policies and procedures

Diamond Nurse · Jan 7, 2004

hey I am new to this too, we had a hired consultant who did our basic p & p book, and if your a member of Beacon Health they have one you can buy. It was overwelmingly comprehensive. Our consultant didnt make ours as inclusive.

I commend you on this task. I am looking right now into where I would get info on the agency specfic stuff

ex:

~change indwelling Q month?

~soak one of the 2 drainage bags daily in a solution

of vinegar or.....bleach? ect...

any help would be appreciated.

I have found lots of help here..

:nurse:

renerian, BSN, RN · Jan 7, 2004

You will need some of the following:

operation policies

regulatory policy to back up the above

clinical practice policies

How are you structured so I can guide you further?

renerian

Diamond Nurse · Jan 8, 2004

well I believe the policy manual done by our consultant covers the operations and regulatory part. I think I need to develop our clinical policies. such as what solution to soak foley drainage bags in and how often they are changed ect.....

also

the consultant included a list of patient information, and some I have to order from health care concepts (privacy and pt rights), other from briggs (dr's order forms, narrative notes, op.pt evals, care plans) and still others I need to develop myself based on examples from other agancies (business name hours of operation, location ect.

Diamond Nurse · Jan 8, 2004

well the owner, OT and CEO, administrator is Dan. I am the RN, human resources, clinical case manager, and ect

that is our organizational structure.

we do have OT, PT, and SLP coverage. I am the only nurse at this time.

BRANDY LPN · Jan 8, 2004

Not sure if this will help but does have alot of policies:

http://www.resourcenurse.com/RN/refcenter/policies_home

renerian, BSN, RN · Jan 8, 2004

You can buy those two and adapt them if you need to which everyone does. Then if you have a policy for adopting that manual you purchase as your clinical practice manual you will be fine at survey time.

Do you have any social workers? Are you one corporation that will be serving multiple payers?

renerian

Home Health Columnist / Guide · Jan 8, 2004

Books to help:

Manual of Home Health Nursing Procedures

by Robyn Rice

http://www.amazon.com/exec/obidos/tg/detail/-/0323009123/qid=1073536382/br=1-3/ref=br_lf_b_3//103-7483392-5992621?v=glance&s=books&n=227657

Handbook of Home Health Nursing Procedures

by Robyn Rice

Handbook of Home Health Standards and Documentation -- Guidelines for Reimbursement **** A Must, new ed coming 2004

by Tina M. Marrelli

Nurses' Guide to Home Health Proceduresby Jean Smith-Temple, Patricia A. Carr, Joyce Y. Johnson (Editor)

Competency in Home Care (Must have measurements for competency

by Terasa M. Astarita, Gayle Materna, Cynthia Blevins, Tarasa Marie Astarita

-----------

Only book I know have is Marelli, my bible for care plans.

Have heard many peope say Rice's books great. other Home Care

Manual by rovinski is from 1989--couldn't find more recent issue.

Great new Article I read tonight:

The Agency for Health Care Policy and Research Guidelines: Implications for Home Health Care Providers

http://www.aacn.org/AACN/jrnlci.nsf/GetArticle/ArticleTwo93?

RE cath care/supplies--What Medicare intermediarys permit:

Indwelling Catheters (A4311 - A4316, A4338 - A4346)

No more than one catheter per month is covered for routine catheter maintenance. Non-routine catheter changes are covered when documentation substantiates medical necessity, such as for the following indications:

1) Catheter is accidentally removed (e.g., pulled out by patient)

2) Malfunction of catheter (e.g., balloon does not stay inflated, hole in catheter)

3) Catheter is obstructed by encrustation, mucous plug, or blood clot

4) History of recurrent obstruction or urinary tract infection for which it has been established that an acute event is prevented by a scheduled change frequency of more than once per month

When a specialty indwelling catheter (A4340) or an all silicone catheter (A4344, A4312, or A4315) is used, there must be documentation in the patient's medical record of the medical necessity for that catheter rather than a straight Foley type catheter with coating (such as recurrent encrustation, inability to pass a straight catheter, or sensitivity to latex). In addition, the particular catheter must be necessary for the patient. For example, use of a Coude (curved) tip indwelling catheter (A4340) in female patients is rarely medically necessary. Documentation of medical necessity may be requested by the DMERC. If documentation is requested and does not substantiate medical necessity, payment will be made based on the least costly medically appropriate alternative (A4338, A4311, or A4314, respectively

http://www.adminastar.com/Providers/DMERC/MedicalPolicy/files/UrologicalSupplies34.htm

P.S.: Our agency standard is to place on 485 POT "2 prn SNV for foley catheter leakage/malfunction" on all foley catheter clients.

Wound Care Words Of Wisdom: What Medicare considers appropriate supply amounts

https://allnurses.com/forums/showthread.php?s=&threadid=16242&highlight=wound+care+medicare

? about SN frequency orders on 485

https://allnurses.com/forums/showthread.php?postid=54302#post54302

Home Care Services--has multiple links

http://www.nlm.nih.gov/medlineplus/homecareservices.html

missiedi · Jan 20, 2004

thanks for your support and good luck to you as well. i have to make this work my credibility is at stake. my focus however is a little different. the agency i am consulting for is just starting and awaiting approval. it will actually be training home health aides ly and sub-contracting as a provider of home health aide services. i did get a tip to use info from cdc,osha for some general policies like emergency disaster, infection control, fire safety etc. for employee forms you can go to office depot for free downloadable forms that might help with employee policies. if i get through this i will then be contracted to write a training program. right now there is a president ,vp, and rn which would be me not a direct employee at this time.

renerian, BSN, RN · Jan 21, 2004

Are you contracted?

renerian

missiedi · Jan 22, 2004

if you mean did i sign a contract? yes i did.