question about a skilled nursing visit (homecare)

[KEVIN88GT]

Had a question on the exam. Question asked which of the choices were reimburseable SKILLED nursing. This was a multiple answer question.

I picked:

-wound care

-teaching a patient to perform an injection

Professor said that this choice was also correct:

- Observing caregiver perform wound dressing change.

I did not agree that this was a SKILLED nursing task and had my mom, a RN visiting nurse call her agency and confirm that it was in fact NOT.

What does everyone else think of this. (My school is ridiculous. I have to fight for points unfortunately.):angryfire

[old rural nurse, RN]

If the nurse was teaching the caregiver how to do the dressing change and was watching a return demonstration, then yes, it would be a skilled visit. Now, if they performed it correctly, you couldn't justify further visits to observe, but could still go 1-2 x wk to assess the wound. If the caregiver did not do it correctly, you should be able to have a few more visits to teach them the correct procedure. However, it doesn't sound like your test question gave you that information and normally just to "observe" anything is not a skilled service, you must "assess" something for it to be skilled. Hope this helps you!