Skilled nursing visits & preemies - how many visits?

Published

I am new to home health - skilled nursing. I have taken on a preemie assignment for next week and I am unsure how many visits are appropriate. The home health process is a little confusing but in the end, a nursing assessment is a nursing assessment - its the paperwork & visits that get me. I am thinking 1 - 2 visits per week until......when? what would you recommend? do you wait for them to reach a certain weight?

A little overwhelmed already! :confused:

Up Vote Up Vote ×
I am new to home health - skilled nursing. I have taken on a preemie assignment for next week and I am unsure how many visits are appropriate. The home health process is a little confusing but in the end, a nursing assessment is a nursing assessment - its the paperwork & visits that get me. I am thinking 1 - 2 visits per week until......when? what would you recommend? do you wait for them to reach a certain weight?

A little overwhelmed already! :confused:

I'm new to home health care as well.I just finished training and landed my first pt.my boss told me that according to the agency policy we are required to see pta once a week for 9 weeks,then reevaluate,readmitt if necessary.Once per week is standart in my agency however if is up to a nurse to really decide if the patient needs to be seen twice a week,basically it is a nursing judgement.Have you seen the baby arleady? Only you can decide if the baby requires more visits.

Up Vote Up Vote ×

Thanks! I have not seen the baby yet, being d/c this weekend. No major issues other than being a preemie so I need to do wt & feeding checks. I figured once a week but I didnt know if nurses used a general rule to start off with.

Thanks for your reply! :nurse:

Up Vote Up Vote ×
Specializes in PeriOperative.

My daughter was a preemie, and we declined home health visits. We had no major issues and I've had preemies before. I was told that the home health nurse would come and assess weight gain, vital signs, and development once a week on a very limited basis (2-3 visits).

We eventually had home health come to administer Synagis once a month. Synagis is routinely administered to preemies during RSV season. Visits stopped when RSV season ended (baby was 7mo)

Up Vote Up Vote ×

I'm a home health nurse, and while I don't have preemies, we only have adult patients, I would talk to your manager if you have any questions about visits and frequencies. If you are medicare certified, then that throws an entirely different monkey wrench into the situation. As far as holding on to a patient for 9 weeks just to see if they need to be recertified, we'd all be out of jobs at my agency! There are many, many, many patients that we discharge well before the 9 week mark because they are no longer in need of our services or they are no longer homebound. Many insurance companies require the patient to be homebound, and if you are continuing to see a patient beyond that point, just because the cert period hasn't expired, I believe that could be deemed fraudulent.

Up Vote Up Vote ×
Specializes in home health, dialysis, others.

Well, I think the 'homebound' issue is moot in this case. The issue is WHY you will be seeing this particular infant. Are there lingering feeding issues? Respiratory problems? etc.

When talking with the parents/caregivers, try to determine how much support THEY need! You may need to visit twice a week for a few weeks, then drop down to once a week. Ask you supervisor for input, as well.

And it may depend on the type of insurance they have - you may need to get approval from the insurance company, or they may tell you only 3 visits are allowed, etc.

Best wishes on your new job!

Up Vote Up Vote ×

I'm not a nurse, but I'm the mom of a micropreemie. My son was born at 24 weeks gestation, stayed in the NICU for 4 months, and was finally discharged. His neonatologist ordered home nursing visits 3x/week. After that initial order, the home nurses evaluated my son's condition and progress and they decided when to cut back on visits, with the doctor's approval. I don't know if this is how it works with all preemies, or just very sick preemies like my son.

Up Vote Up Vote ×
I'm not a nurse, but I'm the mom of a micropreemie. My son was born at 24 weeks gestation, stayed in the NICU for 4 months, and was finally discharged. His neonatologist ordered home nursing visits 3x/week. After that initial order, the home nurses evaluated my son's condition and progress and they decided when to cut back on visits, with the doctor's approval. I don't know if this is how it works with all preemies, or just very sick preemies like my son.

Wow! My sister gave birth at 26 weeks. He was 1.14 and she had home visits for 8 weeks. Ill get a handle on it - just a very different type of nursing that I need to adjust to!

Thanks!

Up Vote Up Vote ×

I hope your sister's son is doing well. My son weighed in at 1 pound 8 ounces, and was 13 inches long. His home visits lasted for about 4 months, and the nurses came back during RSV season with Synagis.

Up Vote Up Vote ×
+ Join the Discussion