txdon

txdon

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All Content by txdon

  1. Abuse Allegations

    txdon posted a topic in LTC: Directors, Assistant

    Just curious have other DON's handle abuse allegations. What is your process? Also, how are incident reports handled? The DON at my facility handles all of these and a lot are getting lost or not...

  2. Staff and artificial nails

    txdon posted a topic in LTC: Directors, Assistant

    More than half of my staff are wearing artificial nails with outlandish nail polish. This is not allowed per policy but the staff has gotten away with it for years. Not only is this against policy,...

  3. Wound Care

    txdon posted a topic in LTC: Directors, Assistant

    DON's I need your help. I need help developing an effective wound care program at my facility. I currently have a wound care nurse who does all the wound measurements for pressure and non-pressure...

  4. Bathing in LTC

    txdon posted a topic in LTC: Directors, Assistant

    Okay, I need more help or suggestions. My facility has serious issues with the number of resident's who receive daily baths. There are two sides to my facility, one side gives atleast 14 baths per...

  5. State Calculations

    txdon posted a topic in LTC: Directors, Assistant

    My facility was recently retagged for incorrect diabetic flowsheets. Nurses either forgot to put the correct insulin given or forgot to notified MD if bg was outside of parameters. During the state's...

  6. 2 Questions

    txdon posted a topic in LTC: Directors, Assistant

    First, does anyone have a clear job duties list for CNA's on nightshift. This shift is my weak link. Basically they think their job is just to answer call lights and maybe clean a few w/c's....

  7. In Survey - facing G tag!

    txdon posted a topic in LTC: Directors, Assistant

    Help! My facility is having its annual survey and we are possibly facing a g tag. I am apprehensive talking about this situation online but really need so guidance from someone who understands...

  8. Resident Rights

    txdon posted a topic in LTC: Directors, Assistant

    Does a resident have the right to demand who his caregiver will be? Is that consider a resident right? I have had two residents who have demanded or refused care by a caregiver because they only...

  9. Staff and artificial nails

    txdon posted a topic in Geriatric, LTC

    More than half of my staff are wearing artificial nails with outlandish nail polish. This is not allowed per policy but the staff has gotten away with it for years. Not only is this against policy,...

  10. Complaint Survey

    txdon posted a topic in LTC: Directors, Assistant

    I just had a complaint survey that resulted in a G tag for wounds - F314. Both cases involved failure to do enough to prevent further progression with a facility acquired wound. Both started as...

  11. Careplans and Quarterlies

    txdon posted a topic in MDS Coordinator Information

    Ok, I will admit I am not at all familar with MDS. I am a fairly new DON and need some MDS advice. The current MDS nurse wants the floor nurses to do careplans when they write new telephone orders...

  12. LTC Wound Care Program

    txdon posted a topic in Wound, Ostomy, Continence

    I need help developing an effective wound care program at my LTC facility. I currently have a wound care nurse who does all the wound measurements for pressure and non-pressure wounds weekly. She puts...

  13. Complaint Survey

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

    What are T&P clocks and audits? All residents are on air mattresses, these particular wounds were acquired from sitting - both were on strict orders to only be up with meals. The surveyor felt...

  14. Medication Unavailable

    txdon posted a topic in LTC: Directors, Assistant

    Recently our corporate pharmacist did an audit and identified several times nurse's circling their initials on the MAR and writing on the back," Medication unavailble". Can someone tell me what...

  15. Careplans and Quarterlies

    txdon replied to txdon's topic in MDS Coordinator Information

    My facility cencus is 89 with 19 Qmix. Thanks for clarify careplans and quarterlys. At my facility we don't have unit managers to oversee this process. Each nurse is now responsible for...

  16. Medication Unavailable

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

    I think a large part of the medication not being available is due to nurses not reordering the medication in a timely manner. Usually this occurs towards the latter part of the weekend, leaving the...

  17. Wound Care

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

    Thanks for all the wonderful advice. At my facility the "wound nurse" is responsible for doing weekly documentation on all pressure and non-pressure wounds. She follows the resident weekly until...

  18. Non-healing Wounds

    txdon posted a topic in LTC: Directors, Assistant

    Help, we have a resident who is declining rapidly. She developed a stage II and within a couple of week's time it has progressed to a Stage IV! She was just put on hospice but I am concerned how to...

  19. IDT Notes

    txdon posted a topic in LTC: Directors, Assistant

    My facility policy is to write an IDT note on every person with a non-pressure wound. We are expected to write a note weekly until healed. The problem is I have multiple residents with non-pressure...

  20. appropriate behaviors

    txdon posted a topic in LTC: Directors, Assistant

    Does anyone have a list of appropriate behaviors to use when doing behavioral sheets for psychtropic meds? The nurses are having a difficult time with

  21. appropriate behaviors

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

    Thanks for the responses. One problem I have is with new admissions who are on psychotropics. We have to fill out behavior sheets upon admission, but often times behaviors are unknown as to why they...

  22. Frequent Faller

    txdon posted a topic in LTC: Directors, Assistant

    I have a resident who "slides" out of bed onto the floor when trying to ambulate to wc. She is a one person assist and has a transfer pole to promote more independence to and from bed. When she slides...

  23. Frequent Faller

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

    Thanks debRN for your comments. At my facility our policy is whenever the resident falls and it is unwitnessed, we have to do neuros. How should I go about changing that if that if that is the...

  24. Frequent Faller

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

    Why would your facility want you to do away with bed/chair alarms? We use them not as a form of restraint, rather as a reminder to seek assistance before getting out of bed for those who are...

  25. UPHD's

    txdon posted a topic in LTC: Directors, Assistant

    Can someone please help me understand why unplanned hospitals discharges are such a negative in LTC and SNF's? I recently had 6 patient go to the hospital, five out of the six were admitted. Only...