txdon

txdon

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About txdon

Latest Activity

  1. Bathing in LTC

    Okay, I need more help or suggestions. My facility has serious issues with the number of resident's who receive daily baths. There are two sides to my facility, one side gives atleast 14 baths per shift. A total of 28 baths per day just on one sid...
  2. Resident Rights

    Does a resident have the right to demand who his caregiver will be? Is that consider a resident right? I have had two residents who have demanded or refused care by a caregiver because they only want a certain aide or nurse care for them. They don...
  3. In Survey - facing G tag!

    Help! My facility is having its annual survey and we are possibly facing a g tag. I am apprehensive talking about this situation online but really need so guidance from someone who understands actual harm citations.
  4. 2 Questions

    First, does anyone have a clear job duties list for CNA's on nightshift. This shift is my weak link. Basically they think their job is just to answer call lights and maybe clean a few w/c's. Second, I am having a difficult time getting my nurses...
  5. Complaint Survey

    What are T&P clocks and audits? All residents are on air mattresses, these particular wounds were acquired from sitting - both were on strict orders to only be up with meals. The surveyor felt that one resident should have had more interventions...
  6. Complaint Survey

    I just had a complaint survey that resulted in a G tag for wounds - F314. Both cases involved failure to do enough to prevent further progression with a facility acquired wound. Both started as Stage II's and progressed, one resulted in osteomyliti...
  7. Careplans and Quarterlies

    My facility cencus is 89 with 19 Qmix. Thanks for clarify careplans and quarterlys. At my facility we don't have unit managers to oversee this process. Each nurse is now responsible for careplanning t.o's and changes. They are assigned 8 resident...
  8. Medication Unavailable

    I think a large part of the medication not being available is due to nurses not reordering the medication in a timely manner. Usually this occurs towards the latter part of the weekend, leaving the weekend staff scrambling. Any suggestions on how to...
  9. Careplans and Quarterlies

    Ok, I will admit I am not at all familar with MDS. I am a fairly new DON and need some MDS advice. The current MDS nurse wants the floor nurses to do careplans when they write new telephone orders that would warrent careplanning a new diagnosis or ...
  10. Medication Unavailable

    Recently our corporate pharmacist did an audit and identified several times nurse's circling their initials on the MAR and writing on the back," Medication unavailble". Can someone tell me what nurse's show write on the MAR when a medication is unav...
  11. Wound Care

    Thanks for all the wonderful advice. At my facility the "wound nurse" is responsible for doing weekly documentation on all pressure and non-pressure wounds. She follows the resident weekly until healed. She is responsible for doing a weekly assess...
  12. LTC Wound Care Program

    I need help developing an effective wound care program at my LTC facility. I currently have a wound care nurse who does all the wound measurements for pressure and non-pressure wounds weekly. She puts them on a special tracking form that includes tha...
  13. Wound Care

    DON's I need your help. I need help developing an effective wound care program at my facility. I currently have a wound care nurse who does all the wound measurements for pressure and non-pressure wounds weekly. She puts them on a special tracking...
  14. Non-healing Wounds

    Help, we have a resident who is declining rapidly. She developed a stage II and within a couple of week's time it has progressed to a Stage IV! She was just put on hospice but I am concerned how to clearly document this progression effectively to s...
  15. IDT Notes

    My facility policy is to write an IDT note on every person with a non-pressure wound. We are expected to write a note weekly until healed. The problem is I have multiple residents with non-pressure non-healing wounds that remain status quo. I need ...