CLIENT A: The client is a 25 y/o home vented patient with severe Multiple Sclerosis, bedbound, unable to direct his own care but a parent is available 24/7 either in home or telephonically and never more than 30 minutes from home; the parent is very willing to participate in care decisions. The unlicensed assistive person (UAP) has been with this client for 2 years and is very mature/reliable in carrying out activities of daily living (ADLs) and health maintenance activities (HMAs), as well as certain delegated nursing tasks (including trach care and suctioning). All ADL/HMA tasks have previously been exempted from delegation by the RN. Up until now, the Home Health RN has been making routine visits every 90 days, and as needed to reassess if there are any changes in the client’s condition.
This client developed an obstruction of his G-tube, which required an overnight hospital stay for placement of a new G-tube. At home again, his vital signs are stable, and the RN assesses his condition to be stable and non-fluctuating (ie: no change from his previous condition).
Based on RN assessment, it is acceptable to continue exemption of ADLs and HMAs. The client’s condition is stable and the UAP is capable of safely completing tasks related to the client’s change in condition. The RN elects to make skilled RN visits every two weeks for the first month to assess the status of the new G-tube and client’s status in general to be sure the client’s status remains non-fluctuating.
Certain Titles. (n.d.). Retrieved September 1, 2016, fromvRule 225: RN Delegation & Tasks Not Requiring RN Delegation in Independent Living Environments with Stable & Predictable Client Condition. (n.d.). Retrieved September 1, 2016, from Rule 225: RN Delegation & Tasks Not Requiring RN Delegation in Independent Living Environments with Stable & Predictable Client Condition
No comments:
Post a Comment