The goal of a restorative nursing care plan is to ensure that a resident’s abilities in activities of daily living do not diminish unless circumstances of the individual’s clinical condition demonstrate that diminution was unavoidable. The restorative nurse plays a vital part in improving and maintaining the residents’ quality of life and quality of care in the long term care facility.
Restorative Nursing for Long Term Care provides the essential information, forms, and nursing care plans to facilitate the organization and efficiency of a restorative nursing program. The first section gives a full description of the Restorative Nursing position and definitions and criteria of a Restorative Nursing program. Helpful tools are provided to assure easy and comprehensive data collection, completion of MDS 3.0 information, analysis of data, and recording of vital information.
Sections are included for thirteen different restorative nursing programs, and provide evaluations, assessments, and restorative nursing care plans. Care plans and forms are updated yearly to ensure compliance with the change to MDS version 3.0 and with all of the federal regulations and guidelines updated during the past year. All of the forms and care plans in the book are included on the CD so they can be saved to a computer whenever needed. By adding or deleting entries, the forms and care plans can be made resident-specific.
Forms on the CD are not numbered. Forms in the manual are numbered for the sake of convenience. Definitions and criteria of restorative nursing care plans are from the Revised Long Term Care Resident Assessment Instrument (RAI) User’s Manual, CMS.
Generally, restorative nursing care plans are initiated when a resident is discharged from formalized physical, occupational, or speech rehabilitation therapy. A resident may also be started on a Restorative nursing care plan when he/she is admitted to the facility with restorative needs, but is not a candidate for formalized rehabilitation therapy, or when a restorative need arises during the course of a custodial stay.
Restorative nursing care plans:
- Do not require a physician’s order.
- Do not include procedures or techniques carried out by or under the direction of qualified therapists.
- Do not include groups with more than four residents per supervising helper or caregiver.
If a restorative nursing care plan is in place when a care plan is being revised, it is appropriate to reassess progress, goals and duration/frequency as part of the care planning process. Good clinical practice would indicate that the results of this “reassessment” should be documented in the record. When not contraindicated by state practice act provisions, a progress note written by the restorative aide and countersigned by a licensed nurse is sufficient to document the restorative nursing care plan once the purpose and objectives of treatment have been established.
Restorative nursing care plans must meet all of the following criteria:
- Measurable objectives and interventions must be documented in the care plan and in the clinical record.
- Evidence of periodic evaluation by a licensed nurse must be present in the clinical record.
- Nurse assistants/aides must be trained in the techniques that promote resident involvement in the activity.
- These activities are carried out or supervised by members of the nursing staff. Sometimes, under licensed nurse supervision, other staff and volunteers will be assigned to work with specific residents.
For restorative nursing care plans to qualify for Medicare reimbursement:
- There must be two or more different restorative activities at least six days per week, each practiced for a total of at least 15 minutes during each 24-hour period.
- The 15 minutes of time in a day may be totaled across 24 hours (10 minutes on the day shift plus 5 minutes on the evening shift) however; 15-minute time increments cannot be obtained by combining O0500A through J.
Table of Contents
- Job Description for Restorative Program Director
- Policy and Procedure for Restorative Program
- Definitions and Criteria
- Resident Care Regulations
- Data Collection
- Quality Indicators and Quality Measures
- QI / QM Reports 12
- MDS Entries Indicating Possible Restorative Potential
- Coding Section O0500 of the MDS
- MDS RUG-IV Categories
- Restorative Nursing Referral
- Nursing Assistant Flow Sheet
- Summary Notes
- Restorative Program Log
- Factors to Review for ADLs
- ADL Problem Evaluation
- CAT Module ADLs
Ambulation / Falls
- Evaluation for Restorative Ambulation
- Test for Balance
- Coding Section G0300 of the MDS
- Balance / Gait Assessment – Long Form
- Balance / Gait Assessment – Short Form
- Fall Prevention and Restorative Nursing
- Factors to Review for Fall Risk
- CAT Module for Falls
- Fall Risk Assessment Form
- Fall Risk Care Plan
- Cane Care Plan
- Crutches Care Plan
- Gait Belt Care Plan
- Walker Care Plan
Policy and Procedure for Transfers and Lifts
Evaluation for Transfers
Transfers Care Plan
Evaluation for Bed Mobility
Turning Repositioning Care Plan
Range of Motion
Policy and Procedure for Range of Motion
Range of Motion Exercises
Coding Item G0400 of the MDS
Measuring Range of Motion
Evaluation for Range of Motion
Range of Motion Care Plan
Evaluation for Wheelchair Use
Locomotion Care Plan
Brace / Splint
Evaluation for Brace / Splint
Brace / Splint Care Plan
Amputation / Prosthesis
Evaluation for Amputation / Prosthesis Care
Amputation Prosthesis Care Plan
Dressing / Personal Hygiene
Evaluation for Dressing / Personal Hygiene
Dressing Care Plan
Personal Hygiene Care Plan
Eating / Swallowing
Factors to Review for Nutritional Status
CAT Module for Nutritional Status
Evaluation for Restorative Dining
Restorative Dining Care Plan
Chewing Problem Care Plan
Swallowing Problem Care Plan
Coding MDS Section H
CAT Module for Urinary Incontinence
Evaluation for Incontinence
Policy and Procedure for Toileting Programs
Bowel Incontinence Care Plan
Functional Incontinence Care Plan
Stress Incontinence Care Plan
Urge Incontinence Care Plan
Toileting Care Plan
Factors to Review for Urinary Catheters
Audit for Urinary Catheter Use
Catheter Care Plan
Factors to Review for Communication
CAT Module for Communication
Evaluation for Communication
Speech Impaired Care Plan
Receptive Communication Problem Care Plan
Hearing Aid Use Care Plan
Evaluation for Medication Self-Administration
Medication Self-Administration Care Plan
Nasal Spray Care Plan
Inhaler Care Plan
Blood Glucose Monitoring Care Plan
Insulin Care Plan
Evaluation for Ostomy Care
Ostomy Care Plan
CD-ROM is in back of the book
Also included is a free book with your book purchase! Restorative Nursing Inservice Book Includes five inservices
activities of daily living:
- Range of Motion
- Therapeutic Dining
- Transfers and Lifts
- Urinary Incontinence
The restorative nursing inservices in this manual are focused on the learning needs of restorative nursing assistants, and uses the language of the MDS 3.0 and nursing care plan, encouraging consistency in the long term care health care team approach. Quality assurance expectations are reflected in the lessons, making quality of care a priority as well as meeting regulatory expectations. Each restorative nursing inservice topic packet includes everything needed to implement an entire inservice and includes:
- Objectives and Outline
- Speaking Notes
- Test with Key
- Pre-test and Post-test