RE: Getting orders on care plans

[Faye Jones]

I do wonder at the logic of having to be minutely specific on careplans (but don’t doubt you have to be).  We recently had a resident with unstable hypertension who had 2-3 order changes/stat meds a day for 2-3 days and if we had put all of them on the care plan it would have looked unintelligible.  I would think it is more important to monitor effect of meds, s/s complications and how about that stroke she might have if no one is watching.  I would think it is better to have a short, concise, effective careplan but then that’s me. I mean most of the floor staff are CNA’s and they need a careplan that makes sense, the LPN/med nurse if she is doing the job has all the info in her MAR/TAR and the RN pretty much knows her residents.  I want my staff to read the darn things not be turned off by 20+ pages of paper that are not discernable.  I truly do not comprehend the need to duplicate the same info in multiple places as long as you make it clear where the details can be found and it is accessible.  Oh well enough for that soap box-just one of my pet peeves.  -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of T Prit Sent: Friday, February 20, 2004 1:29 PM To: [EMAIL PROTECTED] Subject: RE: Getting orders on care plans   I'm in Alabama and we have been cited before for not being specific enough.  I do like the idea of the notebook at the nurse's stations to monitor orders. "Richardson, Christine" <[EMAIL PROTECTED]> wrote: If you don't mind what state are you in? I'm in MO and I don't think that would work with our inspectors. -----Original Message----- From: Faye Jones [mailto:[EMAIL PROTECTED] Sent: Thursday, February 19, 2004 12:43 PM To: [EMAIL PROTECTED] Subject: RE: Getting orders on careplans Our Supervisors do all of their own careplanning. However, we do not specifically name any drugs/treatments or give minute details. We use broad classifications such as “Administer diuretic as ordered”  “Decubitus care as ordered-See MAR for specifics”.  We have found this much more manageable for 2 reasons: 1.      Being too specific means you constantly have to update which is time consuming. 2.      Care plans became so long and cumbersome due to the many changes that no one could figure out what was current We have not had any problems with survey since we changed our ways-in fact we have less problems with issues r/t inaccuracies. Our most efficient nurse managers have a “care plan note book” and as things arise they make an entry such as 2/19 Faye—UTI and when they do the IDCP use a pink highlighter to “pink it out”.  The note book sits by the unit computer and all 3 shifts are welcome to assist. This seems to work well for them.  They tell me that they usually can get them caught up on the weekend. We used to divide each unit into 3 sections with each shift responsible for their 1/3 for daily updates but this seems to have gone by the wayside.   -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of T Prit Sent: Thursday, February 19, 2004 12:38 PM To: [EMAIL PROTECTED] Subject: Getting orders on careplans   Hey group:  We recently had survey and we got a tag on careplan and assessment because the careplan was not updated due to the fact that a resident was started on a diuretic.  The nurses say that they are not able to put new orders on the careplans at order times because they don't have enough time.  The question is what do your facilities do to see that new orders are put on the careplan in a timely matter?  Any suggestions are greatly appreciated. Terri Do you Yahoo!? Yahoo! Mail SpamGuard - Read only the mail you want. NOTE: This e-mail message may contain information that is privileged, confidential, and exempt from disclosure.  It is intended for use only by the person to whom it is addressed. If you have received this message in error, please do not forward or use this information in any way. Delete it immediately and contact the sender as soon as possible by the reply option or by telephone at the telephone number listed (if available).  In the event you cannot fulfill your obligation or there has been any improper release of this information, please contact the Privacy Officer at Carondelet Health at (816) 943-4611.   Do you Yahoo!? Yahoo! Mail SpamGuard - Read only the mail you want.