pam kieslich hca220 final.pptx

7/30/2019 Pam Kieslich HCA220 Final.pptx

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HOSPICE ADMISSION

NURSING TRAINING

HCA/220

Pamela Kieslich

Ellen Lipscomb

October 7, 2012


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OVERVIEW

Evaluate patients for hospice care.

Use tools for evaluation of patients.

Understand regulation and policies.

After this training presentation the admissionnurse will be able to:


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GOALS

Timely evaluation of hospice referralpatients.

Understanding common hospice diagnosis.

Assess patient to determine appropriatehospice diagnosis.

Charting of patient comprehensive

assessment and plan of care. All documentation is on time and complete

according to CMS and state policy.


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REFERRALS

Physician offices

Family members Hospitals

Other hospices

Patient referrals come from many sources:

Company policy states referrals are addressed

within 2 hours of initial call and patient evaluation

completed within 4 hours.


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THE REFERRAL PROCESS

Referral received

Obtain physician order for evaluation

Request History & Physical (H&P)

Schedule evaluation with family


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CANCER

Any malignant cancer that will no longer be

treated with aggressive measures.

Laboratory tests confirm

carcinoma/neoplasm.


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CARDIOPULMONARY

Congestive Heart Failure (CHF)

Coronary Artery Disease (CAD)

Acute Myocardial Infarction

Chronic Obstructive Pulmonary

Disease(COPD)

Cystic Fibrosis


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LIVER DISEASE

End Stage Liver Disease

Cirrhosis alcoholic and non-alcoholic

Hepatitis

Sclerosing Cholangitis


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RENAL DISEASE

End Stage Renal Disease

Chronic Renal Failure

Lupus Nephritis

Rapidly Progressive Glomerulonephritis

Nephrotic Syndrome


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HIV/AIDS

Human Immunodeficiency Virus (HIV)

Acquired Immune Deficiency Syndrome

(AIDS)


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TOOLS TO DIAGNOSIS

Body Mass Index (BMI)

Ratio of height to weight

Mid Muscle Area (MMA) Mid arm circumference and tricep skin fold

Palliative Performance Scale (PPS)

Determines functional status


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TOOLS TO DIAGNOSIS (cont)

Functional Assessment Stage (FAST) Determine functional and mental status of

dementia patients

New York Heart Association (NYHA) Determine heart failure level

Pain Scale (0 10)

Determine level of pain

Pressure Ulcer Staging

Determine severity of wounds


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REGULATIONS & POLICIES

CMS Section 418.54

State Section 63-1-860


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SUMMARY

Admission nurse has the knowledge of:

common hospice diagnosis

tools to help support diagnosis

CMS and state regulations

pam kieslich hca220 final.pptx

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