LVN and Resumption of Care

jnette, ASN, EMT-I · Mar 14, 2008

If an LVN makes a visit to a patient's home and finds out that the patient was recently hospitalized (for more than 24hours), should she complete that visit? And if she completes this visit, should the visit be placed in the patient's chart in the agency?

This patient will need a ROC OASIS done by an RN. I would suggest in a situation like that to call your agency and inform them of the pt's hospitalization. They will then have to send a RN out to do the ROC within 48 hours of hospital DC.

So to answer your question, no.. do not complete the visit, but inform the patient you will need to call the office and proceed from there. :)

caliotter3 · Mar 15, 2008

On more than one occasion I have completed a shift with a patient who was discharged from the hospital before the RN got out to do the post hosp assessment. In one case, I was in the office and the DOCS came up to me to get a report on how the patient was doing and I told her what to look for. I've implemented post hosp orders also. I just inform the agency what is going on and they usually get the RN out to the house within the proper time frame, although not necessarily before the shift nurses go back to work. So far, there has been no problem. Should I encounter a problem when I make that first visit, of course I would call the agency to get the RN involved immediately.

jnette, ASN, EMT-I · Mar 15, 2008

Since I'm not familiar with shift work or cases, I was speaking from my experience doing scheduled frequency visits only.

As Caliotter says, it is very likely to be different with shift cases, and I could understand why, if the pt. needs a nurse in the home 24/7.

So it would depend on what kind of HH you do.. visits, or actual shifts.

Wouldn't hurt to check with your agency anyway, just to know should this come up. :)

caliotter3 · Mar 15, 2008

I agree with checking with your agency ahead of time. There are so many possible situations that can come up and often no one is around or not conveniently around to ask questions of when the time comes. The more you have an idea about what to do before it actually happens, the better prepared you are to deal with the unexpected.

I always look for things to anticipate with my clients and try to prepare ahead of time. Saves on stress and prevents worry.

DutchgirlRN, ASN, RN · Mar 15, 2008

on more than one occasion i have completed a shift with a patient who was discharged from the hospital before the rn got out to do the post hosp assessment.

if a patient is being seen in shifts rather than in visits then that is private duty nursing which is a whole different situation. https://allnurses.com/forums/f325/ when i was an lpn i would resume my regular shifts after a hospitalization of any length. not even an issue.

it would seem from the op's question that this patient is a hh patient. an lpn should notify the office before doing anything.

in 99.9% of the cases an rn would have to go out and do a resumption first. the only case i can think of a visit being done, which i think would be non-billable, would be if the patient needed something immediately like a wound vac drsg change, foley leaking, etc....perhaps it would be billable as a prn visit? i really don't know.

i agree with jnette, best to ask your agency ahead of time before the situation arises. whenever in doubt about anything while you're in the home it's best to always call the office

LadyT618, MSN, APRN, NP · Mar 15, 2008

Thanks for all your responses and yes, this is a home health patient, not private duty. We know the ROC should be done by a nurse, but we have some LVNs on staff that still complete the visit, even though it really isn't necessary, like in the example given by DutchgirlRN. We figured it would be a non-billable visit anyhow, since a ROC must be performed by an RN before any other visits can be resumed.