timing nebulizer treatments

[kavdah]

When doing nebulizer tx our nurses leave the room after doing assessment and setting up/starting treatment. My boss is saying in that case we need to have an assessment that shows pt can self administer medication to show they understand tx and will keep it on/turn it off etc. What if pt is not cognitively aware to teach but always leaves the mask on until nursing comes back to take it off? I know if you have a confused pt who takes mask off you need to show he is getting all medicine but how do you come with the time to stay with that pt? Thank you for any help, Karen:nurse:

[Talino]

If you're referring to P1b.D. Resp. rx, you only count the actual minutes spent by the "trained nurse" with the patient. Ongoing treatment time in the absence of the nurse is not captured.

[meghan61]

I just attended a seminar and asked the AANAC MDS 3.0 Nurse guru how she would recommend meeting the criteria for capturing nebulizer treatments on the MDS. To meet the "trained nurse component" she recommended having return demonstrations in each nurses file. For documentation, she stated to use the TAR or MAR and list the actual minutes spent with the patient. So, I am hoping Talino will help me here!!! Who trains the nurse? A respiratory therapist? A credentialed RN? How does the state nurse practice act apply?

Thanks so much! Terrie

[Talino]

Return demonstration is just what it's meant to be, a follow-up of a previously learned experience. Therefore, an "initial" training must have taken place. 'am not sure if there is a more stringent requirement from the state, but based on this federal instruction, I interpret the training can be acquired from either a resp. therapist or an experienced nurse who had worked extensively in a pulmonary unit. Check w/ your oxygen supplier. They'll be happy to provide you with the training to maintain your business. Educational videos are also available that you can purchase to train your nurses. Most important, have a policy/procedure to prove your nurses competence.

[meghan61]

Thank you so much! You're the best.