Nursing and the Law: Navigating Problematic Nursing Chapter Standards with CMS and the Joint Commission

The Nursing and The Law program from Nash Healthcare Consulting (NHC) covers hot topics involving nursing challenges including problematic nursing chapter standards with CMS (Center for Medicare and Medicaid Services) and the Joint Commission (TJC). Other topics involving nursing to be addressed include CMS hospital's regulations on safe opioid use, IV medication, blood transfusions, restraints, compounding, beyond use date, history and physicals, verbal orders, informed consent, plan of care, the timing of medications, and the post-anesthesia evaluation.

CMS memos on insulin pens, safe injection practices, worksheets, organ procurement organizations, humidity, and privacy and confidentiality will be covered. Additionally, interpreters and low health literacy will be discussed to help hospitals comply with CMS and Joint Commission standards and compliance with the OCR Section 1557 on signage, patient rights, nondiscrimination, qualified interpreters, and 2020 changes. Medication errors are the most common type of medical error. An IOM study found that a hospital patient is subject to one medication error per day. Medication management is important for both CMS and the Joint Commission. Infection prevention is important, and every hospital should have a safe injection practices policy which includes the ISMP IV Push guidelines.

• Describe the CMS memos and how they impact nursing including infection control
• Recall changes to medications including the timing of medication administration
• Describe that every hospital should have a safe injection practices policy that follows the CDC guidelines
• Recall the impact of informed consent changes on nursing

• CMS Memos of interest
• Insulin pens
• Lowering humidity
• ACA: Non-discrimination, interpreters
• Changes in 2020 and required signs
• Interpreters and low health literacy
• Changes to history and physicals
  • Who can perform
  • Healthy outpatient options
• CMS changes to the timing of medications by nurses
• Safe opioid use and safe blood administration
• Verbal orders CMS and TJC
• Pharmacy requirements impacting nursing
• Reporting of medication events
• Nonpunitive environment
• Visitation rights
• Advocates
• support person and same-sex marriages
• CMS post-anesthesia evaluation
• CMS restraint and seclusion
• Reporting death with restraints
• Restraint and seclusion
• What is and is not a restraint
• Informed consent requirements
  • Joint Commission RI.01.03.01
  • CMS mandatory elements
• Three CMS worksheets as self-assessment tools
• Infection control and focus by CMS
  • Breeches to be reported
  • Safe injection practices
  • Cleaning equipment
• Infection control standards and nursing
• ISMP IV pushes medication guidelines and nursing
• Compounding and labeling medications
• Medication errors
• Joint Commission and importance of documentation
• Patient falls

• Nurses
• Risk Managers
• Patient safety officer
• Chief Operating Officer (COO)
• Chief Nursing Officer (CNO)
• Chief Medical Officer (CMO)
• Nurse Managers
• Nursing Supervisors
• Legal Counsel
• Pharmacist
• OR Nurse Manager
• Compliance Officer
• Joint Commission Coordinator
• Quality Improvement personnel
• Consumer Advocates
• Nurse educators
• Clinic Managers
• Anyone interested in nursing, risk management, and patient safety issues