Latest Comments by CoffeeRTC

CoffeeRTC, BSN 18,563 Views

Joined Jan 22, '03. CoffeeRTC is a RN LTC. Posts: 3,713 (24% Liked) Likes: 1,800

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  • 0

    Quote from KelRN215
    Was it a PEG with a crossbar or a tube with a balloon? And did you have a replacement tube on hand?

    G-tubes replaced in existing tracts do not typically get XR confirmation, in my experience. In pediatrics, our patients have MIC-Key buttons or AMT tubes and parents are taught to replace those q 3-4 months at home.
    We haven't had residents with feeding tubes for years, but often times we were able to replace in the facility and then call for an xray to verify placement.

  • 0

    Please tell me her refusal for care is well documented and care planed out the wazoo? Why is she refusing care? Pain issues? Has psych seen her?

  • 2
    BeckyESRN and HeyHeyitsMaay like this.

    Psych eval? Depression related to nursing home stay?

    I'm the LTC nurse that would be calling you. I like the idea of having the resident sign off on getting the medication too. Does the fent patch need to be increased again? If he is truely in pain, that might help. I'd also make sure he is on a good bowel regime. Of course, I would be making sure everything is documented out of the wazoo and care planed.

  • 0

    Are there any LTC Risk Managers on here?

    I've been filling in for our facility. Right now I'm self-taught. I've skimmed our intranet and tried to pull up all info in the RM tab.

    How are you tracking your events (incidents)? Do you have a program or spreadsheet?
    There seems to be little info provided by our company.

    Right now I've been reviewing the event report and any witness statements (hunting them down if they were not done), reviewing the nurse's notes, checking orders and care plans. With this, they have an analysis form. It asks for a description of what happened, the cause, the immediate action or intervention that was taken and then any follow-up actions.

    Are there any resources for RM in LTC? Groups or organizations?

  • 0

    I work LTC. We have a mix of skilled residents that need a lot of care and long-term intermediate care residents. When you say 35 residents do you mean each or split between two nurses? Were there CNAs too?

    Abandonment only occurs if you accepted the assignment in the first place. If you took report or the keys then yes.

  • 1
    papillonailes likes this.

    We use this brand of foley and collection tube. The flush port on the actual foley is accessed by a needless Luer lock syringe
    and the specimen access on the drainage tube with a needle.

  • 7
    Beth1978, cyc0sys, NutmeggeRN, and 4 others like this.

    Geri psych stay?? Danger to self (hygiene issues that can lead to serious infections) and danger to others with the hitting, bitting, and bruises. Of course you are doing event reports for the staff injuries? Family involvement??

  • 0

    Quote from JasBSN
    I work in LTC, we recently had a rep from the company who makes the briefs we use come in and inservice our CNAs. If a brief is leaking and you feel like the resident needs to be double briefed, you are most likely using a size too big. A standard brief can hold about a gallon of liquid if it fits properly. I have been told that it is illegal to double brief in my state (IL), but I have no proof to back it up. I do know it is against my company's policy and at the very least will earn you a write up.

    ^^^ This^^^

    You will not find it wrintten specifically "no double briefing" but it is a dignity and neglect tag.

    We've had "heavy wetters" before and I've seen CNAs do different things...full double brief, brief with a women's incontinence pad, brief with wash cloths or folded towel.

    Appropriate interventions might include a toileting or changing schedule that is resident specific or monitoring timing of fluid intake. Maybe that resident needs checked and changed hourly from 11pm to2 am? Maybe they need to increase fluids at breakfast and lunch and monitor intake after 9pm.

  • 6

    Quote from Been there,done that
    Double briefing is not an appropriate care measure. Get a Foley or a supra- pubic catheter order. You will not have enough time to check/ change your patient every hour. Trust me on this... they will be lying in their own urine for hours.

    Welcome to nursing.
    A catheter for convenience is never going to happen. Nor should it.

  • 0

    I miss being a part of a big company. We had programs for everything. I'm sure I can come up with a spreadsheet of some sorts but just didn't want to re-invent the wheel.

  • 1
    Crush likes this.

    I see that this is an old post, but updated. You would have known by now if it was reported to the state and if there was any actions against you.

    As far as suspected abuse. If the CNA saw a nurse handling a resident in a rough manner, they must report it. It is up to the facility to investigate it and determine if in meets the definition and also to report the allegation of abuse to the state.

    Every facility should have their own p and p for wound care.

    We measure wounds weekly. We are still paper charting so all of our treatments are in a book. We have all wounds (pressure and non-pressure wounds including bruises, incisions etc) on thier own sheets. If we had a question on the size or appearnce of the wound, we are able to see what what documented at the last measurement. If they are on skilled charting for the wound, then there should be a daily nurses note about it.

  • 0

    I have never seen these in SNF or in my state.

  • 0

    Quote from Pepper The Cat
    Pulse sat of 87 isn't overly low for a pt with COPD.
    Are we missing something?

    First off, there are occupancy regulations. The rules were broken...big time.

    I'm not sure what you are worried about. If you checked on him 7 minutes before the event, things can happen. A previous posted asked about fall risk, bed alarms etc? If they weren't utilized that may be a problem. Vital signs were stable and an O2 sat of 87 isn't horrible for a residnet with COPD that is laying face down.

  • 0

    Are there any LTC Risk Managers on here?

    I've been filling in for our facility. Right now I'm self-taught. I've skimmed our intranet and tried to pull up all info in the RM tab.

    How are you tracking your events (incidents)? Do you have a program or spreadsheet?
    There seems to be little info provided by our company.

    Right now I've been reviewing the event report and any witness statements (hunting them down if they were not done), reviewing the nurse's notes, checking orders and care plans. With this, they have an analysis form. It asks for a description of what happened, the cause, the immediate action or intervention that was taken and then any follow-up actions.

    Are there any resources for RM in LTC? Groups or organizations?

  • 0

    Post in the LTC forum for more answers. This is a great question. We do a two step PPD on all readmits.


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