updating plans of care

[nursebitback]

the rule that states you have to update the plan of care every two weeks, does it mean you have to update your care plan problems and basically rewrite them? the agency I work for doesn't make us do this and some of the care plan problems haven't been updated since june of 2008. Social worker's and Nurses too. They use computerized charting. I have started reading the regulations and when I told them about some of the things I learned, well, I don't think they like me anymore. I also told them that I think we may have a problem because there have been about 22 revocations in the last year with about 19 of them being readmitted as soon as they got out of hospital. Some have done this twice. They average about 50 patients. The more I read, the more I find things that I think aren't being done right? Is this possibly some sort of syndrome a hospice nurse gets when she starts reading the rules? such as maybe she is taking them too literally or maybe reading too much into them?

[AtlantaRN, RN]

Each IDT meeting is a Care Plan Meeting. Each nurse reads through the care plan and goals and interventions we are using to meet the goal. Essentially, we date and initial the heading of the care plan and date any updates that are made. I don't believe you are reading the rules too literally. ((frankly, it wasn't until we got our new branch manager that we started doing the care plans correctly)). Granted, it's pretty redundant bouncing between "risk" for constipation and "actual" constipation...it's alot of writing. One of the things each nurse does at each nursing visit is not only review the MAR with patient and family, but also review the care plan and make changes as to what is working and what is not...then we have to update the care plan at the office....it's alot of paperwork

linda

[nursebitback]

thank you. another question- do you leave a copy of the plan of care in the patient's home? and a medication profile? I think home health has to do this but I can't find anything about hospice, I could easily be missing it though.

[AtlantaRN, RN]

My former employer, yes, we left a copy of the MAR and careplan in the home. My new employer, we only leave a copy of MAR (but I believe we should be leaving a copy of the care plan).

linda