Nurses Helping Nurses
allnurses Network: Central | Jobs | Books | Newsletter
allnurses: A Nursing Community for Nurses
Home General News Blogs Articles Students Region Specialty Degrees F.A.Q.
LTC: Directors Nursing and Assistant (DON/ADON) /

Daily Nursing Rounds in Skilled Rehab Unit



Did You Know?
allnurses is the largest community for nurses on the web. We now have over 388,691 members! Join today to network with other nurses, laugh, share, and much more.

Apr 11, 2009 01:04 PM

Daily Nursing Rounds in Skilled Rehab Unit

by KdubRN

I am a new ADON in an LTC center and am the unit manager for the Skilled/Rehab unit. In the month I have been there, I have found that serious care issues are falling through the cracks and changes in condition are being missed.

In an effort to stay on top of these changes and improve the quality of care, I have been working with my assistant nurse coordinator in developing a plan to implement DAILY NURSING ROUNDS. He and I plan to review 8-10 patients each day from 0900-1000 on Monday-Friday. This way each patient would be reviewed once by the end of the week (full house is 42 patients).

We plan to review nurse notes, weights, nursing assistant documentation, compare the MARs with the orders, the treatment records, changes in continence, mental status, labs, pain, and general appearance of the patient's room. Unfortunately, this allows only 6-7 minutes per patient if we are hoping to round in one hour or less. Daily rounds on each patient would be ideal but that's just not realistic.

Does anyone have any suggestions on either improving this system or implementing another system that would address the same problem but possibly in a different way? Thanks for your assistance!


Share

Search Tags
adon, long term care, nursing rounds
Top

 
Advertisement
Sponsored Links
 
Reply
5 Comments
No. 1
from cfsleo812
Old Apr 11, 2009, 10:01 PM

Default Re: Daily Nursing Rounds in Skilled Rehab Unit
How about having your nurses put a copy of all new orders, and admissions in a basket solely for you and your assistant. You and your assistant can review these during the day as things occur, and flex your time to come in early to review the orders/24 hour report and new patients before your morning meeting. I have seen that if you come in earlier and flex your time, you can concentrate and focus your attention on the patients and what need to be done. Once the regular work day starts, it is a rollercoaster and a race you have to pace yourself to stay on top of things.
Top

1 Reader Gave Kudos
 
No. 2
from KdubRN
Old Apr 12, 2009, 08:34 AM

Default Re: Daily Nursing Rounds in Skilled Rehab Unit
Thanks for the input! Unfortunately, we are already doing that. It works well but the things that are falling through the cracks are the things that aren't being addressed or aren't being brought to the doctor's attention (i.e. progressive mental status change leading to decreased oral intake and before you know it they are hypotensive and then that is brought to the doctor and she starts an IV).

What we are trying to do is find a way we can pick up on the subtle changes or smaller issues so that we can address them before they become big issues.
Top
 
No. 3
from BoomerRN
Old Apr 15, 2009, 01:05 PM

Default Re: Daily Nursing Rounds in Skilled Rehab Unit
At the last place I worked, each department head, unit nurse managers and others met every am for a short time to discuss residents. The 24 hr report was used and others' observations about the residents was discussed. For example, the activities people often picked up changes and important observations in the residents and reported these in the meeting.
Top

1 Reader Gave Kudos
 
No. 4
Old May 15, 2009, 03:50 AM

Default Re: Daily Nursing Rounds in Skilled Rehab Unit
it is so refreshing to hear that you are all about patient care !! most of the Administrators in LTC only care about cutting costs !!
Top
 
No. 5
Old May 16, 2009, 11:36 PM

Default Re: Daily Nursing Rounds in Skilled Rehab Unit
keep a log of all problems encountered and have a weekly meeting of unit heads to discuss them and come to conclusions how to prevent further mistakes and problems...
Top
 
Reply




Thread Tools


Who's Online
82 members
1,230 guests
1,312

42

lawsuit - But don't most RN's work through breaks/lunch...

0

Patient Evaluation of Retail Clinic Care

5

The hard to reach on-call doctor, and its effects on...

9

Woman charged with passing off prescription drug as...

22

Man in "Vegetative State" was conscious for 23...

2

Interesting article on ThedaCare's Collaborative Care Model

13

Possible breakthrough regarding MS

63

16th Philly area hospital to stop delivering babies: Mercy...

14

Really interesting article on Indian open hearts

12

High-Tech Pump Does What Her Heart Can't



43

Dear preceptor

1

Society Needs Care Too

13

Why am I doing this, anyway?

2

Nurse Heal Thyself

10

My Papa, why I am the nurse I am today.

17

I made it through

11

An angel's gaze

16

A Sister Never Forgets

16

Ruby's Marbles

42

What Do Operating Room Nurses Do?

14

My Little Old Jedi

21

I love this job......

23

"I hear voices"

20

Preventing FRUTI (Foley Related Urinary Tract Infection) in...

24

Error and Attitude





Currently Reading This Page: 1 (0 members & 1 guests)

Interested in the hottest topics of the week? Subscribe to the Nurse-zine Newsletter.
Enter email address: