Scope of practice ?

[cornettclan]

Our facility just recently put out a memo telling us that due to Meaningful Use ( I don't even know what that is) when we have a pt expire in order to discharge them from our Meditech system we must put in a Preliminary Cause of Death. I feel like this is outside of my scope of practice as an RN. I am not a doctor, I cannot say why someone died. Some of the other nurses and I are refusing to do this. What do you guys think?

[LR59]

When someone passes at our facility, we get 2 RNs to check for signs of death and verify it. We then get a verbal order from MD to pronounce them deceased if they are DNRs only. Otherwise we have to involve local authorities. On our death certificate paperwork we put admitting diagnosis, not cause of death. As you say we are not MDs.

[mindlor]

Lets see here, just put down multisystem failure haha seriously thoughm that is out of scope

[merlee]

'respirations ceased' is a preliminary cause of death. This is not what is seen on a death certificate but should be enough to get the pt out of your system.

[Esme12, ASN, BSN, RN]

Placing it in meditechnis not outside of your scope. Multisystem failure, Cardio-pulmonary failure, Cessation of Cardio-pulmonary function are good "preliminary causes". It's meditech......not anything official. No biggie.

[SHGR, MSN, RN, CNS]

Placing it in meditechnis not outside of your scope. Multisystem failure, Cardio-pulmonary failure, Cessation of Cardio-pulmonary function are good "preliminary causes". It's meditech......not anything official. No biggie.

I agree with the above. I worked hospice for many years. RN's have a pretty good idea generally what the cause of death is , and as stated above, this is not the official cause of death- it's just for this computer system. Meaningful use will affect your hospital's reimbursement and you don't want to lose funding because of this. Get it clarified with your DON/legal departments.

[AJPV]

"Decreased cardiac output" - it's even an official "NANDA" Dx

[nurse2033, MSN, RN]

This is perfect example of management by memo. It seems like a little training would be in order here. (Sorry I don't have an answer for you.)

[RescueNinja]

We thought this at my facility (LTC) too until one of our local coroners was angry that we hadn't been putting anything in the preliminary cause of death section of our facility's internal paperwork. He told us that it is not a legal diagnosis, but it's important for the nurses who have been caring for the pt to put what they think killed the pt as it helps the MDs get a better view of what was going on.

If I am unsure I just put whatever their main diagnosis is. Most of the time it's expected anyway and the doctor has charted or told you what the disease process is at that time. In the hospital I work at we don't do anything like this, just LTC.

[Perpetual Student]

Clearly it was a badger attack.

[AJPV]

Just chart "weaponized ebola" and see how long it takes to get a phone call.

[DixieRedHead, ASN, RN]

Try "Heart stopped beating, respiration ceased, lack of blood pressure".

That should cover about all of it.