pt compliance in home health

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I would like to ask..

  • if the pt is noncompliant with his insulin coverage is that not a ground per Medicare to dc the pt? Pt states the doses are too high and dangerous etc and dictates how many units to give him. MD updated regulary and aware.
  • if agency does not dc pt and nurse continues with this situation is she "liable" in some way.

many thanks for any response.

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If the individual nurse is uncomfortable with a situation in home health that is known to the patient's doctor and the supervision of the agency, that nurse has the option to ask to be removed from the case. If too many cases are of this nature, then there is a fundamental difference of opinion between the nurse and the supervisors and the nurse should seek employment elsewhere.

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I would like to ask..

  • if the pt is noncompliant with his insulin coverage is that not a ground per Medicare to dc the pt? Pt states the doses are too high and dangerous etc and dictates how many units to give him. MD updated regulary and aware.---
  • if agency does not dc pt and nurse continues with this situation is she "liable" in some way.

many thanks for any response.

how are the patients blood sugars? is what he is saying making sense that the dose is too high? how about trying to get a sliding scale order from the MD, would that help?

document, document, document is the best advise

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thanks you for your responses.To the first inquiry-no the BS ranges were from 130-310 and the insulin doses seemed safe.We did ask that he be put on a sliding scale to help with the compliance problem..so am waiting to see if that helps.but i am not feeling "too positive" about that.shall see!

Will follow your suggestions of doucument,document and make my decision re my work as i see how he co-operates.thanks again.

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