Treatment
What is the first thing you do with a resident in a treatment session?
Take vitals - O2, RR, HR
What documentation needs to be completed by the end of your shift?
EVERYTHING!! Daily note and billing; Orders and assessments if due!
What is a trial discharge?
When you discharge a resident after improving to their max potential.
Why is compliance so important?
Automatic denial :(
How long should a typical treatment session take?
around 10 minutes
What are some other things you can document about aside from levels obtained and pulmonary symptoms?
changes in heart rate; changes in activity level with other daily tasks; reports from interdisciplinary team; decreased anxiety; sleep habits; patients report
How do you know when to discharge someone for a trial discharge?
When you have assessed resident, they have had no changes/improvements and have no other goals to work on. (No "improve" goal = discharge)
What is the order of things you do on the first day adding someone to the program?
Complete all 4 treatments
Write Initial Evaluation
Write daily note
Enter billing
Provide consistent, repetitive instruction using different cues and strategies!
What is the main goal of your daily note?
Paint a picture of what happened during the session; make the reader picture they were there and can picture how the session went.
They show a decline during their trial discharge from the last levels they were at when they stopped the program.
When do orders need to start and end?
3 week and 6 weeks- dates need to cover every day of treatment!! (cannot have break in orders)
What would you do in this situation:
Resident has improved to 1300ml but now hitting 1100ml, no changes in oxygenation and has constant crackles in right upper lobe.
Answer Vary! But want to try different strategies and cues to improve the IS back to 1300ml with more trials; potentially try cupping for longer time especially in right upper lobe; try for stronger huff and cough to clear lungs.
Should match your clinical findings; or you clinical judgment on what the resident may be able to improve or not.
What do you need for compliance and to document skilled maintenance?
Screening form that indicates decline; MD referral order; skilled maintenance order; initial evaluation that documents the decline and has goals to maintain
When do you complete a reassessment?
Last day of order set; BEFORE starting new orders
What are some things we may see improve than just the "pulmonary" functions with this treatment?
HR; anxiety; increased activity level, sleeping better, decreased wounds, decreased hospital readmissions, improved socialization
1. Copy and paste notes
2. contradictions (info/#s)
3. Have same whole number for treatment sessions for every resident/every session.
What is different about the skilled maintenance order than the regular orders?
Stay in compliance with the MD order of 5x/week.
what's your favorite part of the pulmonary program?
Better be something good!