Nursing Law Update

This program will cover hot topics in nursing in 2020. It will cover hot and problematic standards with CMS (Center for Medicare and Medicaid Services) and the Joint Commission (TJC). CMS issues quarterly memos on all the deficiencies received by hospitals making it easier to track top problematic standards.

It will discuss the CMS hospital regulations on safe opioid use, IV medication, blood transfusions, restraints, compounding, BUD, history and physicals, verbal orders, informed consent, plan of care, the timing of medications, and the post-anesthesia evaluation. This program will also discuss recent CMS memos on insulin pens, safe injection practices, worksheets, organ procurement organizations, humidity, complaint manual update, deficiency memo, final worksheets, and privacy and confidentiality. It will also discuss interpreters and low health literacy 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. It will also discuss the revised hospital discharge planning and hospital improvement rule final changes.

MRI patient safety guidelines, use of trigger tools to detect errors and opportunities for improvement, and how to reduce medication errors will be discussed. 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. Studies show there is a considerable variation in medication error rates across facilities. Medication management is an important area for both CMS (in the hospital conditions of participation) and the Joint Commission. Infection control is important and every hospital should have a safe injection practices policy that includes the ISMP IV Push guidelines.

• Describe the CMS requirement that a post-anesthesia evaluation be done on all outpatient surgery patients within 48 hours of receiving anesthesia including deep sedation
  • Note CAH must be done before the patient leaves the hospital.
• Recall that all hospitals should follow the CMS and American College of Radiology standards for MRI safety
• Discuss that a physician who signs off a verbal order must also date and time it
• Recall that medication errors are the most common type of medical error
• Describe that every hospital should have a safe injection practices policy that follows the CDC guidelines

• TJC and CMS top problematic standards
• CMS CoP changes
• CMS discharge planning and hospital improvement rule final changes
• A patient advocate or support persons
• Interpreters and low health literacy
• Section 1557 of ACA nondiscrimination, interpreters, signs, patient rights, auxiliary aids for patients
• CMS changes to the timing of medications by nurses
• CMS changes on medication errors, ADE, and drug incompatibility
• Verbal orders CMS and TJC
• Informed consent requirements
• H&P CMS and TJC
• CMS restraint and seclusion
• CMS post-anesthesia evaluation
• MRI guidelines
• Medication error prevention issues
• Infection control is a hot issue
• Standards of practice and guidelines
• Falls programs
• Importance of documentation
• Safe injection practices
• IV medication and safe opioid use
• ISMP IV push guidelines
• CMS compounding and BUD and what staff need to know
• TJC patient-centered care standard on interpreters
• TJC Record of care documentation standards

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