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“Care My Way” Comprehensive Care Planning Jaclyn Pederson Background The Care Plan Balance Before Team Knowledge After Clinical Expertise Team Knowledge Clinical Expertise Care Plan Audit Tool and Goals July 2019 – Citation on F 656 (Comprehensive Care Planning) Following this citation, and after further review, our care planning team determined that several resident specific goals and approaches were not integrated into their care plans. In fact, many of our staff members knew specific ways to care for the resident, including resident preferences, yet these instructions and interventions were not captured in the care plan. Improvement Data Act: Share audit findings and provide continued education and empowerment of team. Plan: Develop a comprehensive understanding of the care planning processes and best practices. Do: Create or update care planning audit tool. Provide ongoing support to the team in updating and using the care plan appropriately. Number of Care Plans 18 16 Check: Audit all care plans using the Care Planning Audit Tool 10 8 6 4 2 0 1 2 3 4 5 Results Number of Care Plans Approach Specificity 18 16 14 12 10 8 6 4 2 0 Category Result Quarterly Review 56% Accuracy Score One Two Three Four 64% 29% Goal Comprehensiveness 100% 0% 93% 7% Five 25 Improvement needed to meet project goals 20 Project Result 30 Individualization: A new staff member could read 100% of care plans and know how to take care of each specific resident Met or several aspects specific to the resident using examples and measures. Impact Quality of Resident Care Quality of Resident Life Resident and Staff Relationships “Robert Smith” Example: Staff Member and Resident at St. Elizabeth Home, accessed: 4/2/20. stelizabethcampus. com/resources Clinical Expertise Team Knowledge Diagnosis: Diabetic ulcer to the right heel Bobby is not comfortable with his wound treatment and prefers to watch television to distract himself during the treatment. Nutrition: Pureed and thickened liquids related to dysphagia and fatigue Bobby dislikes most pureed foods as he is not yet used to the texture. If refusing the meal offer mashed potatoes or applesauce. Mood State: Resident Bobby’s wife, Gina, recently passed away. Bobby has occasional tearful episodes related to this receives antidepressant medication related to history event. Offer short visits daily to allow Bobby to of anxiety and feeling down. talk about Gina as this helps him with his grieving process. 36% 71% Goal Comprehensiveness Number of Care Plans Improvement Needed to Meet Goals 44% Individualized Approach Specificity accurate – “ 5” on the 1 -5 scale. Approach Specificity: 100% of care plans include some 20 12 Accuracy Score: 100% of care plans are completely resolve of the identified problem. Overall Accuracy Score 14 quarterly at minimum. Goal Comprehensiveness: 100% of care plans represent Methodology Anthony Wahl/The Janesville Gazette via AP. Sister Denise praying the rosary with a resident at St. Elizabeth Nursing Home in Janesville, Wis. , July 26, 2017. https: //www. aikenstandard. com/ap/sisters-at-heart-of-st-elizabeth-home-for-years/article_8 e 08 eae 2 -891 a-11 e 7 -bff 7 -cf 50997 c 5 c 05. html Quarterly Review: Ensure 100% of care plans are updated Recommendations Director of Nursing and Administrator= Process Owners Quarterly audit of care plans – accuracy and updates 15 Continue care planning education as needed 10 5 0 No Yes Acknowledgements: St. Elizabeth Campus: Michelle Godfrey, NHA; Casey Schuett, Assistant NHA; Christy Skalecki, DON; Tanya Wilburn, Former DON; Constance Tetrev, Former Nurse Manager; Jennifer Miller, Nurse Manager; Emily Shoemaker, Life Coach; Athena Johnson, Life Enrichment Director; all nursing and caregiving staff; Marquardt Management: Sherry Cira, Chief Innovation Officer; Ginger Davies, Nurse Consultant; UWEC Health Care Administration Faculty and Staff, UWEC Learning and Technology Services.