Ambulatory Surgical Center of Southern Nevada
6950 S. Cimarron Road, Suite 100 Las Vegas, NV 89113 (702) 952-1660
June 30, 2021
Director of Legislative Counsel Bureau
401 South Carson St.
Carson City, Nevada 89701 RE: Patient Safety Checklist & Patient Safety Policy Review
We are submitting our annual Patient Safety Checklist and Policy Review Report pursuant to Assembly Bill 280. Should you have any questions or concerns, please contact me at phone number or address listed below.
Sincerely, ~!J\f\Nv)'U'/ r11 I Kelli Wuerfel, Facility Administrator Ambulatory Surgical Center of Southern Nevada 6950 S Cimarron Rd, Suite 100 Las Vegas, NV 89113 (702) 952-1660 REPORT TO THE DIRECTOR OF THE LEGISLATIVE COUNSEL BUREAU PURSUANT TO ASSEMBLY BILL 280 OF THE 2011 LEGISLATIVE SESSION- SUBMITTED BY:
Ambulatory Surgical Center of Southern Nevada
6950 S Cimarron Rd Suite 100, Las Vegas, NV 89113
Kelli Wuerfel, Administrator
Period: July 1, 2020– June 30, 2021
Checklists Developed Include: Revisions* Usage** Review*** Patient Safety Checklist ASC- All Departments X Procedure Safety Checklists (fire risk assessment, HLD) ASC- Intra Op X Housekeeping- facility Patient Room and Environment Sanitation wide X Medication Reconciliation ASC- All Departments X Equipment/Environment Safety Checklists (electrosurgical cautery, eyewash, maintenance logs) ASC- All Departments X Survey Checklists (Infection Control, hand Hygiene) ASC- All Departments X Patient Safety Policies Developed Include: Patient identification before providing treatment ASC- All Departments X Infection Control Plan/Policies ASC- All Departments X Hand hygiene nationally recognized standard precautionary protocols ASC- All Departments X Patient Safety Policy ASC- All Departments X Patient Safety Checklists and policy Compliance ASC- All Departments X Scope of Patient Care (i.e. admission criteria, discharge from PACU, etc.) ASC- Nursing X
Total # Total # Summary of Review Developed Revised Total # Reviewed Patient Safety Checklist 1 0 All checklists reviewed by Patient Safety Committee Complete P & P Review by Patient Safety Committee and Patietn Safety Policy 1 0 Governing Body
*Checklists and Patient Safety Policies were reviewed for the state time period. Need for revision is noted by the date the revision was made.
**Usage outlines the unit/departments the checklists are used in.
***As part of the annual review any required revisions will be identified. If revisions are required, this is noted in the revision box. Any additional patient safety checklists or policies identified will be noted in the (review) column. If the annual review reveals no charges are required this box will be marked with an “X”. An “X” means that the checklists are policies were reviewed but no changes were required.