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Goals of 2009 Nursing Practices of which First Signal has Aligned

Goal 1
Goal 1, which is to “improve the accuracy of patient ID,” has remained the same for all accreditation programs since the inception of the NPSGs in January 2003.”1 The purpose of this goal is to provide the correct care, treatment, and service to the correct patient. Note that the patient’s room number or physical location is never to be used as one of the identifiers.

Goal 2
Goal 2 has also remained the same since the inception of the NPSGs and is applicable to hospital, ambulatory healthcare, and office-based surgery accreditation programs as well. Goal 2 speaks to “improving the effectiveness of communication among caregivers.”  There are five elements of performance (EPs) for this goal. First, hand-off communications are to be interactive. In addition, information must be up-to-date regarding the patient’s condition, care, treatment, medications, services, and any recent or anticipated changes. The method used to verify the received information is to include repeat-back or read-back techniques, and the receiver of the hand-off information must have the opportunity to review relevant historical data about the patient. Lastly, interruptions during hand-offs are to be kept at a minimum so that information can be accurately conveyed and not forgotten. While hand-off communications make sense and can prevent lost or misinterpreted information, they do take up valuable time. Consider the most efficient way in which these communications can take place at your facility. Create a hand-off communications list and document the responses. This
will lead to shared communications between providers and ultimately, safer patient care.

Goal 6
Develop innovative ways to improve the effectiveness of clinical alarm systems.

Goal 7
NPSG.07.01.011 requires facilities to be in compliance with the CDC and World Health Organization (WHO) hand hygiene guidelines. The goal’s aim is to “reduce the risk of healthcare-associated infections by encouraging staff to reduce the transmission of infectious agents through proper hand hygiene techniques, thereby preventing their patient from contracting a healthcare-associated infection”. In addition, there are now three new component requirements to Goal 7 that involve the prevention of multiple drug-resistant organisms, central line-associated bloodstream infections, and surgical site infections (SSIs). NPSG.07.05.01 is applicable to the hospital, ambulatory healthcare, and office-based surgery accreditation programs and obliges organizations to “implement best practices for preventing SSIs.” SSI rates are to be measured for the first 30 days following a surgical procedure and for the first year after a procedure involving implantable devices has been performed. While these may be common practice in most perioperative departments in the United States, the Joint Commission has allowed for a 1-year, phase-in approach to give facilities more time to develop and implement more in-depth strategies and protocols. This NPSG will necessitate collaboration and communication between the perioperative, quality, and infection control departments.

Goal 9
Goal 9 is to “reduce the risk of patient harm resulting from falls.” Falls are an issue for every accreditation program even if the goal is only applicable to the hospital program. In any event, perioperative services should be part of the fall reduction program and should take an active part in developing risk assessment and data collection strategies that can be used throughout the organization.

Goal 13
This goal requires organizations to encourage patient involvement in their own care, and is viewed as a patient safety strategy. In order to comply with NPSG.13.01.01,1 organizations are to identify and
encourage patients and their families to report concerns. Implementation of this goal requires educating the patient and family on the types of reporting methods used at the facility. Measures that will prevent adverse events are to be described to patients and their families. In EP 3, the Joint Commission suggests that these measures include patient ID practices, preventing SSIs, and marking the pro-
cedure site. Note that after the information has been imparted to the patient, the patient’s understanding of what was taught is to be reported, evaluated, and documented.

Goal 14
Goal 14 is designed to prevent healthcare-associated pressure ulcers.

Goal 16
Goal 16 requires that hospitals “improve recognition and response to changes in a patient’s condition.” In all areas, specially trained individuals are ever-present and are available if a patient’s condition begins to worsen. Staff need to understand the importance of early detection of a rapidly deteriorating condition.

Adpated from The National Patient Safety Goals: 2009