Combined Assessment Program - Review of the White River Junction VA Medical Center White River Junction, Vermont

Review Purpose: The purpose was to evaluate selected activities, focusing on patient care administration and quality management, and to provide crime awareness training. We conducted the review the week of July 11, 2011. Review Results: The review covered eight activities. We made no recommendations in the following activities: ? Management of Workplace Violence ? Medication Management ? Quality Management ? Registered Nurse Competencies The facility’s reported accomplishments were the development of a tracking system for reusable medical equipment, the hospice chorus, and the Veterans Free Farmers’ Market. Recommendations: We made recommendations in the following four activities: Coordination of Care: Ensure all components of written advance directive notification are provided to each patient, and document notification in the medical record. Update facility advance directive policy to identify the staff responsible for notification and to address the training requirements for staff involved in advance care planning discussions. Physician Credentialing and Privileging: Ensure all privileges granted are appropriate for the clinical settings. Enteral Nutrition Safety: Ensure that enteral nutrition documentation includes all required elements and that compliance is monitored. Environment of Care: Ensure that employees with occupational exposure risk receive annual bloodborne pathogens training and that compliance is monitored.