I would like to clarify the issue regarding pulse Ox. In Home Health it
is *required* to have a doctors order for any modality. That includes
monitoring oxygen stats, hot packs, ice packs.We all think it's silly,
but that is the regulation. What I do is always put "Monitor O2 Sats
PRN" on my initial order - In our agency we have a checklist sheet that
goes to the doctor for signature, I added a check box for this and check
it when necessary. I also include it when writing continuation orders.
Medicare will cite this as an issue during an audit. Just as you must
have doctors orders for any visit, you must have orders for O2.
I use my pulse ox when working with a patient on O2 to make sure I am
not stressing the patient, I use it to show the patient when teaching
pursed-lip breathing so they can see the increase - sort of
bio-feedback. If Oxgyen drops too low too often I would inform the
doctor. In the home health setting you must inform the doctor of any
changes, issues, such as a patient not taking meds, or not using O2 as
specified by doctor.
This is one of many differences between in-patient and home health
-don't assume that because you did it in the SNF you can do it in the
home the same way :-)
Sue
--
Sue Hossack MOT, OTR/L, ATP
Occupational Therapist
http://www.ot-care.com
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