restorative nursing

Specialties Rehabilitation

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I had just taken a position of restorative nurse coodinator, the program is new at my nursing home. can any body out there give me advice to make this program GREAT.:bowingpur Gale54

Specializes in Geriatrics and Quality Improvement,.
as a matter of fact, we have cna students doing their clinicals at our facility. i am good friends with their instructor, i will ask her tomorrow and post her response tomorrow afternoon. we are in north carolina.

anything??

:jester::nurse:

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Specializes in Hospice, Geriatrics, Wounds.

yes, i spoke with the cna instructor today. she says nursing rehab is part of her curriculum, but there isn't a set amount of hours required for that specific topic. minimum requirements in nc are 75 hours total (classroom & clinical) for nurse aide i certification (but in looking i noticed most classes are 150+hrs). regulated by nc division of health service regulation. check out this link for further information, including the curriculum - where you will see there is a pretty good section on rehab nursing.

http://www.ncdhhs.gov/dhsr/hcpr/curriculum/index.html

i can tell you from just watching the students at our facility, they do well with the patients. and, they are high school kids. the instructor has done a fine job with them and seems to have done a great job with the rehabiliation part of the curriculum. (she actually quizzed them today in front of me about rehab stuff after i told her about your post. )

any further questions, just let me know, i will be glad to ask her. sometimes it may be late when i respond, i have to wait until everybody is in bed to have some time to myself.

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Specializes in Geriatrics and Quality Improvement,.

thats great!

i already took a peek at the cirriculum, it is different from what we work from, we have actual minutes of discussion on our cirriculum.

it is not accessible on line, but suffice it to say, if you had a 4th column it would say "55 minutes' "30 minutes" or "15 minutes" for the amount of time we have to spend on an issue. going over time is not a problem, it is the minimum required time on the subject, not the max. and there is a seperate list for clinical time spent, and a 3rd list for competency.

we actually have one nurse for didactic, one for clinical. they often disagree on teaching type & style, but they usually agree on who is good and who is bad. im ssending the cirriculum to the calss instructor, for her input.

thanks for the post, it is great!

:jester::nurse:

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Specializes in Hospice, Geriatrics, Wounds.

spoke with the cna instructor again today and she says the program is 270h total, 95h of clinical - 40h minimum clinical for ltc. as i posted before, these are high school students being taught in the public school system their junior or senior year.

she also said they teach abbreviations, some med-surg, a & p, death & dying and have a lab at school where they practice clinical skills before doing clinical outside of the school. she is doing some skills checks at our facility during clinical.

hope that helps!

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Specializes in Birth center, LDRP, L&D, PP, nursing education.

New to restorative nursing and LTC!!! When you say that an RA is doing however many programs, does that mean that there are that many residents with restorative programs or that there are that many programs total? I know you can get reimbursed for 2 per resident.

Any other resources, tips, or tricks you can offer?

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Hi its been awhile since I have been on so hi to everyone. Have a question for everyone out there has anyone started the cultural change? We are trying to get started at our facility adn it is very slow in coming. Anyone have any suggestions or have tried something that has worked? I know the mind set for all staff needs to change first and that everyone from Administration on down has to be involved and on board. So please help if nayone has any ideas or have some success stories please share. Thanks from florida

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Specializes in Geriatrics and Quality Improvement,.

hello again everyone, sorry i have been outa touch for so long...

de422.. cultural change.. it started here on a few scattered units a while ago, some nurse and aides have adapted to it more easily than others. it needs to be part of their belief system. we have been trying to get the culture change rolling with the good we are doing inn nursing rehab. the cna's make up the largest workforce in the facility, of course, so i am constantly messaging them, about the good works they or a co-worker are doing. i call them out by title or unit. when we see an example of the change in action, we are sure to point it out. the oig agrees, that if a strategy isnt monitored or followed up on, it falls apart. repetition is the key, but also repetition of the praise that goes with it. so the shift is management too.

we held a raffle for our administrator, and nursing rehab won. i had him doing the nr program, and seeing how hard the staff works, how relentless the program is on the time schedule is...

aside from the $$ we raised for a charity, it was great fun, and the whole building turned out for the event.

other units started a beauty day... manicure, hand massage, or razor training for the men.

on another unit..... fluids at a specific time, didnt matter what you thought you were doing, you are now a rolling ice water & apple juice cart operator. it became social and smiles for the staff, for the residents, improved hydration, decreased skin integrity issues. and the staff adjusts, everyone wanted to get in on it after it was no longer a chore, but a pleasure.

and the best one.. tai chi on one unit, slow exact movements, from a nurse who studies tai chi, in a chair, directing residents through arm, head and neck movements, slowly.

the events stopped being about the staff, and more about the residents, so the mind shifted, now with the new mds 3.0, the shift will be completed.

mary c......

i have currently 47 people on program, the majority of them are on 2 programs, but some of them are on 3. i explain to the staff, its not a maximum number, its a minimum. minimum of 2 programs to get reimbursed.

so, if you multiply that x2, (94 programs) plus 3 res on 3, then 97 programs running.

of course there are only limited number of things we can do, and i have them printed, cut out and scotch taped to my clipboard, so i can show people what i am doing even now...

i send out positive messages weekly to the staff with accolades for improvements made by residents that would nto be true without that aide, words of gratefullness shared by residents, what ever positive message i cn conjur!!

ok, so i am asking how all of you are gearing up for the new mds, and who is filling out the nursing rehab section of your mds?

:jester::nurse:

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Specializes in LTC.

New here and need help!!

I used to work as a Restorative CNA years ago. We were a team of approx 5-6 aides and one LPN who, along working on the floor, also ran the program. I do remember what my duties were when I worked as the Restorative aide.. but not sure what the LPN as the Restorative Nurse duties were. I am currently an LPN and at my current facility, I see a need for a Restorative Program. I have been reading some posts on this thread and would like to present my DON and administrator a presentation on Restorative Nursing, our need for it and how we can inplament this program w/o hiring additional staff (if possible). Any advice, tips or suggestions would be greatly appreciated. I am looking for the books that were already posted. Since money is tight, I have already requested a few from the library, which they are searching for me. And dont be afraid to dumb it down for me either..I want to know everything about Restorative Nursing there is to know.

Thanks everyone!!

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need help!!!!! have one week to come up with a "plan" and two weeks to implement a program for restorative nursing. new to MDS after seven year lapse and now this!

need DETAILED INFORMATION on dining/ambulation/grooming/exercise. want to make it fun and creative as possible. do not want to step on activities toes but not sure how to make both work together or if that is even possible.

is the step down program from rehab to restorative only for medicare? if you have someone on medicaid and they are coming off of rehab to restorative with a referral does it make a difference to do the step-down program with them?

found a good BRIGGS form to document on and understand that the cna does weekly notes and I have to do monthly notes. is that what you all do?

is there a good book/program to get that can give me step-by-step instructions on getting this thing going. hate to read pure detail but do better with good examples of how and what to do.

if anyone knows of a good restorative (creative) program in NC I would love to contact them or visit them to see how they do what they do.

my owners has his eyes on the CMI and "maximizing his reimbursement" and those eyes have focused on this restorative nursing thing.

Please any help would be very appreciated.:eek:

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Specializes in Geriatrics and Quality Improvement,.

1st: CMI and Nursing Rehab are not mutually exclusive, and also not totally inclusive. CMI is oncreased when you understand HOW to do the MDS, and how to do the cross match. Whomever submits the MDS electronically, needs to have a server that provides the encrypted feed. We use.. Equip. they provide a crossmatch and error reports, these are how to increse CMI. If you like, write to me seperately, I can provide you with a ppt. I created on CMI.

2nd: Nursing Rehab cannot start in 2 weeks!! YOu need forms that work for you to document, you need a policy & procedure, and you need an audit procedure, which includes documenting follow up on how well or poorly the resident is doing. The forms or electronic forms need to have initials, minutes and clear goals for the resident. Inservice needs to be provided for each resident.... Assessment, Care Plan, Flow Record, Inservice, Note....

There is a book, you can look it up online, order it, have them order it.... Nursing Rehab Made Easy.

Let me know what else I can help with.

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Is anyone else posting on this thread? I am new to rehab nursing. I am reading the thread but with the new MDS 3.0 and other changes, I was wondering if there is anything that changed?

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Specializes in Geriatrics and Quality Improvement,.
Is anyone else posting on this thread? I am new to rehab nursing. I am reading the thread but with the new MDS 3.0 and other changes, I was wondering if there is anything that changed?

Hey eneyway.. I still check in on this thread.

If you are interested in the Rehab Nursing changes, check out the new QIS survey procedure.

https://www.qtso.com/qisforms.html

Scroll down to the Stage 2 Critical Pathways.

See:

Critical elements for ADL and ROM

and further down is

Critical elements for Rehab and community discharge.

they both talk about the role of Nursing Rehab in LTC.

the 3.0 information on NR is relatively easy to follow. Few changes.

Good luck.

:jester::nurse:

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