RNLaura

The more you can experience the better. You need to know how to care for all types of vascular access, ostomies, urological devices, and especially wound care. Work on your assessment skills. Strike up conversations with the MD's and surgeons in your hospital. The more you know, the more your home care patients will know. You can also contact a local home care agency and ask if you can shadow a few nurses so that you can get a feel for what you need to focus on.

I was taught to address the reason you are there (acute skilled needs) and not get into chronic problems. If they are diabetic, note that they are "independent with diabetes management" if appropriate. If more than one MD involved in case, note who manages PT/INR for example, on a postop patient. If patient is attending outpatient PT, I note it. I was also taught that a diagnosis must cover all meds. For example, Lexapro is listed, so must a diagnosis for depression. Hope this helps!

A lot of changes are in process at the CHHA/LTHHCP where I am an RN Home Care Nurse. The Director of Public Health is enforcing the "Industry Standard of # Billable Visits/Day" = 5-7 and the "Industry Visit Weight Points Standard" = accumulate 9 points/day (3 points for case opening and 1 point for each other type of visit). Any one have any experience with either of these?