Long-term care nurses gain power through physician assessment tool: expert

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Long-term care nurses should embrace a physician assessment tool in INTERACT II as a way to reduce hospital readmissions, a compliance expert emphasizes.

While all of INTERACT II is helpful, the SBAR (Situation, Background, Assessment and Request) component provides a way for nurses to communicate with physicians in discussing a resident's condition. It prompts the nurse to use sentences such as “Things that make the condition worse are _____.”

“It's a way to empower nurses,” said Sheila Capitosti, vice president of clinical and compliance services at Functional Pathways. In the past, nurses who called physicians, especially after hours, would often lead to the resident being sent to the hospital emergency department.  That's changing, according to Capitosti and others attending “Therapy Services: Impact on Avoiding Hospitalizations” a session at the American College of Health Care Administers convocation Monday in Orlando.

The SBAR section “conserves documentation,” Capitosti says, as many nurses would be recording vital signs or other notes within a medical record. In the six months since the Centers for Medicare & Medicaid Services began penalizing hospitals that readmit patients with certain conditions, she says she has seen a difference in how nursing homes approach hospitalizations.

“A lot of medical directors really embrace INTERACT,” she said. “I've seen use of it escalate since October.”

Other best therapy practices include having a strong fall-management system and a restorative nursing program that evaluates deficits that could lead to hospitalization, said Cherie Rowell, director of clinical services at Functional Pathways.

“Whether it's a long- or short-term stay, there needs to be a formalized program so that everyone's on the same page,” Rowell said.

The ACHCA convocation concludes today.

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