additional assessments

[katoline]

i was wondering if or how many others do additional assessments while doing their mds interview? my previous employer had the charge nurse or supervisor doing those. we tried to give everyone a calendar to post and admissions were done routinely.

currently at this new company, with each obra assessment we do, 10 additional assessments, with an additional two more if the resident wishes to administer thier own medication or is a smoker. the assessments include, fall risk, braden scale, pre-physical restraint and reduction, side rail, bowel and bladder training, pain eval, psychoactive medication eval, aims, elopement risk, resident transfer. besides those, we are to do a bedside nursing daily skilled summary which is rather like a weekly or monthly summary including VS, medications and all.

i was concerned about the 20% of my time in the dining room before, now i have additional assessments, twice daily meetings, stand up and stand down for survey preparation, etc. etc. i think once i get to know people, it will go more quickly and they are very useful tools - if you have the restorative nsg set up to really address the issues and the nursing/rehab staff to come up with goals, plans and evaluations.

[rukiddingme]

We have 5 standard assessments that us MDS nurses do. Norton, pain, fall risk, abuse, and elopement. We also have a comprehensive pain assessment if the pain assessment triggers it, and an Endurance assessment on public aid residents. Our interviews are being done by one staff member - and she also does a narrative note about how the interviews went (to report reasoning behind items that may have triggered as problems in the interviews).

[Bella'sMyBaby]

Why wouldn't the nursing staff do their own assessments on their patients?

The nurse caring for the patient needs to know what's going on with their patients. With 3.0, how would the MDS Dept. have the time? With all the additional assessments, we don't even have time to take a lunch. We are already working way over 40 hours, late nights & some weekends to keep from drowning & we are NOT being paid for it!!

[returnexpected]

What Bella said...

the nurses here do the assessments (pain, Braden's, fall, elopement risk, hydration, incontinence risk) and those go on the residents' charts. The nurses use those same assessments and observations to complete assigned sections of the MDS (parts of B, E, F, J, K, and L). I do the data entry for those only.

[rukiddingme]

The nursing staff at my facility have very little knowledge about the MDS, and do nothing with the MDS. From what I see, they are so strapped for time that if I were to mention them doing assessments, it wouldn't fly. They don't even get told when a resident is in the 'lookback' period so they can write more detailed notes during this period!

[kdhnursern]

I fill out the AIMS, Braden, elopement, fall risk, pain, and side rails for every quarterly and add a 3 day bowel and bladder for annuals. The nurses doing the admits do all these and I use that info for the admission, 5 day, and 14 day. I do everything but the 3 day B&B for the 30, 60, and 90 day. When you add the Section C, D, F, and J's, that's a lot of assessments to do. And in training, when they said those interviews would take about 17 minutes average......they just weren't trying them on MY residents!!! I have found that I get a lot of info from those interviews, I just don't think it's realistic to expect someone to do the full set in 17 minutes. And, BTW, I do all my own data collection and data entry. 120 bed facility and 2 MDS Coordinators have 60 residents each.

[Bella'sMyBaby]

I fill out the AIMS, Braden, elopement, fall risk, pain, and side rails for every quarterly and add a 3 day bowel and bladder for annuals. The nurses doing the admits do all these and I use that info for the admission, 5 day, and 14 day. I do everything but the 3 day B&B for the 30, 60, and 90 day. When you add the Section C, D, F, and J's, that's a lot of assessments to do. And in training, when they said those interviews would take about 17 minutes average......they just weren't trying them on MY residents!!! I have found that I get a lot of info from those interviews, I just don't think it's realistic to expect someone to do the full set in 17 minutes. And, BTW, I do all my own data collection and data entry. 120 bed facility and 2 MDS Coordinators have 60 residents each.

And you are doing all of this in how many hours per week?

[katoline]

Wow! what different answers from everyone. I wonder how many are hourly and how many salaried?

I wonder if when assessments are late, overtime, if applicable, is outrageous and all this hits the pursestrings, if it will make any difference? there are going to be cutbacks in medicare/medicaid payments and most for profit snfs are not going to want to hire any extra people.

CMS is still looking at careplans as though they are actually being used, so changes must be kept up to date. seems there should be a better system. I'm on my 3rd 3.0 pps assessment on one confused resident and when i come in to her room she says "oh no, blue bed, blue bed! i'm getting tired of this game!" i can imagine that the residents who are more with it are going to be less humorous. why the same questions over and over? they think we are fruitcakes. we just had state in the building and they expressed their discontent with the new system.:chair:

[rukiddingme]

We have had alert & oriented residents state "Didn't I just answer these questions for you 2 weeks ago? Why do I have to do them again?"

Of course they're told it's rules from the government, and some just shake their head.