Not sure how many of you hate that question, about how long the pt is expected to live.
Turns out in NJ, this has been a big problem. Most nurses do not check "less than 6 months" unless pt is Hospice. However, God forbid the pt dies, the accrediting agencies are having a fit, stating poor "outcomes" which make agencies and nursing care look bad.
I was discussing this with our QI person yesterday, and she learned in a seminar, that you should ask yourself,
"Would I be surprised if this pt died in less than 6 moths."
To me that makes much more sense, esp if > age 80, hey who knows if we were to die in our sleep??
Needless to say, I have been checking off just about everyone I see in the < 6 months to live.
The bottom line is, the question is inappropriate for nurses to assess in the first place and should be reworded or thrown out. Try telling HCFA that! Anyway, this little info made better sense to me than trying to guess, so thought I would pass it on.
Jul 22, '01
This is also of concern in my HH agency. Patients with very advanced illness; multiple comorbidities; esp who are bedbound will be appropriate to expect that they could possibly die in less than 6 months. I think HCFA will find they need to adjust their threshold a little higher.
Jul 22, '01
Hey Margaret H. Thanks for the concurring opinion. Many HH Nurses have said the same. The people @ HCFA need to get a life and join the rest of us in "The Real World" ! They would be the first ones to hang us out to dry for "Practicing Medicine" and yet, they are actually encouraging that.