As most of you know, Sierra Vista is in the middle of a State and Federal Inspection beginning last week and ongoing. Unfortunately there were deficiencies flagged in the hospital which then initiated a second, deeper inspection. During last weeks inspection several of the failures were related to Anesthesia practices in the Operating Room as well as Labor and Delivery. Some of these are well known to us and others might be considered new.
As this is a State/Federal inspection and not JCAH it involves the potential for loss of Licensure and loss of Medicare Certification. Understandably the hospital administration is concerned and very focused on the areas flagged and any other potential issues going forward. This past week our commitment and relationship with Sierra Vista was directly questioned in very clear language.
The Directors at Sierra and Board met and drafted this email to circulate to you.
Expectations and policies from regulatory agencies are continually changing and many times not well defined. They can however be covered by some general guidelines listed below;
No food or drink in the Operating Rooms ever.
All equipment which is packaged should be considered sterile and for single patient use. It should remain unopened until ready for use under your direct observation. This would generally include airway supplies such as ET Tubes, Stylets, Oral and Nasal Airways, and Laryngoscopes.
Supplies for fluids and medications such as tubing, syringes and needles also should not be left unattended once opened. Medications need to be labeled and under direct observation. Carrying open medications and/or syringes with medications drawn up on your person or in your bag is not acceptable. IV ports and Medication vials should be swabbed with alcohol prior to use. Tops of carts and the interior drawers should have no opened supplies if unattended.
The Nursing Leadership in the operating room includes Olivia, Jo and Kathy. All of the nurses however in surgery and upstairs in Labor/Delivery as employees of the hospital are instructed to note and report any practices which they feel are not in line with the above. It will be elevated immediately to administration. Potential actions include individuals being unwelcome up to a reevaluation of our contract. Inappropriate comments or actions which any staff felt was unsupportive of them would be considered by the hospital to be just as unwelcome.
In summary, the hospital is our partner and where we do our work. We have a strong history at Sierra Vista and because of that a new relationship at TCCH. For some of us the above will take significant changes in practice patterns and for others not so much. It is a culture change. Mistakes will occur and if noted by anyone can be handled best by simply acknowledging the lapse and avoiding repetition. Discussing your concerns or questions with our leadership or the hospital leadership at a later time would be a positive action. Challenging, arguing with or otherwise engaging the staff or inspector who addresses you is not an approach that will be received well.
Finally we hope to have a General Partnership meeting in the spring and invite some of the management from Sierra to address the group and answer questions.