All, We recently queried CMS for accepting the following documentation as refusal to 30ml/kg bolus and they stated it did not meet the criteria. Can anyone provide a rationale as to why this documentation doesn't suffice? My providers prefer taking a more positive approach that is more inclusive of the patient, not the negative tone of 'patient refuses.' Any advice is greatly appreciated as well.
The following was documented by one of my MDs - "Patient meets criteria for 30ml/kg bolus, there is concern for fluid overload and cardiogenic shock. The plan was discussed with patient and patient's daughter who agreed to modified plan of care to include gentle hydration and vasopressors, not a 30ml/kg bolus." Thanks so much, Danette Danette Culver, MSN, APRN, ACNS-BC, CCRN-K, RN-BC Clinical Nurse Specialist, Sepsis Coordinator Norton Healthcare, Louisville KY O: 502.629.4058 C: 812.881.0080 A Clinical Nurse Specialist (CNS) is a Master's prepared Advance Practice Nurse whose function is to improve outcomes in patient care. The CNS is a clinical practice expert, an educator, a researcher, and a consultant who influences the three spheres of practice: patient care, nursing, and systems. - National Association of Clinical Nurse Specialists ______________________________________________________________________ This message is confidential, intended only for the named recipient(s) and may contain information that is privileged or exempt from disclosure under applicable law. Any patient health information must be delivered immediately to intended recipient(s). If you are not the intended recipient(s), you are notified that the dissemination, distribution or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at either the e-mail address or telephone number above and discard this e-mail. Thank you.
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