recaps/changeover

[aortas]

hi there! just wondering for those of you who work in LTC/SA, how do you ensure that recaps are completed in a timely manner?

back story, long time ago, i worked 11-7 with one other fantastic nurse who was a whiz at recaps, i learned quickly how to complete them accurately and ahead of time, before the actual day of changeover on 65+ residents. however, once my co-nurse and I got 7-3 and MDS positions, the 11-7 nurses who took over (theres since been at least 4) have had poor time management skills/lack of initiative/etc and do not complete recaps.

take for instance this month, which was particularly bad. on thanksgiving day, none of the recaps were even divided up into POS/MAR/TAR, they were just sitting in the envelopes from the pharmacy. changeover is not a magical process done by little elves who are masters at accuracy and filing. my DON pulled me off the floor the past two days on 7-3 shift and had me complete subacute recaps for the 30 residents recaps who weren't even touched.

the 11-7 nurses who are supposed to do recaps have been trained on what to do, and some have even been doing them for over a year, but rarely are they done, let alone correctly. so i'm just wondering, who is responsible for completing the recaps in your facility? is it a "recap nurse", is it 11-7, is it all shifts? tell me what works for your facility! thanks!

[dream'n, BSN, RN]

I remember monthly recaps from when I worked LTC long ago. They are a serious pain in the butt. I'm not surprised they aren't being done properly by your new 11-7 nurses. They take FOREVER and you have to have a strong focus for the details. I found it hard to work my regular shift with patients and do the recaps. Plus people generally cannot focus as well when they are interrupted for patient care and it's the middle of the night. Personally I think an extra nurse should be paid overtime to be able to come in and to focus on doing the only the recaps, during the day, and away from the floor.

[aortas]

thanks dream'n. personally, i don't know if coming in on 7-3 to do the recaps was the most time effective as there are many distractions-patients asking for things, other departments needing things, familiies wanting to talk, doctors coming in, the usual... plus trying to do recaps while other nurses are passing meds and doing treatments off the paperwork you need can be problematic. one 11-7 nurse comes in on her nights off to do recaps, which for her works better because she's accustomed to night shift, less people, and less patient care. we don't have electronic charting either! its all by hand, highlighter, pen, and whatever the pharmacy decides to print and send...the long term ones are the easiest but the subacutes who come in near the end of the month and are more acute and have more med and treatment changes, the longer.

[CapeCodMermaid, RN]

When I was a nurse manager, I used to take all the new and old MARs into a room, shut the door and bang them out in a day and a half for a 40 bed short term unit. Now, thank God, we are computerized and no longer have to do them. Most facilities around here have 11-7 do first edits and 7-3 do the second edit.