Advance Directives
Are Advance Directives documents voluntary?
Yes! It is important that persons have their health care wishes, especially end-of-life preferences, met, but it is voluntary.
(1) Who are the key persons responsible for the administration of this policy?
(2) Who does this policy apply to as it pertains to staff?
(1) AVPS, RMs, Staff Scheduling Supervisor, and Staff Scheduling Coordinators
(2) DSPs and Medical Appointment Personnel, and Per Diem Staff
Who is responsible for the administration of this policy?
Assistant Vice President, Clinical Nutrition Wellness (Agency-Wide), Registered Dietitians (RDs), Direct Support Professionals (DSPs), Direct Support Professionals II (DSPs II), Residence Managers (RMs), Assistant Resident Managers (ARMs) and Day Habilitation with Walls Managers and Specialists are responsible for implementation, oversight and ensuring compliance with this policy.
Who is responsible for the administration of this policy?
Approved Medication Administration Personnel (AMAP) certified staff, Medical Appointment Personnel (MAP), Residence Managers (RMs) Assistant Residence Managers, RN and Licensed Practical Nurses (LPNs) (if applicable) are responsible for implementation, oversight and ensuring compliance with this policy.
This policy applies to all employees in direct care positions.
What are the three types of advance directives?
Living Will
Health Care Proxy Form
Do Not Resuscitate Order (DNR)
What is the name of the calling system?
Ring Central called (UKG Dimensions Centralized Scheduler System) - one place where employee calls are logged
Where can dietary restrictions and allergies be found?
In MyEvolv Nutrition section, house diet chart, and IPOP
Who is the primary key stakeholder in medication administration?
The person we support!!
What are the disciplinary steps for sleeping while on shift if no adverse effect and/or breach in required supervision occurs?
1st Sleeping Event: the RM or AVP will draft a Final Written Warning CDR along with any evidence and submit to the employee’s Human Resources Business Partner (HRBP) and to the Director of Employee Relations for review and approval.
2nd sleeping events: If an employee is found sleeping while on shift a second time within a 12-month period from the 1st sleeping while on shift event, with no adverse effect on the person(s) supported resulting from the incident and/or no breach in required supervision, the RM or the AVP will draft a termination CDR and a suspension request with documented evidence and submit to the employee’s HRBP and to the Director of Employee Relations for review and approval.
Is the Medical Orders for Life-sustaining Treatment (MOLST) an advance directive?
NO! It's a compliment to an advance directive.
MOLST (like the Health Care Proxy) allows an adult to express his or her preference regarding health care treatment, including a desire to continue or to refuse treatment and life supports. MOLST is intended for patients with serious health conditions who:
Want to avoid and/or receive any or all life-sustaining treatment
Reside in a long-term care facility or require long-term care services
Who are on comfort care or hospice; receiving near end of life services
Might die within 1-2 years
The only option for non-consenting persons is the use of MOLST when they meet one of the circumstances listed above.
What information needs to be provided to the scheduler when calling?
For residences with feeding, swallowing, and special diets, RMs and/or their DSP II how often should observations be conducted?
RMs and/or their DSP II are responsible for conducting three observations monthly alternating between mornings and evenings to ensure that dietary protocols and special diets are being followed correctly. Once completed, the meal observation sheet is to be sent to the assigned dietitian for review.
What is the initial opioid prescribing for acute pain limited to?
7 days!
What are the disciplinary steps for sleeping while on shift if there is an adverse effect and/or breach in required supervision occurs?
The RM or the AVP must follow the process for reporting the incident to the Justice Center. The incident must also be reported with documented evidence to the Quality, Performance, Compliance (QPC) hotline, the employee’s HRBP and to the Director of Employee Relations.
1st Sleeping Event:
In addition to reporting the incident as indicated above, the RM or the AVP will draft a Final Written Warning CDR with evidence and submit to the employee’s HRBP and to the Director of Employee Relations for review and approval.
2nd Sleeping Event:
If an employee is found sleeping while on shift a second time within a 12-month period from the 1st event, the RM or the AVP will document the event and submit a Termination CDR with evidence to the employee’s HRBP and to the Director of Employee Relations for review and approval. While the investigation is pending the employee will be suspended without pay.
Once an Advance Directives form is finalized who is the primary person responsible for training the Residence Mangager?
The RN! Teamwork makes the dream work!
What to do if no one answers the phone?
If no SSC answers the centralized phone line when calling, the caller leaves a message using RingCentral to ensure there is a record of the call (RingCentral is a landline. If staff leaves a voice mail message, RingCentral transcribes the message for review by the SSC team)
For residences without feeding, swallowing, and special diets, RMs should conduct observations how often?
RMs are responsible for conducting monthly meal observations alternating between mornings and evenings to ensure that dietary protocols, menus and persons’ diets and portion control are being followed correctly.
What are some of the parameters that must be met for a administration of a controlled substance?
The person must have a prescription from a health care provider
The AMAP must initiate The New York Foundling Controlled Substance Medication Count Sheetas soon as a controlled substance is delivered to the site
The AMAP initiates a new Controlled Substance Medication Count Sheet for every new medication container that has a new RX number
When a controlled substance is administered the amount left must be documented in the Controlled Substance Medication Count Sheet to reflect the amount remaining in the container (administration of controlled substance medications must be accurately documented and accounted for at all times)
For PRN controlled substance, an RN must be contacted before administration
For any inconsistencies in count, an RN must be notified immediately upon discovery
At minimum, how late should a staff let their manager know they will be absent?
In instances when you will be absent or late, you must inform your supervisor prior to your normal starting time. Employees in direct care positions must call their supervisor to provide as much advance notice as possible – typically at least 4 hours prior to the start of their shift when the absence is reasonably foreseeable. Employees must provide reasonable advance notice, in writing, when their need for sick leave is foreseeable.
How often should choking prevention be conducted?
Yearly Relias trainings are assigned to all DD staff regarding OPWDD choking prevention.
Where is the documentation for the Active Controlled substance medication count sheet stored?
In the person's MAR