The Joint Commission in its
Sentinel Event Alert in April 2018 identified that violence against healthcare workers is grossly underreported.
This
Sentinel Event Alert explores this topic and addresses methods to create a culture in which these occurrences are reported so they can be analyzed through systematic efforts to reduce the likelihood that such events will be replicated in the future (TJC, 2018a, b).
In response to The Joint Commission
Sentinel Event Alert on the safe use of opioids in hospitals, Wake Forest Baptist Medical Center initiated surveillance monitoring as the standard for most patients.
Sentinel Event Alert: Inadequate hand-off communication.
Cipriano, PhD, RN, NEA-BC, FAAN, president of the American Nurses Association (ANA): "ANA is pleased that The Joint Commission has issued a
Sentinel Event Alert on physical and verbal violence against health care workers.
"We often hear of whanau waiting outside the mortuary, separated from their loved one by walls and a bureaucratic technical process that categorises your loved one as a coroner's case, a Health and Disability Commissioner HDC case, a
sentinel event, or a death in police custody," Pakeho said.
NQF's list of 29 events that should never occur includes "unintended retention of a foreign object in a patient after surgery or other procedure." (7) Similarly in a 2013
Sentinel Event Alert, the Joint Commission specifically includes vaginal sponge retention as a reportable
sentinel event that is a violation of patient safety and quality of care.
The Joint Commission (formerly the JCAHO-Joint Commission on Accreditation of Healthcare Organizations) recognizing the urgency of the suicide problem, issued a
Sentinel Event Alert on February 24, 2016.
The Joint Commission (2011) issued a
Sentinel Event Alert on healthcare worker fatigue and patient safety, listing the following impacts of fatigue:
The
sentinel event of my life, apart from my decision to follow Christ, was the day I stopped my car at Duke University's East Campus to give several girls a ride to Wright Refuge, an emergency foster care facility, where we would spend the afternoon playing and tutoring the children.