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Re: JCAHO standard MM 4.10

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  • echoguy@tampabay.rr.com
    Cheryl, I have the CD Interactive Echocardiography by T. Binder. I agree with you, no one has made a CD with as much data as: Th. Binder did with Rehak,
    Message 1 of 10 , Dec 30, 2006
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      Cheryl,
      I have the CD Interactive Echocardiography by T. Binder.
       
      I  agree with you, no one has made a CD with as much data as:
       Th. Binder did with Rehak, Porenta,  Zangeneh, Maurer, Baumgartner on this CD
       
      You may contact me :
       
      Kerry Woll, AS, RCS, RVS.
      P.O. Box 14884
      Bradenton, Florida 34280
      home: 941-746-8964
      cell phone: 407-463-6489
      "We Can Make the Difference"
      e-mail: echoguy@...
      ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
      ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
    • Brenda King
      very interesting..... but what is JACHO looking for in regards to documentation that this has been done and or what are some of you people doing to document
      Message 2 of 10 , Jan 2, 2007
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        very interesting..... but what is JACHO looking for in regards to
        documentation that this has been done and or what are some of you people
        doing to document this. we just started using difinity and the repts.
        failed to mention any of this. any help or advise would be appreciated.
        thanks
        brenda

        >From: <abello4@...>
        >Reply-To: echocardiography@yahoogroups.com
        >To: <echocardiography@yahoogroups.com>,<echocardiography@yahoogroups.com>
        >Subject: Re: [echocardiography] JCAHO standard MM 4.10
        >Date: Tue, 26 Dec 2006 10:54:01 -0500
        >
        >Hi, It appears that this is an issue for any lab that administers any kind
        >of contrast now.
        >Ths ACR and JCAHO have been negociating this issue but apparently niether
        >is budging.
        >
        >JCAHO want every patient to be checked for drug interactions. If its and in
        >patient in a hospital setting it's not a problem if you somehow send or
        >scan the contrast order to pharmacy so they can check before you give it.
        >This is nothing new to pharmacy or nursing since this is usually how all
        >drugs are treated. This is new to us since it is recent that it was decided
        >by FDA and JCAHO that contrast is a drug.
        >For out patients if you either have to decide on a process to do medication
        >reconciliation on the patient or have a physician present.
        >We are still working on a process but for the meantime we decided to ask
        >one of the cardiologists or hospitalist to swing by the echo lab for a few
        >minutes.
        >I hope this helps.
        >Anne
        >
        >
        > >
        > > From: "annabuffington" <annabuffington@...>
        > > Date: 2006/12/21 Thu PM 07:46:05 EST
        > > To: echocardiography@yahoogroups.com
        > > Subject: [echocardiography] JCAHO standard MM 4.10
        > >
        > > I'm seeking input as to how labs are addressing the JCAHO standard
        > > concerning the use of IV contrast material.
        > >
        > > We currently have a standing order for use of Definity should the
        > > sonographer be unable to image two or more walls or if there is
        > > concern of an apical clot.
        > >
        > > Our consultants have advised us that the standard MM 4.10 applies to
        > > the use of all contrast agents (including Definity). The standard
        > > states that Pharmacy review is required unless a LIP (physician)
        > > controls the ordering, preparation, and administration of the
        > > medication. In other words a "standing order" isn't sufficient.
        > >
        > > How are other labs handling this?
        > >
        > >
        > >
        > >
        > >
        >

        _________________________________________________________________
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      • Hogan, Candy
        When I get the Definity from Pharmacy, my order that I turn in has allergies on it. So far I don t know any drug that is a contraindication. chogan ... From:
        Message 3 of 10 , Jan 2, 2007
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          When I get the Definity from Pharmacy, my order that I turn in has allergies on it.  So far I don't know any drug that is a contraindication.
           
          chogan
          -----Original Message-----
          From: echocardiography@yahoogroups.com [mailto:echocardiography@yahoogroups.com]On Behalf Of abello4@...
          Sent: Friday, December 29, 2006 11:48 AM
          To: echocardiography@yahoogroups.com
          Subject: Re: Re: [echocardiography] JCAHO standard MM 4.10

          Hi Gersten,
          JCAHO wants us to check all drugs including contrast with the pharmacy for interactions. How do you do this?
          Thanks
          Anne

          >
          > From: Ger F <docger14@yahoo. com>
          > Date: 2006/12/22 Fri PM 12:49:14 EST
          > To: echocardiography@ yahoogroups. com
          > Subject: Re: [echocardiography] JCAHO standard MM 4.10
          >
          > At the major ECHO meetings ( MAYO, MGH, ORLANDO W Dr.
          > DeMaria, etc) the protocol reported on is that the
          > sonographer determines after a few minutes or less if
          > the images are readable without contrast. If not, then
          > the sonographer decides on the contrast. An i.v. is
          > started by someone certified in same ( Nuclear tech,
          > nurse, etc) and the sonographer, who has been trained
          > by the Definity folks in how to shake and admin gives
          > the contrast. Our lab happens to be in a hospital so
          > that the rare reaction can be handled appropriately.
          >
          > Not sure how this would be in a free standing place.
          > Would need a crash cart available and ACLS trained
          > people I would imagine.
          >
          > We do supine bicycle stress echo so there is always a
          > physician present in the case of stress echo with
          > contrast.
          >
          > The given criteria for contrast are usually 2 or more
          > segments that can not be seen and used for eyeballing
          > or planimetry to determine regional or global wall
          > thickening. These are frequently in the high apical
          > lateral wall (seg 8 and 13 in the old numbering
          > system)
          > GF
          >
          >
          > --- annabuffington <annabuffington@ yahoo.com> wrote:
          >
          > > I'm seeking input as to how labs are addressing the
          > > JCAHO standard
          > > concerning the use of IV contrast material.
          > >
          > > We currently have a standing order for use of
          > > Definity should the
          > > sonographer be unable to image two or more walls or
          > > if there is
          > > concern of an apical clot.
          > >
          > > Our consultants have advised us that the standard MM
          > > 4.10 applies to
          > > the use of all contrast agents (including Definity).
          > > The standard
          > > states that Pharmacy review is required unless a LIP
          > > (physician)
          > > controls the ordering, preparation, and
          > > administration of the
          > > medication. In other words a "standing order" isn't
          > > sufficient.
          > >
          > > How are other labs handling this?
          > >
          > >
          > >
          > >
          >
          >
          > ____________ _________ _________ _________ _________ __
          > Do You Yahoo!?
          > Tired of spam? Yahoo! Mail has the best spam protection around
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          >
          >

        • abello4@bellsouth.net
          In 2004 JCAHO revised the definition of a medication and included contrast as part of the definition. I really don’t think the reps are up to date about
          Message 4 of 10 , Jan 2, 2007
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            In 2004 JCAHO revised the definition of a medication and included contrast as part of the definition. I really don’t think the reps are up to date about this. JCAHO wants us to check for drug-drug interaction.
            With in-patient it's relatively easy since everything the patient is given is already in the computer and if you somehow advise the pharmacy what you are giving, they can check and notify it's OK to give the drug. We still haven’t figured out how we are going to do this with out patients.
            The situation with Definity contrast is that there is no known drug-drug interaction so it is pointless to wait for the pharmacy's OK.

            What I do is scan all the orders to the pharmacy as soon as I know we need to give it and make sure to write it on the patients MAR (medication administration record).
            JCAHO recently announced some proposed revisions to MM4.10 and MM 8.10. From what I gather it seems that we may be able to have pharmacy review it retrospectively (after we give it), but it's not clear.

            I went on the JCAHO website and wrote a comment about this situation. I am also planning to call one of their standards interpreters to get their input.
            I suggest we all contact JCAHO about this.


            Anne
            >
            > From: "Brenda King" <bkbroiler40@...>
            > Date: 2007/01/02 Tue PM 01:49:34 EST
            > To: echocardiography@yahoogroups.com
            > Subject: Re: [echocardiography] JCAHO standard MM 4.10
            >
            > very interesting..... but what is JACHO looking for in regards to
            > documentation that this has been done and or what are some of you people
            > doing to document this. we just started using difinity and the repts.
            > failed to mention any of this. any help or advise would be appreciated.
            > thanks
            > brenda
            >
            > >From: <abello4@...>
            > >Reply-To: echocardiography@yahoogroups.com
            > >To: <echocardiography@yahoogroups.com>,<echocardiography@yahoogroups.com>
            > >Subject: Re: [echocardiography] JCAHO standard MM 4.10
            > >Date: Tue, 26 Dec 2006 10:54:01 -0500
            > >
            > >Hi, It appears that this is an issue for any lab that administers any kind
            > >of contrast now.
            > >Ths ACR and JCAHO have been negociating this issue but apparently niether
            > >is budging.
            > >
            > >JCAHO want every patient to be checked for drug interactions. If its and in
            > >patient in a hospital setting it's not a problem if you somehow send or
            > >scan the contrast order to pharmacy so they can check before you give it.
            > >This is nothing new to pharmacy or nursing since this is usually how all
            > >drugs are treated. This is new to us since it is recent that it was decided
            > >by FDA and JCAHO that contrast is a drug.
            > >For out patients if you either have to decide on a process to do medication
            > >reconciliation on the patient or have a physician present.
            > >We are still working on a process but for the meantime we decided to ask
            > >one of the cardiologists or hospitalist to swing by the echo lab for a few
            > >minutes.
            > >I hope this helps.
            > >Anne
            > >
            > >
            > > >
            > > > From: "annabuffington" <annabuffington@...>
            > > > Date: 2006/12/21 Thu PM 07:46:05 EST
            > > > To: echocardiography@yahoogroups.com
            > > > Subject: [echocardiography] JCAHO standard MM 4.10
            > > >
            > > > I'm seeking input as to how labs are addressing the JCAHO standard
            > > > concerning the use of IV contrast material.
            > > >
            > > > We currently have a standing order for use of Definity should the
            > > > sonographer be unable to image two or more walls or if there is
            > > > concern of an apical clot.
            > > >
            > > > Our consultants have advised us that the standard MM 4.10 applies to
            > > > the use of all contrast agents (including Definity). The standard
            > > > states that Pharmacy review is required unless a LIP (physician)
            > > > controls the ordering, preparation, and administration of the
            > > > medication. In other words a "standing order" isn't sufficient.
            > > >
            > > > How are other labs handling this?
            > > >
            > > >
            > > >
            > > >
            > > >
            > >
            >
            > _________________________________________________________________
            > The MSN Entertainment Guide to Golden Globes is here. Get all the scoop.
            > http://tv.msn.com/tv/globes2007/
            >
            >
            >
          • Daskalakis Kosmas MD
            From: echocardiography@yahoogroups.com [mailto:echocardiography@yahoogroups.com] On Behalf Of echoguy@tampabay.rr.com Sent: Saturday, December 30, 2006 11:55
            Message 5 of 10 , Jan 3, 2007
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              From: echocardiography@yahoogroups.com [mailto:echocardiography@yahoogroups.com] On Behalf Of echoguy@...
              Sent: Saturday, December 30, 2006 11:55 PM
              To: echocardiography@yahoogroups.com
              Subject: [echocardiography] Re: JCAHO standard MM 4.10

               

               

                Happy new year to all

               Iam a cardiologist here in Athens Greece, and I have some medical students in echo lab. Is there a way to have this CD with the echo atlas? Please contact me if there is a solution.

              Thanking you in advance

              Daskalakis G Kosmas MD

               

               

              Cheryl,

              I have the CD Interactive Echocardiography by T. Binder.

               

              I  agree with you, no one has made a CD with as much data as:

               Th. Binder did with Rehak, Porenta,  Zangeneh, Maurer, Baumgartner on this CD

               

              You may contact me :

               

              Kerry Woll, AS, RCS, RVS.
              P.O. Box 14884
              Bradenton, Florida 34280
              home: 941-746-8964
              cell phone: 407-463-6489
              "We Can Make the Difference"
              e-mail: echoguy@...
              ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
              ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^

            • cheryl lawrence
              Dr Kosmas, It is out of print. Futura Publishing is no longer selling it which is why I m trying to find a used copy that someone will sell me. Cherie
              Message 6 of 10 , Jan 4, 2007
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                Dr Kosmas,

                It is out of print. Futura Publishing is no longer selling it
                which is why I'm trying to find a used copy that someone will
                sell me.
                Cherie
                Cleveland, OH







                ---------[ Received Mail Content ]----------

                Subject : RE: [echocardiography] Re: JCAHO standard MM 4.10

                Date : Wed, 3 Jan 2007 20:44:01 +0200

                From : "Daskalakis Kosmas MD" <cosmasda@...>

                To : <echocardiography@yahoogroups.com>











                From: echocardiography@yahoogroups.com

                [mailto:echocardiography@yahoogroups.com] On Behalf Of

                echoguy@...

                Sent: Saturday, December 30, 2006 11:55 PM

                To: echocardiography@yahoogroups.com

                Subject: [echocardiography] Re: JCAHO standard MM 4.10











                Happy new year to all



                Iam a cardiologist here in Athens Greece, and I have some medical students

                in echo lab. Is there a way to have this CD with the echo atlas? Please

                contact me if there is a solution.



                Thanking you in advance



                Daskalakis G Kosmas MD











                Cheryl,



                I have the CD Interactive Echocardiography by T. Binder.







                I agree with you, no one has made a CD with as much data as:



                Th. Binder did with Rehak, Porenta, Zangeneh, Maurer, Baumgartner on this

                CD







                You may contact me :







                Kerry Woll, AS, RCS, RVS.

                P.O. Box 14884

                Bradenton, Florida 34280

                home: 941-746-8964

                cell phone: 407-463-6489

                "We Can Make the Difference"

                e-mail: echoguy@...

                ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^

                ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^










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