Maria,

There have been lots of great solutions proposed for this issue.  Here
are some more thoughts on it:

1)      The Plan of Care function within the NUR module may not be able
to handle every instance of Care Planning that you need to handle.  So,
some facilities have taken the approach that the POC encompasses more
than just what Meditech labeled ages ago the Plan of Care.  If your POC
also includes a print profile or some other CDS or NPR report then if
someone other than an RN initiates the POC part in Meditech, it might be
argued with reviewers that that does not indicate that they "started the
POC".  Especially when if you add interventions through query linking so
they are all attached to a problem and outcome, then LPNs or RT or who
ever will have their names attached to adding to the POC.

2)      If your initial POC is built in a predefined way that includes
appropriate minimal documentation tools that you would need on nearly
anyone who is in your facility, then that POC might be able to be
initiated separately from any assessment of the patient for POC
additions.  Some facilities have used a "Quick Start" intervention that
identifies the patient's age and where they are going in the facility.
Then a base set of interventions are query linked so that folks can
document on the patient prior to having time to do the Admission History
or Admission Assessment.

3)      Yes, it does make sense to separate what an LPN is allowed to
document from what requires an RN.  There is no way that an RN can
easily co-sign for someone else's assessment that was done an hour ago
or what ever.  I don't see that any duplication of questions happens
when the two are separated.  For instance, on the history you would ask
do you use a hearing aid.  On the assessment you would ask, do you have
that hearing with you.  Those are two different bits of information.  If
there is information from one form that could be helpful on the other
form then a simple attribute could pull it across so the second person
simply verifies that it is still true.

 

Daniel Davis

________________________________

From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Maria P. McPherson
Sent: Thursday, August 02, 2007 10:24 AM
To: [email protected]
Subject: [MEDITECH-L] query linking diagnosis to care plans
frominterventions

 

For those of you out there that use query links to add diagnosis to the
care plan, how do you accomplish adding a care plan on the admission
assessment by triggering diagnosis if the nurse is an LPN?  Do you have
an RN review the care plan chosen by the LPN and document a note, etc..?

 

Maria P. McPherson, RN

Nursing Informatics Analyst

Columbus Regional Healthcare System

500 Jefferson Street

Whiteville, NC 28472

910-641-8259

mailto:[EMAIL PROTECTED]

 

 

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