Do all LTC's chart the meals on the MAR's?

CapeCodMermaid, RN · Sep 26, 2012

It continues because people think it's a regulation. I spend hours goig through the emars to get rid of things we don't need to do. In the end, I think it will pay off so the nurses have time to be nurses.

RunnerRN2015, ASN, RN · Sep 26, 2012

When I worked at a LTC facility (CNA), we had to chart meal percentages for every meal, record every snack, record when they urinated, and keep track of BMs, including size and firmness. If they didn't have a BM for a certain number of shifts, they were given a laxative.

morte, LPN, LVN · Sep 26, 2012

No, at the time I was agency, so didn't ask. I am thinking it is to make sure that constipation is addressed in a timely fashion. When you get the paper work from the CNAs at 250 pm it is a pain to try to get to the MAR before second shift wants it. At one place what was done to solve that problem was documentation transcription was done by the next shift. That worked out, because they were the one's to address any way.

Were you given a reason?

LTCNS, LPN · Sep 26, 2012

I have found that a good many policies and "regulations" are put in place because another home got a deficiency from state, so all homes have to comply with the new regs. IOW, everyone gets punished for something one home got dinged for. Next survey will be something else and policies will change again. It's a never ending cycle.

AngelRN27 · Sep 28, 2012

At my facility, percentage of meals consumed is documented by the CNA in their own log book. As for BM's, they have their own spot at the back of the MAR to be charted by the nurse. The CNA's report BM's to us at the end of the shift... I agree, time consuming. The reason BM's are documented by the nurse, though, is so that we can intervene if there has not been any BM for X amount of days...

EDIT: I don't think that BM logs should be a nursing responsibility just because it is state mandated. In our Geri population, it is extremely important because they easily become impacted as per their already slow motility, plus polypharmacy. Maybe it seems insignificant, but a day or two of fecal impaction can cause obstruction, and eventually perforation of the bowels, which can obviously be fatal.

zieglarf, LVN · Oct 4, 2012

I have to chart food and fluid intake but not in the MAR.

I don't chart BMs - I check the bellies for distension and listen for active bowel sounds on certain residents and ask the CNAs if there were any BMs; then I give PRNs if needed.

CapeCodMermaid, RN · Oct 4, 2012

Fecal impactions do not usually occur in a day or two. I don't think anyone here implied that BMs weren't important. MY point is, writing them on a piece of paper does NOT require the SKILL of a licensed person. It's data entry. What IS important is what's done with the information.

barbarake21 · Oct 5, 2012

It continues because people think it's a regulation. I spend hours goig through the emars to get rid of things we don't need to do. In the end, I think it will pay off so the nurses have time to be nurses.

CapeCodMermaid - Can I come work for you??

CapeCodMermaid, RN · Oct 5, 2012

CapeCodMermaid - Can I come work for you??

Sure!

morte, LPN, LVN · Oct 6, 2012

get in line, lol.

CapeCodMermaid - Can I come work for you??

Blackcat99 · Oct 6, 2012

I am off orientation now. Some of the CNA's are not doing their vital signs, meal percentages and BM's. I am required to chart it on the MAR but the aides are just ignoring their worksheets so I have no idea if the patients is eating well or not and or having regular BM's. I hate to say it but I am ready to start writing up CNA'S. Any other suggestions? I sure don't have time to follow them around and beg them to do their jobs.

CapeCodMermaid, RN · Oct 6, 2012

If you've asked them to do this, and have made the expectation clear, you really have no choice but to counsel them. YOU can't do your job if they don't do theirs. Perhaps one more get out of jail free talk stressing the importance of this information.