Restorative Nursing

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Restorative Nursing

• ROM
• And
• Late Loss ADLS

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RESTORATIVE

• I. WHAT IS IT?
• II. WHY IS IT IMPORTANT?
• III. ADDITIONAL BENEFITS

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DESIGNATED VERSUS INTEGRATED MODELS
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F TAGS

• F241-DIGNITY
• F272-COMPREHENSIVE ASSESSMENT
• F279-COMPREHENSIVE CARE PLANS

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F TAGS

• F309-HIGHEST PRACTICABLE LEVEL OF FUNCTIONING
• F310-ADL STATUS
• F311-MAINTAIN OR IMPROVE ABILITY
• F312-NECESSARY SERVICES

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F TAGS

• F317- ROM NOT REDUCED
• F318- TREATMENT OF ROM
• F315- FOLEY CATHETER FREE
• F316- PREVENT UTI RESTORE BLADDER FUNCTION

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F TAGS

• F 325- NUTRITIONAL STATUS MAINTAINED

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STATE REGULATIONS

• RULE 707-NURSING CARE SERVICES
• RULE 708-REHABILITATIVE NURSING CARE

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QUALITY INDICATORS

• DEFINITION
• LATE LOSS ADLS
• QUALITY INDICATOR 17
• HCFA/OBRA MANDATES
• 1990

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QUALITY OF LIFE AND QUALITY OF CARE

• OBRA/HCFA 1990
• HIGHEST FUNCTIONAL LEVEL
• MULTIDISCIPLINARY APPROACH
• ADAPTIVE EQUIPMENT
• RISK IDENTIFICATION AND PLAN
• RESTORATIVE PROGRAM

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SURVEY FOCUS

• CRITERIA THAT PROMOTE AND IMPACT RESTORATIVE CARE

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NEED FOR RESTORATIVE

• ASSESSMENT TRIGGERS
• POTENTIAL
• INACTIVITY

• NORMAL CHANGES OF AGING
• FALLS
• STAFF

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ASSESSMENT TOOLS

• PERSONAL PREFERENCES
• VALID MEASUREMENT OF CHANGE
• SELECTION OF COMPONENTS

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OBJECTIVES OF ASSESSMENT

• WHAT DOES RESIDENT DO FOR SELF?
• WHAT CAN RESIDENT DO FOR SELF?
• WHAT WILL RESIDENT DO FOR SELF?

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ASSESSMENT TOOLS

• KATZ (ADL)
• BRIGGS
• MOBILITY SCREEN

• POSITIONING SCREEN
• PHYSICAL THERAPY TOOL
• QUARTERLY RANGE OF MOTION

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ASSESSMENT VARIABLES

• SITUATIONS
• CAREGIVERS
• TIME
• RESIDENT-SPECIFIC DATA

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FRAMEWORK

• ATCHINSON
• CHRISTIAN REST HOME
• OTHER MODELS OF CARE

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DEVELOPING A PLAN

• FOCUS AND PRIORITIZE
• MEASUREABLE OBJECTIVES
• SET LONG TERM GOALS

• TIMETABLE
• RESPONSIBLE COORDINATOR
• STAFF TRAINING

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THE RESTORATIVE AIDE

• PROM
• AROM
• DOCUMENTATION
• EVALUATION

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DOCUMENTATION

• DIRECTOR OF RESTORATIVE PROGRAM
• FLOW SHEETS
• INTRADEPARTMENTAL RECORDS
• MONTHLY REPORT

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LATE LOSS ADLS

• TRANSFERS AND BED MOBILITY
• DINING
• TOILETING

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REMEMBER

• THE RESIDENT IS THE MOST IMPORTANT TEAM MEMBER
• MENTAL EXERCISE IS AS IMPORTANT AS PHYSICAL
  EXERCISE
• GOOD NURSING IS THOUGHTFUL NURSING
• LISTENING IS THE MOST EFFECTIVE WAY TO
  COMMUNICATE (IOPMR)