Title: Nursing rehab
Holly, it helped us when we differentiated between floor CNAs and Restorative Nurse Aides.  We finally sent two of our best CNAs (after we advertised for the position) to Good Samaritan in Washington state (we are in Idaho) for a weeklong course they provide on restorative nursing.  They came back with training and best of all, specific programs including forms, guidelines etc.  It was a great investment, and I recommend Good Sam for this program.  I have 2 other CNAs that alternate so we cover 7 days a week, try to have 2 staff on because they are more efficient usually with 2 RNAs at time.  Sometimes I rely on floor CNAs but am always disappointed because, honestly, they just don't have 'ownership' of the program.  Like someone else said, we focus on basic restorative nursing program, ROM, ambulation, ADL self care, restorative dining etc.  Good Luck!
Kathy Archibald RN Living Center Supervisor
FAX 1-208-547-2790
Voice 1-208-547-2771
email [EMAIL PROTECTED]
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----- Original Message -----
Sent: Monday, April 05, 2004 2:00 PM
Subject: Re: Nursing rehab

Holly,
First of all, start with a few of the programs--ambulation, range of motion and eating, maybe.  Provide an inservice with stations for each restorative program and teach the CNAs how to do basic restorative techniques. 
Have licensed staff attend the same inservice, but also provide an inservice just for licensed staff to teach them how to identify residents who could benefit from the program, how to care plan for a restorative nursing program and also how to communicate the program to the CNAs and document the resident's progress in their weekly/monthly charting. 
We have developed a simple flow sheet that is part of the CNA documentation record.  The licensed nurse enters the restorative program on the CNA flow sheet.  The flow sheet has an area for the CNA to enter his/her initials signifying that the program was done and also has an area to enter the number of minutes that the program took that day.  It has an area for each shift each day so the minutes can be totalled for the 24 hours. 
Therapy helps by assisting the licensed nurses with establishing goals for the care plan.   Most of the residents are at least screened by therapy to determine if skilled therapy is needed, if not , then can help set goals for restorative nursing program.


-----Original Message-----
From: Holly McGran <[EMAIL PROTECTED]>
Sent: Apr 5, 2004 11:02 AM
To: [EMAIL PROTECTED]
Subject: Nursing rehab



        We are having the hardest time getting our nursing rehab/restorative nursing program off the ground. It has become a very complicated system of everyone questioning whether or not it is nursing rehab; CNAs not documenting or not understanding the minute concept. Difficulties communicating to the CNAs what goals are nursing rehab and to document on those and not the others that are not nursing rehab etc. etc. and what we end up with is the vast amount of our MDSs with -0 for this section. Does anybody have any ideas/best practices or input on how to get a handle on this. I would appreciate anything�.thank you in advance.

Holly McGran 

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