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JCAHO and AAMT is a crock. Patient safety means not hiring DIMWITS

Posted By: Crazy crazy people. on 2005-08-14
In Reply to:

who can't read or retain what they have been taught. If you don't know what TYPED p.o. means or are confused, do not take care of patients. You are obviously too stupid. Go flip burgers somewhere where someone can instruct you every step of the way and you can do no harm. No brainer. Just a little wrist action and by all means DON'T TOUCH THE HOT GRILL. Think you can remember what that means. HEAT BAD!


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FYI on the Do not use list per AAMT BOS and JCAHO


Hi everyone! I know this is not going to be easy but we all need to start abiding by the dangerous abbreviation list below and the JCAHO updated list attached. The biggest change will be the "q.d." Please start making these changes immediately. I would suggest putting some of them in your auto correct as it will probably be very helpful. You could put it in there as q.d. and change to daily so if you were to type q.d. by accident, it would change it automatically to daily.

We will give you a few months to get used to these changes and probably by February, we will take points off for QR if any of these errors are found.

Thank you and if you have any questions, please let the QA team know.






POLICY


Dangerous abbreviations listed below are NOT to be used.



Abbreviation
Potential Problem
Preferred Term

U (for unit)
Mistaken as zero, four, or cc.
Write “unit”

IU (for international unit)
Mistaken for IV (intravenous) or 10 (ten)
Write “international unit”

Q.D.

Q.O.D

Q.I.D.
Mistaken for each other. The period after the Q can be mistaken for an “I” and the “O” can be mistaken for “I”.
Write “daily” and “every other day” and “four times a day.

Trailing zero (X.0 mg)

Lack of leading zero (.X mg)
Decimal point is missed
Never write a zero by itself after a decimal point (X mg), and always use a zero before a decimal point (0.X mg)

MS

MSO4

MgSO4
Confused for one another. Can mean morphine sulfate or magnesium sulfate.
Write “morphine sulfate” or “magnesium sulfate”

TIW (Three times weekly)
Confused for twice weekly
Write “three times weekly”

mg

(for microgram)


Mistaken for mg (milligrams) resulting in one thousand-fold dosing overdose.


Write "mcg"

ZnSO4 Can be confused with IV electrolytes
Write “zinc sulfate”

Per os Can be mistaken for “left eye”
Use “PO”, “by mouth,” or “orally”



















HERE IS WHAT I HAVE!!! ATTACHED IS FROM THE JCAHO SITE PER THEIR FAQ PAGE ALSO. MAYBE WE CAN ALL REACH A COMMON GROUND HERE AND BE ON THE EXACT PAGE WITHIN THE REGULATORY RULES TOGETHER.



A "minimum list" of dangerous abbreviations, acronyms and symbols

Beginning January 1, 2004, the following items must be included on
each accredited organization's "Do not use" list:

Set
Item
Abbreviation
Potential Problem
Preferred Term

1.
1.
U (for unit)
Mistaken as zero, four or cc.
Write "unit"

2.
2.
IU (for international unit)
Mistaken as IV (intravenous) or 10 (ten)
Write "international unit"

3.
3.
4.
Q.D.,
Q.O.D.
(Latin abbreviation for once daily and every other day)
Mistaken for each other. The period after the Q can be mistaken for an "I" and the "O" can be mistaken for "I"
Write "daily" and "every other day"

4.
5.
6.
Trailing zero
(X.0 mg),
Lack of leading zero (.X mg)
Decimal point is missed
Never write a zero by itself after a decimal point (X mg), and always use a zero before a decimal point (0.X mg)

5.
7.
8.
9.
MS
MSO4
MgSO4
Confused for one another
Can mean morphine sulfate or magnesium sulfate
Write "morphine sulfate" or "magnesium sulfate"







In addition to the "minimum required list"

The following items should also be considered when expanding the "Do not use" list to include the additional three or more items referenced in the JCAHOFAQ@jcaho.org



Abbreviation
Potential Problem
Preferred Term

µg
(for microgram)
Mistaken for mg (milligrams) resulting in one thousand-fold dosing overdose
Write "mcg"

H.S.
(for half-strength or Latin abbreviation for bedtime)
Mistaken for either half-strength or hour of sleep (at bedtime) q.H.S. mistaken for every hour. All can result in a dosing error.
Write out "half-strength" or "at bedtime"

T.I.W.
(for three times a week)
Mistaken for three times a day or twice weekly resulting in an overdose
Write "3 times weekly" or "three times weekly"

S.C. or S.Q.
(for subcutaneous)
Mistaken as SL for sublingual, or "5 every"
Write "Sub-Q", "subQ", or "subcutaneously"

D/C
(for discharge)
Interpreted as discontinue whatever medications follow (typically discharge meds).
Write "discharge"

c.c.
(for cubic centimeter)
Mistaken for U (units) when poorly written.
Write "ml" for milliliters

A.S., A.D., A.U.
(Latin abbreviation for left, right, or both ears)O.S., O.D., O.U.(Latin abbreviation for left, right, or both eyes)
Mistaken for each other
(e.g., AS for OS, AD for OD, AU for OU, etc.)
Write: "left ear," "right ear" or "both ears;" "left eye," "right eye," or "both eyes


JCAHO has created a set of Frequently Asked Questions (FAQs) that explain the new requirements in greater detail.





It all comes down to safety
An ESL wishing to practice medicine in the US should not only have to pass a written exam, but a verbal one as well.

Just how many ESL are lawyers?? Can you imagine someone unable to speak clear, intelligible English attempting to argue a case before the court?  How long would a trial last with all of the "Objection! YOUR HONOR, WHAT DID HE SAY??!!"  Plus, the number of appeals would be staggering!

And oh, the poor court stenographer...don't even want to go there!!

If you want to call me a bigot...go ahead! I could care less. Since when does being PC come before a patient's life? 

Safety
this is not about medicine but still about safety. My DD was in a bad car accident in September when she was hit by a car going 60 miles an hour in a 35 mile an hour zone. The other driver spoke nor read a word of English, yet managed to have a valid driver's license. Apparently he was able to take the driver's test in his native language, but he was unable to read the speed limits signs, the yield signs, or the construction zone signs he sped through!

Saddest thing about it was she was found at fault because she was taking a left even though he was speeding, did not yield and was driving in breakdown lane!


Safety last
When an ESL surgeon says "The patient gave informed consent" I always wonder who informed the patient and how they could understand what was going to be done if I can't understand it with all my experience. 
keep the cone on for safety
my poodle got such a horrible infection from licking post op that she ended up in Doggie ICU, we almost lost her and it cost a fortune.  Just have patience, scratch his ears for him and the cone will be off sooner than you know.  Remember, you probably feel worse about it then he does
I think you need to look up JCAHO SM
prohibited abbreviations and you will see why you cannot type this.  We are talking about acute care here--not some family practice clinic.  You must follow JCAHO's directive on abbreviations or the facility receives deficiencies if the organization happens to check that record. 
There is safety under the Whistle Blower's Act
employees at the surgery center were to be named as litigants in ANOTHER lawsuit for knowing but not having reported it? Sorry, but I'm not going to jail or losing my house from a civil/criminal case because some doctor wants to commit professional suicide. Also, the surgery center should have a toll-free number for employees to report any misconduct without having to disclose any identity...most medical employers do to promote an lawsuit-free business. I used one for sexual harrassment and was given an ID number and a toll-free number to call back in a certain amount of time to listen to a recorded message of the outcome of the company's investigation. The guy didn't lose his job, but the top manager admitted they knew and allowed his behavior because he was just being himself (????) -- I don't work there anymore (my choice), but I know he won't be climbing that corporate ladder and no one else will be subjected to his behavior.


Same goes for anyone doing drugs on the job...it CANNOT be tolerated!
JCAHO has prohibited q.d. and q.i.d. SM
so that is why these 2 are no longer used in any facility that is accredited by that organization.
JCAHO dangerous abbreviations
Do physician offices/clinic notes need to comply with this list?  I thought JCAHO was joint commission for hospital compliance. 
JCAHO Do Not Use Abbreviations List
This link will take you to the JCAHO site with the "Do Not Use" abbreviations list. Most of the questions you are asking here (i.e. q.d. now being "daily") will be answered on this site.

BOS just came out with a 3rd edition, but not many are using that yet. Try to get a copy of the 2nd edition - it will answer a LOT of questions that will come up for you.

Good luck and welcome back! :-)
It is JCAHO. The most misspelled acronym in medicine! nm
x
Putting patient versus The patient (sm)
When did this "rule" come about? I've been an MT/Editor/medeical records tech/ART for 30 years - Never, ever was I told to put that. You cannot make the sentence be "The patient sent to Radiology" but you can put "Patient sent to Radiology."

Thats just insane.
it's spelled right. Exo means outside and you know what phrenic means. nm
:
crock
I had a crock years ago, that was a 'crock'. So, I've never replaced it. I know lots of people who love theirs, and am starting to think about getting one. I need a small one (I'm single and have a roomie, and we're neither one very big eaters). If anyone has any ideas, feel free to forward them (I don't need a shrink - they've already thrown me back, but other suggestions are welcome hehe)
crock pot
I have used them twice, what a blessing!
It is definitely a crock and a rip off....
xx
Not just them either........BOS - what a crock!!!
xx
What a crock!.....nm
nm
BOS is a crock!

The only reason the AAMT (or whatever they call themselves now) changes the BOS is to make money-- plain and simple!  They think by changing commas, abbreviations, etc., they can call the previous BOS "outdated", so of course you have to spend money on buying a new one.  The AAMT was ALWAYS about making money for themselves in any way possible instead of sticking up for the MTs that are supposed to keep up with all these changes while our paychecks get smaller every year.  They want to certify foreigner MTs just so they can keep the money coming in.  I dropped my CMT a long time ago because they kept changing the requirements for the CEs and I got tired of paying their ridiculous dues when they had done absolutely nothing for me in the 20 years I was certified.  Who says the BOS is the "bible" of transcription anyway?  Who died and left the power-hungry women of AAMT in charge anyway?  


The whole thing is a crock!
nm
crock pot stuff, one more
This is something I made when my kids were growing up. SO EASY! A blade pot roast is what I always used. Put IN crockpot...sprinkle on a package of taco seasoning mix, NO LIQUIDS. Cook eight to 10 hours. Shred meat and serve on tortillas, put out chopped onions, chopped green chili peppers, avacado, chopped tomato, actually anything the kids like...let them make their own soft tacos. Enjoy.
cooking in crock pot right now
Either beef stew meat OR a chuck, whatever.  One can cream of celery, one can cream of mushroom and one can french onion.  Don't have do do a thing.  Delicious
This is a crock - here are the facts about IQ

Okay, here are the facts for those who care (like me).


There are many standardized IQ  tests.  Some only go to 140.  Some tests can go up to 180.  So basically it depends on what IQ test was given just how relatively smart these people are.  I seriously doubt any of these folks actually published something as personal as an IQ score and even if they did, I would question the validity.   You cannot make a blanket statement when comparing IQs.  One more time (for those who didn't read my last post) -- think about high IQs like this -- it is simply processing speed, just like your computer.  Many IQ tests are auditory memory and/or processing skills -- i.e. you have $1.75 and three of the coins are dimes -- what are the other coins and how many of each. ..that type of thing.  I stress that while IQ is important -- what is more important are other qualities such as character, learning from experience, attitude, resiliency, etc.    I would also add that unfortunately research shows neurocognitive diseases such AD, etc. are very unkind to the extremely intelligent.


I have been a member of American Mensa for years....and find it to be a very valuable wealth of information -- ESPECIALLY  in regard to the testing and studies they have done on gifted children.  Very interesting research and publishing in their magazines of information on smart kiddos (like yours I am sure.) 


: I left Houston and moved to Chicago increasing the average IQ of both places :)


AND if you are going to dis MENSA -- there is another organization called Intertel of which I am also a member whose IQ requirement is 99.9.   What we actually do is covert -- but I am at last relieved that they can no longer harvest my eggs :)


 


Other crock pot food -
I have done a lasagna that turned out pretty good, I sometimes throw in some boneless skinless chicken breasts with some homemade BBQ sauce, have done chicken and dumplings which was good, spaghetti sauce. I would actually love some new recipes. The crock pot is so handy - I like to just throw stuff in and forget about it. My husband also works late a lot so he just lets me know when he is on the way and I can just throw on some veggies to go with whatever is in the crock pot.
What a crock! They don't really care what MTs
Their goal is to change the organization so it is open to IT professionals, vendors and others in order to gain larger membership numbers.  The staff and leaders have realized the organization has such a lowsy reputation with MTs that we're not going to join and they've given up on us.  They are not a professional organization for professionals.  They consider themselves a professional organization for the finished product of the profession (the healthcare record), not for the workers they were incorporated to support.  Any list will be totally useless to them.  They've simply assigned you busy work that they don't really care about.
This whole organization is a crock
Someone has to pay for all their travel, first class all the way.

I am still shaking my head i amazement about the one biggie in the organization who got his CMT with only 1 year of at home training doing office notes - no hospital experience, etc. This shows how truly worthless the whole certification process is. Credentialing should reflect adequate training in all areas of the profession, and it certainly degrades the title if someone was able to get certified by doing doctor office/clinic notes.




lemon crock pot chicken

21/2 # chicken, cut up, 1/4 cup flour, 2 T cooking oil, 1 6 oz frozen lemonade,


thawed. 3 T brown sugar, 3 T catsup, 1 T vinegard, 2 T cold water, 2 T cornstarch. Combine flour with 1-1/4 tsp. salt. Coat chicken and brown thoroughly in hot oil. Place in crock pot. Stir together lemonade, brown sugar, catsup and vinegar. Pour over chicken. Cover and cook on high heat 3 to 4 hours. Remove chicken. Pour liquid into saucepan. Return chicken to crock pot and cover to keep warm. Skim fat from liquid. Blend cold water into cornstarch and stir into hot liquid. Cook, stirring until thickened and bubbly. Serve chicken with gravy over hot cooked rice, noodles, or whatever you like.


 


 


"Happy MQer" What a crock!

 I totally agree with MQMT2 about how you should "spend" your check. 


40 clove chicken in the crock pot
Boy would I (and I am sure lots of us) love to have that recipe for 40 clove garlic chicken in the crock pot.  My mouth is watering.  hope it was good.
40 clove chicken in the crock pot
Big thank you....I can smell it now...tutu
Crock pot recipe with milk
Months ago there was a recipe for something and onions and milk -- It wasn't chicken but that's what I substituted and it was awesome.  I can't find the recipe.  If the original poster will reproduce it, I won't lose it again -- promise!!!
what a crock, using lies on your kids like that
you are an unscrupulous mt/mtso


BOS is a crock, but commas are still important!

Especially as demonstrated in the post above.  I think we all know (or should know) when a comma will change the meaning of a sentence.  I agree that is very important.  I believe in the AHDI BOS, Third Edition, it states that comma punctuation points are not deducted on audits because most of them are open to interpretation anyway.  Some sentences could take them or leave them, doesn't matter.


Somebody please tell me why these stupid hyphens are so important!!!!  How can they change the meaning of a sentence?  And another thing, who has the right to change the title punctuation in M.D. to MD.  We tried that on our account, HA, HA, HA.  Heard from those doctors right away and they did not like it one bit.  These things are why I say BOS is designed to cut an MT's pay, make more money for the MTSOs, and to give QA something to do! 


anyone have a good crock pot chicken recipe?

Anyone want to share their favorite crock pot recipe?

did everyone graduate MQs "Code fo Conduct" course? -- what a crock
that's like you stealing my purse and then sending me to class on how not to steal purses....
Put it in the crockpot and forget about it. It's a pan recipe but can be done in the crock pot ju
o
Roast, potatoes, and carrots in the crock pot...yum!
/
In my most humble opinion, I think credentialing is a crock. SM

You hit the nail on the head - its a test created by a group that requires you pay $100 or so for membership (I haven't checked what their fees are for a while), $80 for their rule book, and then $300 to take their test.  And for what?  A penny more per line, maybe? 


Not to mention, the organization which is supposed to be setting the tone and the standards in the medical transcription industry continually and consistently subverts the interests of the American MTs that were the life's blood of their association at its inception back in the good 'ol days.  Without us, their little club would not have grown as it did.  Instead of focusing on the needs of the American MTs and championing causes that would improve our industry and our pay checks, they have embraced offshoring, calling it the globalization of the workforce and say it the wave of the future and its progress.  And as they ride this wave of the future, they leave the American MT in their wake betrayed and alone and poor.


I have have a deep moral objection to giving one cent of my hard earned money to the AHDI.  They can keep their credentials and their membership dues.  Seeing "CMT" behind someone's name doesn't make me respect them anymore that them not being a CMT.  Quite the contrary, I start thinking their $300 sold out another American MT.  Good Job!  You're a CMT, yay! 


crock pot. seach for recipe on google for specifics.
i'm not even thining about dinner.
just put the 20 garlic chicken in the crock pot. Smells GREAT!
q
smoked picnic in crock pot...no muss, no fuss
Add to crockpot (no water needed). Cook high 4 to 5 hours and lo 11 to 12 hours.
What a crock. I've solved it by starting to put in commas
more Keystrokes for me, and hey - QA just LOVES their commas! The more the better, in their eyes.
Thank god for crock pots. 'cept the smell drives you crazy all day.
.
Roast with potatoes and carrots in the crock pot-good warmed over later.
nm
For saurkraut lovers, put apples, onions and pork chops in crock pot.
Wonderful meal. Some fresh rye bread with butter. Yummie.
Cook in equal parts BBQ and grape jelly. Crock pot if time. Yum! nm
 
Oh, someone benefits from AAMT - AAMT DOES!
x
Hubby making 40 clove garlic chicken in the crock pot. I'll make mashed potatoes and glazed
o
yes, they are hiring.....
and the pay is excellent, good benefits, but I understand the supervisor is a total nightmare. Lies, talks about employees to other employees, extremely intimidating and condescending, basically covers her behind by lying about employees...makes life miserable for her MTs. I believe it would be an excellent company to work for if it was not for this problem. But wanted some feed back on things others have heard.
Are they hiring or something? sm
What have you heard about the transcription supervisor. I have been looking around and don't want to get into something really bad.