In regards to my earlier message regarding JCAHO and breastfeeding, I wanted
to clarify a few items.  First of all, JCAHO is Joint Commission
Accreditation Health Care Organization - in other words, the emblem desired
by hospitals for the highest honors.  Secondly,  I agree with Kathy
Dettwyler's comments regarding the nutrition assessment and lactation.  In
fact, I came to work the next day armed with my Ruth Lawrence book and the
pages regarding maternal malnutrition and its lack of linkage to mom's milk
supply.  But, my friend listened to me and told me to give it up.  She was
right!  The examiner was not listening to any of us.  So, on the optimistic
side, for a grouchy examiner to even mention lactation, I still find
encouraging.  With her attitude on life in general, I doubt she herself ever
breastfed.  She knew her standards for JCAHO, which included the process of
referrals for nutritional needs.  We found she didn't know many other
evidence-based practices.  We use NANDA/NIC/NOC documentation, which is
evidence-based, and she didn't agree that it was a plan of care.  She wasn't
correct on a few other items.  We got a score of 93% and I got a migraine!
It was not a fun process!  She was difficult to say the least.
Carol Chamblin, RN, MS, IBCLC

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