Determining visits and another question.

[Floridanurse]

Hi. I am new to doing visits in home health. I have done home care that was shift work and totally different. At this agency, the admitting nurse fills out paperwork saying how many skilled nursing visits that patient will get (was told can be changed by the office later). My question is: Can anyone give me an example of how many visits for general things you would recommend? I know that it will have to be oversimplified and just a general guideline, but I normally work in acute care so thinking of seeing someone only once a week with way out of control blood sugars or with CHF that they are noncompliant with is not in my realm of thinking. Also, I am right in understanding that

2W1 is 2 weeks one visit a week or do I have it backwards? Thanks.

[annaedRN, RN]

Hello. The way to write down visit frequency took me awhile too. 2w1 means 2 times a week for 1 week. 3w2 means 3 times a week for 2 weeks. Or you could write 15 month 1 for an every other day dressing change ( 15 times a month for 1 month. It is sometimes difficult to determine what frequency is best. Sometimes I like to taper down...like 3w1, 2w1, 1w2. Or sometimes 2w2 then 1w3. It really depends on what you are seeing the person for...is it teaching, wound care, CV checks, IVs....each thing and person and their support system makes each case very different in their needs thus visit frequency. Hope this jumbled answer makes some sense to you!

[NurseFeelGood2005]

Floridanurse: at our agency we have different "pathways", which means recommended number of visits for the disease process. For example: if the pt has know dx of COPD we would set them up w/ the COPD pathway which would consist of nursing 2w1, 1w6, RT, RD, PT and TH (telehealth), and a HHA if they wanted or needed it. We also have pathways for CHF and DM too.

Hope that helps.

Chrissy

[caliotter3]

This may seem like a simple answer but can't you ask your supervisor or some of the other nurses how they determine this? I don't have to do this, so I don't have criteria to offer you, but I would think that some of the nurses who have been involved with this for some time could give you input on how they determine number of visits. Otherwise, I would just think about each case individually and come up with a number that seemed reasonable. Like you said, someone in the office can change it if it doesn't sound right. If I come across this info somewhere I'll post it.