The Joint Commission (TJC) has just released a clarifying guideline to assist hospitals in meeting the accreditation standards when Health Care Industry Representatives (HCIRs) are present.
TJC’s expectations are straightforward: when HCIRs are in the clinical environment, TJC standards for infection control, patient rights (particularly informed consent), and safety must be maintained.
This may sound simple, but practitioners in the field have experienced many challenges managing HCIRs. It is a delicate balance between meeting the needs of physicians/staff seeking information and orientation on new devices and applications, and maintaining control of the patient care environment. A compounding factor may also be the eagerness of the HCIRs, as their focus is sales, while the hospital’s priority is patient care.
How can your organization meet the physicians’ needs for HCIR instruction while also meeting its primary obligation to patient care—all while demonstrating adherence to TJC standards?
First and foremost, control is key, and control means knowing who is inside your organization and for what purpose. The HCIR is there to educate practitioners and sell new products, but while doing so, the HCIR must conform to your organization’s policies and procedures.
A strictly enforced policy and process of vendor registration is the first step toward ensuring this conformance, and numerous systems for vendor registration exist. But are these systems sufficient when the HCIR participates in a patient care environment?
The answer is no. It is still the hospital’s obligation to assure that the individual HCIR is competent in infection control practices, confidentiality, patient safety, and life safety. Each and every representative in the care setting must be able to articulate his/her role in an emergency, respect the confidentiality of patient information, and observe the organization’s patient rescue protocols. This responsibility requires at least a rudimentary orientation of the HCIR to the hospital. Additionally, frontline managers must be empowered to enforce these requirements when HCIRs are present. The charge nurse or manager must be certain that all people working in the environment—employee or not—are capable of meeting the requirements of assuring safe patient care.
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