOP
>> 
>> On Feb 17, 2012, at 3:56 PM, "Chamberlain, Jim"
>> <[log in to unmask]> wrote:
>> 
>>> They are incorrect.
>>> 
>>> You need to develop a well written protocol and a process for verbal
>> order  
>>> to initiate the "Antipyretic pathway." The nurses are then
>> administering  
>>> medications per protocol rather than ordering medications themselves.
>>> 
>>> We went through this "exercise" 3 years ago and we passed with flying
>> 
>>> colors.
>>> 
>>> Jim Chamberlain
>>> Washington, DC
>>> 
>>> Sent from my Verizon Wireless 4G LTE Phone
>>> 
>>> -----Original message-----
>>> From: Eugene Izsak <[log in to unmask]>
>>> To: [log in to unmask]
>>> Sent: Fri, Feb 17, 2012 13:47:44 EST
>>> Subject: Preemptive Triage Guidelines
>>> 
>>> Question to the group?  Our JCAHO specialists are telling us triage
>>> nurses are not allowed to give antipyretics preemptively as we have
>>> done in the past (great customer satisfied).  They are allowed to get
>>> urines, order X-rays per protocol. Anyone else having similar issues
>>> with meds, any work arounds?  Thanks in advance.
>>> E Izsak MD
>>> Toledo. Ohio
>>> 
>>> Sent from my iPad
>>> 
>>> For more information, send mail to [log in to unmask] with
>> the  
>>> message: info PED-EM-L
>>> The URL for the PED-EM-L Web Page is:
>>>                http://listserv.brown.edu/ped-em-l.html
>>> 
>>> 
>>> For more information, send mail to [log in to unmask] with
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> For more information, send mail to [log in to unmask] with the message: info PED-EM-L
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For more information, send mail to [log in to unmask] with the message: info PED-EM-L
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