October 21, 2009 | | Comments 3
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Joint Commission offers guidance, but no mandates, for patient-owned items

Many of you deal with patient-owned equipment, such as hair dryers, coming into the hospital.

The Joint Commission published an FAQ on this topic last year, and this is one of those instances in which, in opening the risk assessment door, the FAQ provides just enough semi-specific information to confuse matters.

My first piece of advice in working through this would be to include someone from your risk management office and perhaps even your property insurer — you want to be sure that you involve the primary stakeholders in the process.

At that point, apply risk criteria you develop to each device type and ensure that you don’t have anything that would fall under medical equipment management.

The tenor of the conversation should be indicative of the questions outlined in the FAQ. Remember, The Joint Commission doesn’t tell you how to do something, who should be responsible, etc. Surveyors will evaluate whether you are in compliance with your policy, with the caveat that it behooves you to develop a response strategy should you have an incident involving a patient-owned device.

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Steve MacArthur About the Author: Steve MacArthur is a safety consultant with The Greeley Company in Danvers, Mass. He brings more than 30 years of healthcare management and consulting experience to his work with hospitals, physician offices, and ambulatory care facilities across the country. He is the author of HCPro's Hospital Safety Director's Handbook and is contributing editor for Briefings on Hospital Safety. Contact Steve at stevemacsafetyspace@gmail.com.

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  1. I’m not sure if the implication of this is that it would be better if TJC did dictate policy so that thinking at the local level would be unnecessary, and certainty would be achieved even if it wasn’t necessarily rational or applicable to the local situation. At the hospital level do we want flexibility and the opportunity to exercise our own judgement and set our own policy, or do just want the TJC to tell us exactly what to. Prescription or principle, what do we want?

  2. Hi. My husband is a biomedical engineering specialist. His company has just changed owners. A running problem for the hospital group her serves is the patient-owned CPAP machines. They have been checking them in, but as they have now ground plug & are not “medical grade”, they are checked only for frayed cords, & other functionality issues & a different sticker, stating it’s not medical grade is placed on equipment.

    My question is this, does not bringing a CPAP from “home” or lets say an unknown environment pose an infection control risk to the hospital? Suppose the person lives with a smoker, animals, fails to keep equipment clean or has an un-diagnosed condition (like TB, some sort of flu or other contagion), the machine vents the room air passed through the patient back into the room. If this is a double room, what about the other patient, or the staff for that matter.

    Also, since a hospital probably has more germs than most other average places, couldn’t a nosocomial infection get into the CPAP while it’s in the hospital & be taken home? It seems logical that neither situation is the best practice. Wouldn’t it be simpler for the admitting physician to just order a hospital CPAP & contact the doctor prescribing it for the settings? Or, at the very least, shouldn’t the Respiratory Therapy department be involved? Thanks. LRS

  3. Generally speaking, the scenario you describe makes a lot of sense, but, for some reason (and I am not at all clear on why that is), trying to corral all the different physicians and all the different CPAP devices (they really have proliferated), the sticking point appears to be the availability of the specific CPAP that an individual might be using at home. I think the only reasonable way forward is to work with the pulmonologists, as well as the admitting physicians (with hospitalists in play, this might be a simpler proposition than it used to be) to identify a slate of devices approved for use in the hospital that can be appropriately managed, both from an equipment, but also infection control standpoint. There are potentially significant risks with any device brought from home, but I also appreciate trying to make a patient feel comfortable during their stay. Ultimately, it all comes down to the risk assessment process and the identification of appropriate strategies for managing those risks.

    Hope this helps; please reach out if you have further questions or need additional information – Steve Mac.

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