For those of you who DID participate in the March 2008 informal "survey/questionnaire" (by AHCA) about RAPs for MDS 3.0--THANK YOU!
We are FINALLY submitting our findings and recommendations to CMS. The final report will be posted and be available for all to read within the next week or so...will communicate the location via this listserv.
Preliminarily--most nurses DID NOT WANT TO CONTINUE doing the RAPS, as currently presented, for many reasons. Many nurses wanted to continue with "triggers" for MDS 3.0--as "reminders".
With MDS 3.0 right around the bend, and funding "short", it is highly unlikely that NEW RAPS will be prepared, though the OLD may still be included as a reference.
As nurses, we must, however, recognize and appreciate the value of analyzing, or looking at, an individual's problem (or potential problem) as part of a process in a standardized way--using a multi-disciplinary approach using the RAPs, or more current clinical guidelines.
Sometimes we "know" our patients, but not THIS patient. We "miss the boat" about THIS patient's weight loss, because the dietitian picked up something in his/her assessment that was not considered in the care plan. Sometimes the plan contains components which have been proved to be ineffective in recent evidence-based research. And then we wonder why the care plan failed...
We can't forget that there is an "art" and a "science" behind nursing. It is our skill in using the science which can make the difference whether or not an individual patient's plan works, or doesn't.
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