First, I'll ask you, do your nurses really know what they are supposed to be charting on? Sounds simple, but I feel that at least 40% of the time, nurses aren't sure what is necessary for Medicare documentation, etc.
I have discovered this in depositions and interviews with the attorney's for defense related cases. I also used to try to refrain from this, but I find that shocking nurses is a great way to get them to chart better. How do you do that? Well, you have someone like myself come tell them about what it is like in court for nurses, use case examples or use your facilities attorney to come and speak to your nurses. I also think that having a simple documentation guideline availible at the desk to remind them about what needs to be documented, how often, etc. is helpful. I know that you should not have to do it but there isn't really an option. As an aside, Docs have little document guidelines that they use also. Educate them as much as possible. Also, it is a vital part of their job description and you may need to remind them that poor documentation will be reflective in their evaluations. Do you have a risk manager in your system? Remind them that when they get done with their entries, if someone was to ask them 3 years from now, what was happening with that resident, would they be able to tell someone adequately in court by their entries. There are some good books availible by nurses on documentation(Patricia Iyler, Tonia Aiken, Sheryl Feutz-Harter, Janet Beckmann). There is a new book that will be out in the spring that will address specific issues in LTC documentation, by Pat Iyler.
[This message has been edited by Kizomo (edited 10-25-98).]