Create a healthcare culture of safety. (NQF Safe Practice 1) "A culture that overtly encourages and supports the reporting of any situation or circumstance that threatens, or potentially threatens, the safety of patients or caregivers and that views the occurrence of errors and adverse events as opportunities to make the healthcare system better"

For designated high-risk, elective surgical procedures or other specified care, patients should be clearly informed of the likely reduced risk of an adverse outcome at treatment facilities that have demonstrated superior outcomes and should be referred to such facilities in accordance with the patient’s stated preference. (NQF Safe Practice 2)

Specify an explicit protocol to be used to ensure an adequate level of nursing based on the institution’s usual patient mix and the experience and training of its nursing staff. (NQF Safe Practice 3)

All patients in general intensive care units (both adult and pediatric) should be managed by physicians having specific training and certification in critical care medicine ("critical care certified"). (NQF Safe Practice 4)

Pharmacists should actively participate in the medication-use process, including, at a minimum, being available for consultation with prescribers on medication ordering, interpretation and review of medication orders, preparation of medications, dispensing of medications, and administration and monitoring of medications. (NQF Safe Practice 5)

Verbal orders should be recorded whenever possible and immediately read back to the prescriber—i.e., a healthcare provider receiving a verbal order should read or repeat back the information that the prescriber conveys in order to verify the accuracy of what was heard. (NQF Safe Practice 6)

Use only standardized abbreviations and dose designations. (NQF Safe Practice 7)

Patient care summaries or other similar records should not be prepared from memory. (NQF Safe Practice 8)

Ensure that care information, especially changes in orders and new diagnostic information, is transmitted in a timely and clearly understandable form to all of the patient’s current healthcare providers who need that information to provide care. (NQF Safe Practice 9)

Ask each patient or legal surrogate to recount what he or she has been told during the informed consent discussion. (NQF Safe Practice 10)

Ensure that written documentation of the patient's preference for life-sustaining treatments is prominently displayed in his or her chart. (NQF Safe Practice 11)

Implement a computerized prescriber order entry (CPOE) system. (NQF Safe Practice 12)

Implement a standardized protocol to prevent the mislabeling of radiographs. (NQF Safe Practice 13)

Implement standardized protocols to prevent the occurrence of wrong-site procedures or wrong-patient procedures. (NQF Safe Practice 14)

Evaluate each patient undergoing elective surgery for risk of an acute ischemic cardiac event during surgery, and provide prophylactic treatment of high-risk patients with beta blockers. (NQF Safe Practice 15)

Evaluate each patient upon admission, and regularly thereafter, for the risk of developing pressure ulcers. This evaluation should be repeated at regular intervals during care. Clinically appropriate preventive methods should be implemented consequent to the evaluation. (NQF Safe Practice 16)

Evaluate each patient upon admission, and regularly thereafter, for the risk of developing deep vein thrombosis (DVT)/venous thromboembolism (VTE). Utilize clinically appropriate methods to prevent DVT/VTE. (NQF Safe Practice 17)

Utilize dedicated anti-thrombotic (anti-coagulation) services that facilitate coordinated care management. (NQF Safe Practice 18)

Upon admission, and regularly thereafter, evaluate each patient for the risk of aspiration. (NQF Safe Practice 19)

Adhere to effective methods of preventing central venous catheter-associated blood stream infections. (NQF Safe Practice 20)

Evaluate each pre-operative patient in light of his or her planned surgical procedure for the risk of surgical site infection, and implement appropriate antibiotic prophylaxis and other preventive measures based on that evaluation. (NQF Safe Practice 21)

Utilize validated protocols to evaluate patients who are at risk for contrast media-induced renal failure, and utilize a clinically appropriate method for reducing risk of renal injury based on the patient’s kidney function evaluation. (NQF Safe Practice 22)

Evaluate each patient upon admission, and regularly thereafter, for risk of malnutrition. Employ clinically appropriate strategies to prevent malnutrition. (NQF Safe Practice 23)

Whenever a pneumatic tourniquet is used, evaluate the patient for the risk of an ischemic and/or thrombotic complication, and utilize appropriate prophylactic measures. (NQF Safe Practice 24)

Decontaminate hands with either a hygienic hand rub or by washing with a disinfectant soap prior to and after direct contact with the patient or objects immediately around the patient. (NQF Safe Practice 25)

Vaccinate healthcare workers against influenza to protect both them and patients from influenza. (NQF Safe Practice 26)

Keep workspaces where medications are prepared clean, orderly, well lit, and free of clutter, distraction, and noise. (NQF Safe Practice 27)

Standardize the methods for labeling, packaging, and storing medications. (NQF Safe Practice 28)

Identify all "high alert" drugs (e.g., intravenous adrenergic agonists and antagonists, chemotherapy agents, anticoagulants and anti-thrombotics, concentrated parenteral electrolytes, general anesthetics, neuromuscular blockers, insulin and oral hypoglycemics, narcotics and opiates). (NQF Safe Practice 29)

Dispense medications in unit-dose or, when appropriate, unit-of-use form, whenever possible. (NQF Safe Practice 30)

Use at least two patient identifiers (neither to be the patient's room number) whenever administering medications or blood products; taking blood samples and other specimens for clinical testing, or providing any other treatments or procedures. (JCAHO National Patient Safety Goal 1a)

For verbal or telephone orders or for telephonic reporting of critical test results, verify the complete order or test result by having the person receiving the order or test result "read-back" the complete order or test result. (JCAHO National Patient Safety Goal 2a)

Standardize a list of abbreviations, acronyms and symbols that are not to be used throughout the organization. (JCAHO National Patient Safety Goal 2b)

Measure, assess and, if appropriate, take action to improve the timeliness of reporting, and the timeliness of receipt by the responsible licensed caregiver, of critical test results and values. (JCAHO National Patient Safety Goal 2c)

Implement a standardized approach to "hand off" communications, including an opportunity to ask and respond to questions. (JCAHO National Patient Safety Goal 2e)

Standardize and limit the number of drug concentrations available in the organization. (JCAHO National Patient Safety Goal 3b)

Identify and, at a minimum, annually review a list of look-alike/sound-alike drugs used in the organization, and take action to prevent errors involving the interchange of these drugs. (JCAHO National Patient Safety Goal 3c)

Label all medications, medication containers (e.g., syringes, medicine cups, basins), or other solutions on and off the sterile field in perioperative and other procedural settings. (JCAHO National Patient Safety Goal 3d)

Comply with current Centers for Disease Control and Prevention (CDC) hand hygiene guidelines. (JCAHO National Patient Safety Goal 7a)

Manage as sentinel events all identified cases of unanticipated death or major permanent loss of function associated with a health care-associated infection. (JCAHO National Patient Safety Goal 7b)

Implement a process for obtaining and documenting a complete list of the patient’s current medications upon the patient’s admission to the organization and with the involvement of the patient. This process includes a comparison of the medications the organization provides to those on the list. (JCAHO National Patient Safety Goal 8a)

A complete list of the patient's medications is communicated to the next provider of service when it refers or transfers a patient to another setting, service, practitioner or level of care within or outside the organization. (JCAHO National Patient Safety Goal 8b)

Implement a fall reduction program and evaluate the effectiveness of the program. (JCAHO National Patient Safety Goal 9b)

Prior to the start of any invasive procedure, conduct a final verification process to confirm the correct patient, procedure, site, and availability of appropriate documents. This verification process uses active—not passive—communication techniques. (JCAHO Universal Protocol for Preventing Wrong Site, Wrong Procedure, Wrong Person Surgery™)

Create and use a preoperative verification process, such as a checklist, to confirm that appropriate documents (e.g., medical records, imaging studies) are available. (JCAHO Universal Protocol)

Implement a process to mark the surgical site and involve the patient in the marking process. (JCAHO Universal Protocol)