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The Latest Column
Questions are from the latest Standards Q&A column, posted in September 2018.
What Statistics Should Be Reported?
Do accreditation surveyors expect to see our statistics separated into appointments, sick call, pharmacy refill, etc., or is the total number of patient visits each day adequate?
Standard A-04 Administrative Meetings and Reports requires that statistical reports of health services are made at least monthly. Because they should be used to monitor trends in health care delivery, various categories of information should be collected. We recommend that the reports contain statistics such as service volume, incidence of certain illnesses, infectious disease monitoring, access, timeliness of health services and follow-up, missed appointments, emergency services and hospital admissions, referrals to specialists, deaths and grievances. Simply reporting the total number of patient visits each day would not be adequate to capture these specific trends. Monitoring areas such as these may help with staffing plans, space and equipment needs and facility comparisons when indicated.
Must All Staff Nurses Be RNs?
I am an LPN and have worked at a county jail for several years. We are now being told that NCCHC accreditation requires all staff nurses to be RNs. Is this true?
No, the standards do not require that all nurses be RNs. Standard C-07 Staffing requires that the RHA have sufficient numbers and types of heath staff to care for the inmate population. Other than requiring an RHA and a responsible physician (see A-02 Responsible Health Authority), we do not determine type of staff, numbers or ratios for staffing plans.
In C-07, compliance indicator #5 requires that the adequacy and effectiveness of the staffing plan be assessed by the facility’s ability to meet the health needs of the inmate population. Each facility may have differing staffing needs based on the scope of services offered on-site. In addition, qualified health care professionals should not be performing tasks beyond those permitted by their credentials (see C-01 Credentials). NCCHC survey teams and members of the Accreditation and Standards Committee take these variables into account when determining the adequacy of staffing plans at individual facilities.
Is ‘Clinical Preventive Services’ New?
In the 2018 Standards for Health Services, B-03 Clinical Preventive Services was renamed. What was it called before?
In the 2018 manuals, a table listing changes between the 2014 and 2018 editions shows B-03 as “renamed.” Although the title of the standard is new, much of the content comes from the 2014 standards. Below is a list of the B-03 compliance indicators and a breakdown of where the content appeared in the 2014 manual and/or whether the content is new:
- CI #1 – new content
- CI #2 – from 2014, E-12 Continuity and Coordination of Care During Incarceration (CI #10)
- CI #3 – new content
- CI #4 – from 2014, E-04 Initial Health Assessment (CI #2e). Note that the responsible physician now determines the necessity and/or timing of this testing, rather than a blanket requirement or a letter from the health department regarding the prevalence rate not warranting testing.
- CI #5 – from 2014, B-01 Infection Prevention and Control Program (CI #2b) and E-04 Initial Health Assessment (CI #2f)