What do you think?

Marie_LPN, RN, LPN, RN · Sep 2, 2006

The resident is not a piece of chicken, for Pete's sake.

Yes it's a violation, of the pt.'s privacy AND dignity.

leslie :-D · Sep 2, 2006

We just recently finished with our state survey and were cited on toileting and repostioning. We have a resident that is to be repositioned Q1 hr, well, that got missed, now there is a timer on the door that is set to go off every hour. Wouldn't that be considered a violation of HIPPA? or at least that resident's privacy?
I'm just wondering what others think.... to me it's not appropriate!

how did they discover she wasn't being turned qh?

what does her skin look like?

and what kind of mattress is she on?

qh is aggressive, but only takes 1 minute to do.

i just never had hourly turns as an order, even w/significant breakdown.

and it's trying to find anyone available to help in achieving this goal.

leslie

eta: i'm not convinced it's a hipaa violation...how?

Tweety, BSN, RN · Sep 2, 2006

I'm not totally convinced either Leslie. Unless the alarm screams "it's time to turn Mr. Smith because he can't turn himself". I agree that q1h might not be necessary. Isn't the standard q2h? Even for those with known breakdown?

The problem with the state was there might not have been any documentation that the qh turns were being done.

suebird3 · Sep 2, 2006

We have a rezzie who is on q. 1 hour turns. Luckily, the vast majority of the aides on that hall do the turns.

When State was in at our Facility, the main thing they were onto was Diabetes. What a joke!

SueB

Plagueis · Sep 2, 2006

Where I work, we had a resident who was ordered to be turned every hour, since it was mentioned in report every day. However, I also thought that every two hours was the norm. :confused: The idea of a timer suggests that the facility thinks its staff is somehow "incompetent," and that they need an alarm to tell them when to do certain skills. Will the next idea be alarms on carts to "remind" nurses when to give a certain med to a resident/patient?

leslie :-D · Sep 2, 2006

The problem with the state was there might not have been any documentation that the qh turns were being done.

that's exactly what i was thinking too, tweety.

CapeCodMermaid, RN · Sep 2, 2006

lol...they'll get you on something won't they!?!? We have gotten away from orders and or care plans with turning or toileting schedules that are so specific and have started writing 'frequent' repositioning or 'toilet before meals'. Frankly, if the residents were toileted every 2 hours, there wouldn't be time for anything else...(do YOU go every 2 hours?)

I'm not sure about the HIIPA thing. If we have a resident who is deaf or hard of hearing we post a sign in the room so the care givers know...usually covered with a plain piece of paper, and I've never had any surveyor cite us.

And, as an aside, if someone's skin is so fragile that they need to be turned that frequently, you should consider a special mattress...pressure relieving at least and perhaps an alternating pressure air mattress....and don't forget barrier cream (sorry, it's the wound nurse in me).

txspadequeenRN, BSN, RN · Sep 2, 2006

I personally think turning a resident every hour is a violation within its self. I would not want someone waking me up every hour so I could turn. Now I realize there are some situations that call for this type of thing but every skin break down I have ever treated ..turning every 2 hours handled it. I think that a timer on the door is a great big no-no . Not only does it violate the residents dignity it disturbs the residents living in rooms nearby. What does the family say about all this?

We just recently finished with our state survey and were cited on toileting and repostioning. We have a resident that is to be repositioned Q1 hr, well, that got missed, now there is a timer on the door that is set to go off every hour. Wouldn't that be considered a violation of HIPPA? or at least that resident's privacy?
I'm just wondering what others think.... to me it's not appropriate!

Marie_LPN, RN, LPN, RN · Sep 2, 2006

We've had pts. on the m-s floor who were q30min and q1 turns, their skin breakdown happened so easily.

flashpoint · Sep 2, 2006

We have a bunch of miniature alarm clocks that we can set adn carry in our pockets to remind of us things like qh turns, unusual med times, checking effects on PRNs, etc. It may seem to some that we should be more responsible and just remember to do all of those sorts of things, but the clocks are nice when you get really busy.

Each or residents has a reminder card insode their closet door telling how many are required for transfer, whether they have dentures or hearing aides, whether they us a walker or wheelchair, and just about anything else we might need to know. State has never said a word about it...:)

Tweety, BSN, RN · Sep 3, 2006

We've had pts. on the m-s floor who were q30min and q1 turns, their skin breakdown happened so easily.

Yikes. That patient wouldn't be on our floor. That patient would need critical care just so someone was available q30 minutes. Patients don't get q30 minute anything around the clock on my unit. :)