Geri, psych, TCU, neuro--AKA LTC
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mlolsonny has 15 years experience and specializes in Geri, psych, TCU, neuro--AKA LTC.

Currently RN in LTCF. Have been DON for 2 years and wanted to beat people with a stick and light my hair on fire!

mlolsonny's Latest Activity

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  1. PICC: aspirate blood before every infusion?

    Scrubbing the hub was never in question. Pulling blood through the lumen of the PICC was. This was not how most of our RNs were taught, so we were asking for expert opinions. Thanks for your responses.
  2. Big discussion at nursing home. Single lumen PICC. Educator says aspirate for blood prior to every flush and infusion. A couple of us think that's asking for trouble. What is best practice in home care or outpatient setting? We're measuring expo...
  3. I am going over the wall....

    Don't slam the door behind yourself! You may just need a new boss!
  4. What is this fascinating specialty?

    MDS (Minimum Data Set--nothing minimum about it) is the federally required Resident Assessment Instrument for nursing homes that drives further assessment, care planning, reimbursement, and nursing home quality measures. It's a Long term care sub-spe...
  5. To code or not to code??

    Anticoagulant works with clotting factors, not just platelets as ASA and Plavix. christinaxrn hit the nail on the head!
  6. ADL coding question

    Your assumption is correct. Because supervision occurred 3 or more times, code as supervision. With the information presented, there is absolutely NO justification to code as extensive.
  7. MDS reasons for assessments

    PPS schedule restarts after they go out and come back from hospital.
  8. Right to Refuse

    and nowadays, Gero-psych won't even take them without a bed hold...
  9. New nurse, extremely late on my med pass

    Also a difficult lesson to learn, but until you can get your own work done on time, you can't do anyone else's work. I.e. helping with transfers, bringing people to the BR, etc. Your scope of practice is much broader than a CNAs, so anything that the...
  10. Need examples of medically complex nursing home patients

    My Trifecta patient for complexity has had CVA, CHF, COPD. Add in DM, renal failure, Parkinson's, chronic infections, immunocompromise...
  11. bedrails

    Rails can help confused and agitated people be more mobile and help them get out of bed!!!
  12. Bed rails protocol/algorithm?

    The first two questions with rails, grab bars, assist bars, etc. are restraint and safety. Looking at safety is much more broad than the aspect of acting as a restraint. Here are the questions from a side rail assessment that we developed after a su...
  13. New nurse, extremely late on my med pass

    Unless your start time is absolutely set at 2000, try starting earlier. Group some tasks together, like starting nebs, giving supplements to people that are getting only supplements, etc. Don't get hung up on going to rooms in order. I suspect that s...
  14. Signs You Won't Pass A Survey

    In the simplest: Preventable Problems. Think pressure ulcers, contractures, weight loss, non-healing wounds, medication errors, decline in mobility/ ADL ability. Rationale: If adequate care is provided, most of those are prevented. Certainly you're ...
  15. How much staffing do you have?

    200 hours of staffing for 53 residents @ 1.16 MCM per 24 hours. 24 hours RN (one AM charge, One PM charge, One with focus for the day-- Assessments, Wounds, MD rounds, Mood/Behavior monitoring, Restorative, etc.) 12 hours MDS 40 hours LPN (16 hours A...