Does your agency require that you chart each suctioning?

SDALPN · May 16, 2012

According to my agency, the nurses must chart every single time they suction their patient. Is this some new medicaid rule? Or is this just my agency's new rule? Thanks

This concerns me a bit. If it wasn't charted it wasn't done!! Also its good to have a record of how frequently you are suctioning to monitor increases in the need or decreases in the need for suctioning. Also to monitor the amount, color, etc of the secretions.

Its been a rule as long as I can remember. And if you aren't charting enough "skilled" tasks for medicare/caid they could decrease the hours the patient gets which could effect your hours. So it hurts you and the patient not to chart each time you suction. Part of the way they decide on hours is based on the number of skilled nursing interventions. They look for a certain number of skills per hour/shift/day. And how does the nurse before or after you know if there has been a change in the secretions or need for suctioning if they look at your notes?

If your patients trach plugs and you haven't charted that you've suctioned all shift (especially if you haven't charted the use of an HME or humidifier) and something goes wrong, you will be the one burned in that situation.

CYA!!

Alex Egan, LPN, EMT-B · May 16, 2012

Usually we chat the number of times suctioning occurred, and a code for the type of secretions ie sc=scant th=thick, and cl=clear, on a flow sheet that is part of my daily documentation. If i had to write a narrative note every time I suctioned I would turn in four pages of notes that were all practically parrot charting

Blackcat99 · May 16, 2012

Thanks to you both for your comments. Yes, we have a flow sheet where we chart the number of times suctioning is being done. In addition, we now have to do a narrative note each time we suction. So now instead of having one page of charting, I have 3 pages of parrot charting. Anyway, I guess this is what medicare/medicaid wants so will have to do it. At my other agency, I just have to chart every 2 hours period.

Alex Egan, LPN, EMT-B · May 16, 2012

Narratives every two hours is standard. I would talk to clinical, and if you don't get a good answer talk to corporate. There is no clinical value to three pages of notes that say "suction trach x 1 for mod amt of thin clear mucious". Do you work for a national chain?

Blackcat99 · May 16, 2012

Yes Al I do work for a national chain. I am not sure what to do. This company is entirely punitive. If you don't do what they say, they are always threatening to write you up and terminate you.

Alex Egan, LPN, EMT-B · May 16, 2012

I can't send a pm to you, I'm guessing it's because of your settings, but of you would like to discuss this further please pm me. After. I posted my first reply I realized that I have seen other threads from you about agency issues. Seems like its way past time to get out of there

Blackcat99 · May 16, 2012

Thanks Al. I have sent out resumes but no luck yet.

caliotter3 · May 16, 2012

I've worked for several agencies that have required charting all suctioning, either on flowsheets or within the narrative. If they tell me to do it, I do it, no matter how inconvenient.