Rena
Subj: Re: Rena: Would you care to comment on this?
Date: 11/8/03 12:47:31 PM Pacific Standard Time
From: [EMAIL PROTECTED]
Reply-to: [EMAIL PROTECTED]
To: [EMAIL PROTECTED]
Sent from the Internet
i agree,i always encounter this situation but i'm being conservative with my coding as far as IV fluids..i think this should be clarified in sec G,since it only mentioned tubefeeding and TPN..and i know that you dont eat the IV fluids either and some IV fluids have calories..
[EMAIL PROTECTED] wrote:
I may have lost the thread of this discussion, but I do have some comments. Please let me know if I am not answering your question.
A resident who is independent in eating but who has had IV fluids during the lookback period must be coded in G1(A)h taking into account the level of assistance required to manage the IV fluids (see last bullet on page 3-81 of the RAI User's Manual). Thus, if the staff is managing the IV fluids, the coding would be 3 for self performance if the IV fluids were administered three or more times during the observation period.
In the case in question, the resident is receiving IV vanco in 200 cc of fluid daily. IV fluids for K5a, Parenteral/IV include the fluids in IV piggybacks and other diluents that medications are dissolved in (p. 3-153). Thus, in the case in question, I believe this should be taken into account when coding G1(A)h as described in the paragraph above.
Rena
Subj: Rena: Would you care to comment on this?
Date: 11/8/03 9:03:28 AM Pacific Standard Time
From: [EMAIL PROTECTED]
Reply-to: [EMAIL PROTECTED]
To: [EMAIL PROTECTED]
Sent from the Internet
Thanks for your replies! The only reason I'm fussing over this is because I noticed that my RUG score for this particular resident went from RVB to RVC ( with an ADL index of 15, as per what I actually coded on the MDS: eating=0/1, tranf=3,2, bed mob=3,3 and toileting =3,3). When I contacted Information Systems regarding the RUG code, they informed me that the system automatically assigns a higher self-performance code under "eating" if parenteral IV is checked off in section K. I wondered if I should then code higher on the MDS to include the nursing involvement for the IV Vanco q day (200 cc daily)...Thanks to all!
reneir jerusalem <[EMAIL PROTECTED]> wrote:
what if resident is npo and only get iv fluids for hydration?
Doug and Jane Barbour <[EMAIL PROTECTED]> wrote:
Olga,
IV meds are included in P1c. In section G1h you only code residents self performance and support needed for eating. She eats independently, therefore you code 0 for self performance. IV administration is not a factor.
Jane
----- Original Message -----
From: Olga Lawrence
To: [EMAIL PROTECTED]
Sent: Saturday, November 08, 2003 5:45 AM
Subject: How would you code this?
If a nurse administers IV Vancomycin (200 mls/24 hours) each day over the lookback period, and the resident is independent with eating activity, what would the correct code (self-performance) be under "eating" in section G? Since I would have to include the 200 mls of IV solution in section K and provide the average daily intake of parenteral fluids, I feel that section G would have to be coded in a way which reflects the nurse's involvement.... Is this correct? Thanks! (is code "3" appropriate ?)
Rena R. Shephard, MHA, RN, FACDONA, RAC-C
Healthcare Consultant
