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Help with Care Plans!!! What all to care plan???



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No. 10
from rapkeygurl
Old Oct 06, 2009, 01:25 AM

Default Re: Help with Care Plans!!! What all to care plan???
Wow I like this site, gals, anyways I went to a great seminar put on by the good ole state of texas about what surveyors look for the told us ok like falls for example ask yourself this question? what risks does the resident have? was physical dx, have they have previous falls? what meds might contribute, etc..
I recently have added a careplan for anyone that does NOT take a flu shot -- YEs they have the right to not have it but we are to offer the risks factors etc.. quarterly. I am careplanning DNR or FULL CODE/Advanced Directives. Wearing briefs at night if they wish. I care plans are super cool.
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No. 11
Old Oct 09, 2009, 11:36 PM

Default Re: Help with Care Plans!!! What all to care plan???
As a former winner of the Nobel Prize for Care Plans, (ok, I made that up) I would like to say that If I write a care plan for a patient or resident, the state will not be happy. You have to care plan by the RAPS, which I think we all know insult the intelligence of any nurse. The state will cite you if you don't. AND I have to be careful not to care plan anything that the nurse's won't do, because then nursing gets cited for not following the care plan. It's crazy.
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No. 12
from rapkeygurl
Old Oct 10, 2009, 08:37 PM

Default Re: Help with Care Plans!!! What all to care plan???
yes and in texas now they want you careplan PLUS all the risk factors and disease processes and advanced careplanning etc.. etc etc...
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No. 13
Old Oct 11, 2009, 12:52 AM

Default Re: Help with Care Plans!!! What all to care plan???
Originally Posted by rapkeygurl View Post
.. I recently have added a careplan for anyone that does NOT take a flu shot -- YEs they have the right to not have it but we are to offer the risks factors etc.. quarterly. I am careplanning DNR or FULL CODE/Advanced Directives. Wearing briefs at night if they wish. I care plans are super cool.
I care plan ANY and ALL refusals for care- whether its a bath or a blood test or vaccinations- it is worth careplanning it.
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No. 14
Old Oct 11, 2009, 12:56 AM

Default Re: Help with Care Plans!!! What all to care plan???
Originally Posted by susanthomas1954 View Post
As a former winner of the Nobel Prize for Care Plans,

What, NINE MONTHS into writing care plans and YOU get the Nobel Prize....:-)


AND I have to be careful not to care plan anything that the nurse's won't do, because then nursing gets cited for not following the care plan. It's crazy.
Yes it is important not to give an unattainable goal...keep goals and interventions within reason and within the facilities abilities-
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No. 15
from 123becky
Old Nov 17, 2009, 07:42 PM

Default Re: Help with Care Plans!!! What all to care plan???
Everyone in my facility has 7 care plans. !. Information. i put discharge plan, code status. MD visits. Pod visits, DDS, Ocular visits. Ability to self medicate, elopement risk. Next is COGNITIVE FUNCTION/COMMUNICATION, THEN ADL SELF PERFORMANCE/ RISK FOR FALLS, CONTINENCE / SKIN INTEGRITY, NUTRITION/HYDRATION, MOOD/BEHAVIOR, THE POTENTIAL FOR INFECTION. I manage to cover about everything this way. It is easy to follow. & I update as needed. I follow the RAPS to the care plan. Haven't had any problems Yet. I have heard that some facility can have 20 to 30 separate care plans. How the heck can they be followed & updated? Back in the early MDS days a surveyor told me to keep it simple, it will get done.
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No. 16
Old Nov 17, 2009, 08:42 PM

Default Re: Help with Care Plans!!! What all to care plan???
Originally Posted by 123becky View Post
Everyone in my facility has 7 care plans. !. Information. i put discharge plan, code status. MD visits. Pod visits, DDS, Ocular visits. Ability to self medicate, elopement risk. Next is COGNITIVE FUNCTION/COMMUNICATION, THEN ADL SELF PERFORMANCE/ RISK FOR FALLS, CONTINENCE / SKIN INTEGRITY, NUTRITION/HYDRATION, MOOD/BEHAVIOR, THE POTENTIAL FOR INFECTION. I manage to cover about everything this way. It is easy to follow. & I update as needed. I follow the RAPS to the care plan. Haven't had any problems Yet. I have heard that some facility can have 20 to 30 separate care plans. How the heck can they be followed & updated? Back in the early MDS days a surveyor told me to keep it simple, it will get done.

This would not work for me. How would you include some of the major disease processes, ie: IDDM, or use of anticoagulant meds, use of oxygen, HTN (which our survey team is on a kick about!).
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No. 17
from amylpn24
Old Nov 20, 2009, 05:59 PM

Default Re: Help with Care Plans!!! What all to care plan???
Exactly what was said previously. Do not care plan for the state, care plan for the resident. You will never master what the state is looking for because, A) It varies B)It depends on the surveyor and what type of mood they are in.

In a nutshell, care plan problems or potential problems. Do not care plan diagnosis, the doctor has already directed the plan of care for those. Do not care plan medications unless you are care planning polypharmacy or psyhcotropics. If the patient is recieving coumadin, prednisone etc.; care plan this under skin integrity - ie: potential for bruising, poor wound healing, skin tears etc.

Care plans must be written in simple form. In a format that a CNA can read and understand. Hope this helps.
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