mlolsonny

mlolsonny

Geri, psych, TCU, neuro--AKA LTC

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All Content by mlolsonny

  1. PICC: aspirate blood before every infusion?

    mlolsonny posted a topic in Infusion, Intravenous

    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...

  2. PICC: aspirate blood before every infusion?

    mlolsonny replied to mlolsonny's topic in Infusion, Intravenous

    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...

  3. I am going over the wall....

    mlolsonny replied to Ruas61's topic in MDS Coordinator Information

    Don't slam the door behind yourself! You may just need a new

  4. What is this fascinating specialty?

    mlolsonny replied to adventure_rn's topic in MDS Coordinator Information

    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...

  5. To code or not to code??

    mlolsonny replied to dbsue1954's topic in MDS Coordinator Information

    Anticoagulant works with clotting factors, not just platelets as ASA and Plavix. christinaxrn hit the nail on the

  6. ADL coding question

    mlolsonny replied to glm777's topic in MDS Coordinator Information

    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

  7. Right to Refuse

    mlolsonny replied to 311ltc's topic in Geriatric, LTC

    and nowadays, Gero-psych won't even take them without a bed

  8. New nurse, extremely late on my med pass

    mlolsonny replied to baby_nurse-'s topic in Geriatric, LTC

    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...

  9. Need examples of medically complex nursing home patients

    mlolsonny replied to ovnerati's topic in Geriatric, LTC

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

  10. bedrails

    mlolsonny replied to nancydrew6's topic in Geriatric, LTC

    Rails can help confused and agitated people be more mobile and help them get out of

  11. Bed rails protocol/algorithm?

    mlolsonny replied to Tammy90's topic in Geriatric, LTC

    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...

  12. New nurse, extremely late on my med pass

    mlolsonny replied to baby_nurse-'s topic in Geriatric, LTC

    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...

  13. Signs You Won't Pass A Survey

    mlolsonny replied to Adele_Michal7's topic in Geriatric, LTC

    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...

  14. How much staffing do you have?

    mlolsonny replied to Bubbles82's topic in LTC: Directors, Assistant

    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,...

  15. MED A DOCUMENTATION

    mlolsonny replied to txdon's topic in LTC: Directors, Assistant

    We use EMR and ours uses Events as "to do" list for charting. We open a Clinical Charting Task event and put in what we want documentation on. Our nurses love our

  16. Need a plan

    mlolsonny replied to txdon's topic in LTC: Directors, Assistant

    Use the Seven Habits quadrants to help you prioritize?? I'm amazed at how much more I get done with this type of prioritization. Q1: Upper Left is Urgent and Important-- These are the fires that need...

  17. what is comfort care only?

    mlolsonny replied to Ms.RN's topic in Geriatric, LTC

    Our LTCF has a Comfort Care Directive that spells it out in writing about hospitalization, transfusions, suctioning, IV fluids, meds, antibiotics (oral, injectable, or IV), labs, other testing, even...

  18. Decent tape recorder for report *where to buy*

    mlolsonny posted a topic in Scrubs, Uniforms, Gear

    In our SNF, we use taped report almost exclusively. We've had some trouble in the past with finding a decent tape recorder that will last more than a couple weeks We prefer the desktop models, but...

  19. MSHO anyone?

    mlolsonny posted a topic in General Nursing

    Are any of you MN LTC nurses utilizing MSHO for your residents that have a change in condition? We attended an inservice in January, and have really increased our MSHO utilization. Just wondering if...

  20. MSHO anyone?

    mlolsonny replied to mlolsonny's topic in General Nursing

    We certainly can't be the only ones tho....... I was just wondering about how you judge when to start, if you make it retro (i.e. change in condition on Friday, expect it to resolve over the w/e,...

  21. The Nurse's Role in Providing Spiritual Care - Is It OK to Pray?

    mlolsonny replied to tnbutterfly - Mary's topic in Spirituality, Religion

    In one of my nursing classes, it was presented that if a patient asks for prayer, we should all know a very "generic" prayer that wouldn't be offensive to any faith. Although I am a practicing...

  22. a first Foley insertion story

    mlolsonny replied to Teresag_CNS's topic in Nursing Humor

    Only the first of many faux pas

  23. Please interpret this med order

    mlolsonny replied to Jennabugs's topic in Patient Medications

    We don't accept orders like this unless it's a situation or trying to determine minimal effective dose for a new med. Then we use the smallest dose, and assess effectiveness; if not effective, give...

  24. Error or Not an Error???

    mlolsonny replied to ddgypsy's topic in Patient Medications

    If the MD told you to cut it in half, if it's an error, it's the MD's

  25. Would you feel comfortable with putting your loved ones in a nursing home?

    mlolsonny replied to BradleyRN's topic in General Nursing

    I can honestly say that if I could place my mom in the facility where I work, she'd drive me crazy , but I'd see her more than if she was anywhere else. I had the honor of caring for my DON's mom for...