Ruth, this is really exciting. You ask for ideas. My only idea at the
moment is about seizing the moment and getting rid of the traditional
care plan - problems/interventions/goals, clearly represented by the
functionality of Meditech and other systems, or by the preprinted care
plans so many hospitals still have - for which nurses still have primary
(or even sole) responsibility, and which rarely has any value outside of
the academic setting (although I know there are people on this list who
have come up with some very slick ideas for morphing the care plan into
something more useful).

If HFAP is not looking for a traditional nursing care plan PLUS a
problem list, that would be in alignment with JCAHO expectations as I
understand them. It sounds like both agencies understand that in most
facilities, the nursing care plan is an anachronism. Yet every facility
has forms and processes by which nurses and other clinicians know what
to do.

Without accrediting agencies to insist on a care plan, who is there to
make us have one, beyond facility leaders (who will drop it like a hot
potato as soon as they are sure they can do so safely, in the name of
productivity) or the discipline of Nursing, which invented care plans
and whose leaders (academics; AONE) may be unwilling to let go of what
they consider to be a unique identifier of the profession's scientific
basis and value.

Goodbye to care plans? Oh, joy of joys! Oh, the felicity! Freed from the
time wasting tyranny of the care plan? It makes my heart go pitter
patter.

BUT: what saith CMS? My understanding is that THEY still require a care
plan for every patient - not just residents on skilled units. Yet, they
accept accreditation from HFAP and JCAHO. 

Am I confused?

Sharon (RN)

From: [email protected] [mailto:[EMAIL PROTECTED] On Behalf
Of Ruth Chapman
Sent: Tuesday, May 08, 2007 8:48 AM
To: [email protected]
Subject: [MEDITECH-L] list

 

Good morning L:

Wondering how other sites are going to or are addressing HFAP's
requirement - 16.02.03 - for List of Patient's Problems.

>From a site that I was conversing with that had been inspected, the
inspector recommended:

 

 the Problem List needed to be independent of the Care Plan and have
each problem evaluated - one surveyor gave the suggestion to maintain
the problem list in front of the care plan and evaluate daily; draw a
line through, date and initial the identified problem when it is no
longer a problem.

 

So what kinds of ideas does anyone have out there in Meditech Land for
our NUR users,

 

 

Ruth Chapman BSN, RN-BC

Nursing Analyst
Central Michigan Community Hospital
[EMAIL PROTECTED]






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