Shelley Henry, RN, CPHRM, CHPN’s Post

Tip for Hospice Nurses: continuing with my series on documenting normal findings to support eligibility - when your patient is ambulatory instead of saying “patient ambulatory” follow these steps: 1. Start the sentence with a negative descriptor. 2. Focus on what the pt cannot do vs what they can do. 3. Do not restate normal findings in your Nurse’s Note. It takes a lot of practice to document accurate findings in a way that supports hospice eligibility. For more examples, check out my Hospice Documentation Books at https://lnkd.in/grAn_j99 Ya’ll be safe out there! I love you guys … xoxo ~ Shelley 💕 #tipsforhospicenurses #forhospicenurses #shelleyhenry #amitygroup #amitynurse#hospicedocumentation #documentation #hospicenurse #hospicenurses #documentationguides #documentationbooks #nurseguides #nursebooks #hospiceguides

Documentation Tip for Hospice Nurses: below are some tips to consider when documenting to support eligibility on your pts with Parkinson’s: 1. Make the first word of the sentence negative instead of positive (disoriented x1 instead of oriented x3) 2. Focus on what they cannot do instead of what they can do (unable to ambulate w/o a walker) 3. Detail what their movement looks like (shuffling, slow, unsteady, etc) 4. Detail how their ADLs are affected (unable to hold spoon r/t tremors. Requires adaptive devices to feed self) Find my documentation books for hospice nurses on my website: https://lnkd.in/gN_6fgaj and be on the look out for DAHN, the Documentation App for Hospice Nurses coming soon! Ya’ll be safe out there! I love you guys … xoxo ~ Shelley 💕 #forhospicenurses #hospice #hospicenurse #tipsforhospicenurses #documentation #shelleyhenry #amity #amitynurse #charting #chartingsucks #parkinsonsawareness #parkinsons #parkinsonsdiesease #parkinson

Tips for Hospice Nurses: constipation is a frequent issue for hospice patients. When the bowel regimen is not effective, there are several options that may be effective. Today I’m talking about a few that I find effective, but there are so many. Please share your go-to remedy in the comments below ~ Shelley 💕 #tipsforhospicenurses #forhospicenurses #shelleyhenry #amity #amitynurse #constipation #laxative #palliative #palliativecare #tips #tipsandtricks #bm #hospice #hospicenurse #plan #treatment #PatientCare

Tip for Hospice Nurses: continuing with my series on documenting normal findings to support eligibility - when your patient is ambulatory instead of saying “patient ambulatory” follow these steps: 1. Start the sentence with a negative descriptor. 2. Focus on what the pt cannot do vs what they can do. 3. Do not restate normal findings in your Nurse’s Note. It takes a lot of practice to document accurate findings in a way that supports hospice eligibility. For more examples, check out my Hospice Documentation Books at amitystaffing.com/products. #tipsforhospicenurses #forhospicenurses #shelleyhenry #amitygroup #amitynurse#hospicedocumentation #documentation #hospicenurse #hospicenurses #documentationguides #documentationbooks #nurseguides #nursebooks #hospiceguides

Tip for Hospice Nurses: It's important to make sure that patients and caregivers understand that long-acting pain medication should be given every 12 hours, not just twice a day. I will ask my pt what time they usually get up in the morning, and start their first night dose at the corresponding time. For example, if they usually get up at 7am, I will tell them to take their first dose at 7pm. If we can get them on a smooth schedule from the start, I find that their comfort management is smooth. ❤️ #tipsforhospicenurses #shelleyhenry #amitynurse #hospice #forhospicenurses #hospicenurse #hospicenurses #hospicecare #palliativecare #palliativemedicine #palliative #pain #painmanagement #painmedicine #extended #longacting #nurses #tips #tip #tipsforsuccess #theamitygroup

Tip for Hospice Nurses: I am frequently asked if it is necessary to document a note in the box under each system assessment in the flow sheet (area under each checkbox section). There are several issues to consider, so I will do a series of videos to address each, but generally if I am going to address the area in my nurse’s note, I will not put a note in the flowsheet section. We already spend so much time documenting that I avoid redundancies whenever possible. Be safe out there … Xoxo ~ Shelley 💕 www.AmityStaffing.com #tipsforhospicenurses #forhospicenurses #shelleyhenry #amitynurse #documentation #tips #hospice #hospicenurse #redundant #savetime #timesaving #chart #charting #medicalrecord

Tips for Hospice Nurses: Comparative charting is a good way to illustrate subtle decline - it is simply, “patient was (this), now they are (this). I don’t generally use comparative charting in my routine notes, but I will always use it throughout my Recert notes. With measures, it is very straight forward: 1. LMAC was 27.6, now LMAC is 25.2 2. PPS was 40%, now PPS is 30% 3. B/p avg was 130/80, now 80/50 For more subtle decline, comparative charting looks like: 1. Patient was able to ambulate down the hall to his bedroom; however, due to progressively worsening debility, patient unable to ambulate the short hallway, and must stop and rest halfway. 2. Patient was able to ambulate the short distance to his bedroom with frequent breaks to rest, but due to progression of terminal illness and worsening weakness, patient now must be wheeled to his bedroom. 3. Patient was consuming approx 70% of 3 meals daily, but due to decline, patient now only able to consume approx 40% of 2 meals daily. 4. Patient was mostly continent, but due to progressively worsening weakness patient too weak to get to even the bedside commode now, and requires diapers and protective pads at all times. To make comparative charting on recertification easier and faster, I keep a “recert jot” note on all my pts, and when any decline or event occurs, I write it on the note. If you would like a copy of the recert jot note, email me or visit my website to submit a request. (Please don’t put your request here r/t it’s difficult to capture all the comments) Be safe out there! I love Ya’ll … xoxo ~ Shelley 💕 #tipsforhospicenurses #forhospicenurse #forhospicenurses #shelleyhenry #amity #amitynurse #hospice #hospicenurse #charting #compare #comparative #comparativecharting #eligibility #documentationtraining #nurse #nursenotes #chartingsucks #DAHN #documentationapp

Tip for Hospice Nurses: disposal of Fentanyl Patches. During this video I share one way that I dispose of Fentanyl Patches, but there are several safe ways, and I would love to hear what you do. Please share your tips in the comments. Be safe out there … I love you guys! 💕 Xoxo ~ Shelley #forhospicenurses #tipsforhospicenurses #shelleyhenry #amitynurse #hospicenurse #safetytips #medicationsafety #disposal #hospice

Tips for Hospice Nurses: Comparative charting is a good way to illustrate subtle decline - it is simply, “patient was (this), now they are (this). I don’t generally use comparative charting in my routine notes, but I will always use it throughout my Recert notes. With measures, it is very straight forward: 1. LMAC was 27.6, now LMAC is 25.2 2. PPS was 40%, now PPS is 30% 3. B/p avg was 130/80, now 80/50 For more subtle decline, comparative charting looks like: 1. Patient was able to ambulate down the hall to his bedroom; however, due to progressively worsening debility, patient unable to ambulate the short hallway, and must stop and rest halfway. 2. Patient was able to ambulate the short distance to his bedroom with frequent breaks to rest, but due to progression of terminal illness and worsening weakness, patient now must be wheeled to his bedroom. 3. Patient was consuming approx 70% of 3 meals daily, but due to decline, patient now only able to consume approx 40% of 2 meals daily. 4. Patient was mostly continent, but due to progressively worsening weakness patient too weak to get to even the bedside commode now, and requires diapers and protective pads at all times. To make comparative charting on recertification easier and faster, I keep a “recert jot” note on all my pts, and when any decline or event occurs, I write it on the note. If you would like a copy of the recert jot note, email me or visit my website to submit a request. (Please don’t put your request here r/t it’s difficult to capture all the comments) Be safe out there! I love Ya’ll … xoxo ~ Shelley 💕 #tipsforhospicenurses #forhospicenurse #forhospicenurses #shelleyhenry #amity #amitynurse #hospice #hospicenurse #charting #compare #comparative #comparativecharting #eligibility #documentationtraining #nurse #nursenotes #chartingsucks #DAHN #documentationapp

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