? RE: Starting A Restorative Nursing Program

Hello,
I have been working as a Restorative Nurse Coordinator for 6 years in Mississippi. As mentioned earlier, referring to your MDS will help some, but there is alot more info needed to begin this type program. I am not familar with any published info out there, but I am sure there are some available. Working with your therapy department is essential. Residents are usually referred to Restorative by therapy, but nursing can refer patients too, if there is a need.
All patients beginning a restorative program must be initially evaluated (with a form) of course, and then monthly by a liscened nurse. A restorative plan of care must be formulated and followed, indicating individualized, specific goals for each resident.
The RCNA's document daily on the treatment.
Your RCNA needs to be a leader who who can work well with little supervision.
It is essential that your RCNA be able to document well. The specific goals must be included on the RCNA's daily documentation sheet.
Restorative treatment must be done no less than 5 times weekly for atleast 15 minutes, and have 2 different treatments in order for reimburstment. Example: ambulation and bed mobility x's 15 minutes each. AROM and PROM are considered only 1, so if they only have these 2 treatments, you will not be reimbursed.
On the CNA's daily documentation, the following must be indicated: their INITIAL, how the Resident TOLERATED the treatment, any PROGRESS, how much ASSISTANCE they required, and the # of MINUTES spent with them. If ambulation is the treatment, you also need to include the DISTANCE they walked, and how many REST STOPS they required.
The nurses monthly summary should provide an overview of the residents progress for that month. According to how well the resident did, your plan of care should be updated. Example: residents goal for ambulation is 400ft with 2 min assist. Review of the RCNA's daily documentation indicates that the Resident ambulated 4ooft with 2 assist. You would need to change the goal and care plan to increase ambulation to 450ft with 2 min assist.
Restorative is a wonderful program. It is used to Maintain, prevent, or "restore" a function.
example: currently at our facility a man required restraints in his w/c due to a fx leg from a fall. With approx. 7 months of restorative, this man is no longer restrained and is ambulating 700ft 2x's daily with the RCNA's. His agitation and behaviors have improved. He is obese and a diabetic. His blood sugars have improved, and he has therapeutically lost some weight with exercising. He also is noted as going from being incontinent daily to a few times a week.
I hope any of this helps. I have lots of info, and will gladly share with you if you would like. Just let me know of any questions.
kcherryrn

Hello,
I have been working as a Restorative Nurse Coordinator for 6 years in Mississippi. As mentioned earlier, referring to your MDS will help some, but there is alot more info needed to begin this type program. I am not familar with any published info out there, but I am sure there are some available. Working with your therapy department is essential. Residents are usually referred to Restorative by therapy, but nursing can refer patients too, if there is a need.
All patients beginning a restorative program must be initially evaluated (with a form) of course, and then monthly by a liscened nurse. A restorative plan of care must be formulated and followed, indicating individualized, specific goals for each resident.
The RCNA's document daily on the treatment.
Your RCNA needs to be a leader who who can work well with little supervision.
It is essential that your RCNA be able to document well. The specific goals must be included on the RCNA's daily documentation sheet.
Restorative treatment must be done no less than 5 times weekly for atleast 15 minutes, and have 2 different treatments in order for reimburstment. Example: ambulation and bed mobility x's 15 minutes each. AROM and PROM are considered only 1, so if they only have these 2 treatments, you will not be reimbursed.
On the CNA's daily documentation, the following must be indicated: their INITIAL, how the Resident TOLERATED the treatment, any PROGRESS, how much ASSISTANCE they required, and the # of MINUTES spent with them. If ambulation is the treatment, you also need to include the DISTANCE they walked, and how many REST STOPS they required.
The nurses monthly summary should provide an overview of the residents progress for that month. According to how well the resident did, your plan of care should be updated. Example: residents goal for ambulation is 400ft with 2 min assist. Review of the RCNA's daily documentation indicates that the Resident ambulated 4ooft with 2 assist. You would need to change the goal and care plan to increase ambulation to 450ft with 2 min assist.
Restorative is a wonderful program. It is used to Maintain, prevent, or "restore" a function.
example: currently at our facility a man required restraints in his w/c due to a fx leg from a fall. With approx. 7 months of restorative, this man is no longer restrained and is ambulating 700ft 2x's daily with the RCNA's. His agitation and behaviors have improved. He is obese and a diabetic. His blood sugars have improved, and he has therapeutically lost some weight with exercising. He also is noted as going from being incontinent daily to a few times a week.
I hope any of this helps. I have lots of info, and will gladly share with you if you would like. Just let me know of any questions.
kcherryrn