New to Restorative. Help?

[Oswin]

So... long story short, I'm taking over my LTC facility's restorative program as of... last week. I'm not certified, my DON is and she's been helping me some but she's really busy. I've been given one day a week for this. I just can't figure out the best way to do this. This is complicated by having an... experienced DON who hasn't really had much computer training, so I'm not sure what's actually required to be used vs just what she's comfortable with?

She gave me a functional assessment sheet out of the restorative binder and said those need to be done around their quarterly ARD (and any status changes), then also summed up in a progress note.

Then that I need to keep the interventions the computer updated, care plan updated with current goals and interventions, progress note monthly, make up paper binders for the CNAs for each hallway so they know where the restorative care plans are. Attend the med B meetings and review and update goals.

My biggest issue is coming these functional assessments and the computer vs paper charting. I feel like I'm wasting time duplicating everything when I should be spending more of my limited hours focusing on assessing the program in action and updating goals.

The CNA computer charting auto populates over to the MDSes for our MDS coordinator with how much assistance they're charting for ADLs and it seems like it's a lot of duplication (though the functional assessment is more detailed, can they button a button, for example) it just makes me wonder if filling out this actual functional assessment sheet is required?

Of course I want to actually do the assessment myself not just go off the CNA charting, but just filling out this functional assessment sheet is taking up SO much of my time for each person. I'm not sure why I couldn't just progress note the differences between this and the MDS since I have to progress note it again anyway?

You other restorative nurses out there... what does your work flow look like? If you could talk me through your day, that would actually really help me feel more comfortable.

Do you run your restorative programs with paper or on the computer? Any general advice you'd give a new restorative nurse? (other than attend a certification class, work won't pay for one right now since we've got a certified nurse in the building. yay budget cuts.)

Thanks!

[cmonlaf, MSN, RN]

I handle the restorative at my SNF. I also do MDS for LTC. I do MDS three days a week, and within one of those days I do restorative. I would love to be able to devote one day to it; as of now I usually spend at the most 4 hours a week. I do not do any assessment sheets. I also only write a progress note and assess the programs for each resident quarterly around the time of their ARD. This is also when I update the care plans.

I interview the NARs and use their restorative charting to see how the residents are doing in the programs. It sounds a lot less involved than what you are doing, but unfortunately the NARs don't always have time to do the restorative programs anyway. It's like fighting a losing battle with the NARs sometimes, but that's a whole different story. I don't often have restorative programs influence the RUG score because it's just not always done and/or charted. But we keep them anyway to benefit the residents' functionality.