By Jacquelyn Eaton, TPM, The Healthcare Resort of Topeka, KS
The Healthcare Resort of Topeka implemented a system so that our CNAs and Nurses know what the transfer, ADL and mobility levels are upon the day of evaluations by therapy. Our therapist will complete the evaluations, fill out a quick form and submit the form to me so that I can update the care plan and tasks in PCC in real time. The patients care plan and tasks are updated based on the level of assist on the day of the therapy evaluation, then as needed when the patient progresses to the next level of assist. Therapists here at the facility will also update the CNAs and nursing staff working the current shift to allow them to pass on information at shift change.
We started this process so that staff know more about the patient and weightbearing status. It has become standard practice and a fall prevention program as the nurses know more about the patient and how they move in bed, to chair, with a walker, assist levels with showering, dressing and hygiene. As the patient progresses, the task and care plan will change, but usually by week 1 or 2 the CNAs are very familiar with the patient and a simple update in PCC is all I have to do. We use a Red, Yellow and Green “stop light” tag system to identify when the patient is ready to move on their own:
Green means: “Go, they can walk independently and do their own self-care” May ambulate at will, no assistance in room/dining room or activities
Yellow means: “Slow down, they need hands on help with ambulation and self-care” Help assist to dining room and with self-care
Red means: “Stop, they should not be up on their own and need direct contact at all times with ambulation and self-care” Requires hand assistance with ambulation and self- care
PT, OT and ST collaborate on whether or not they can move their tag up to the next status. We love this process, and it helps us keep patients happy and healthy as well as on their way back to their prior level of function.