HOSPICE ADMISSION NURSING TRAINING

HCA/220 Pamela Kieslich Ellen Lipscomb October 7, 2012

OVERVIEW
After this training presentation the admission nurse will be able to: Evaluate patients for hospice care. Use tools for evaluation of patients. Understand regulation and policies.

GOALS
Timely evaluation of hospice referral patients. Understanding common hospice diagnosis. Assess patient to determine appropriate hospice diagnosis. Charting of patient comprehensive assessment and plan of care. All documentation is on time and complete according to CMS and state policy.

REFERRALS
Patient referrals come from many sources: Physician offices Family members Hospitals Other hospices

Company policy states referrals are addressed within 2 hours of initial call and patient evaluation completed within 4 hours.

THE REFERRAL PROCESS

Referral received Obtain physician order for evaluation Request History & Physical (H&P) Schedule evaluation with family

COMMON HOSPICE DIAGNOSIS

Cancer Cardiopulmonary Liver Disease End Stage Renal Disease Alzheimers and related disorders HIV/AIDS

CANCER
Any malignant cancer that will no longer be treated with aggressive measures. Laboratory tests confirm carcinoma/neoplasm.

CARDIOPULMONARY
Congestive Heart Failure (CHF) Coronary Artery Disease (CAD) Acute Myocardial Infarction Chronic Obstructive Pulmonary

Disease(COPD)
Cystic Fibrosis

LIVER DISEASE
End Stage Liver Disease Cirrhosis alcoholic and non-alcoholic Hepatitis Sclerosing Cholangitis

RENAL DISEASE
End Stage Renal Disease Chronic Renal Failure Lupus Nephritis Rapidly Progressive Glomerulonephritis

Nephrotic Syndrome

ALZHEIMERS AND RELATED

Alzheimers Dementia Failure to Thrive Huntingtons chorea

Amyotrophic lateral sclerosis

HIV/AIDS
Human Immunodeficiency Virus (HIV) Acquired Immune Deficiency Syndrome (AIDS)

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

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

REGULATIONS & POLICIES

CMS Section 418.54 State Section 63-1-860

SUMMARY
Admission nurse has the knowledge of:
common hospice diagnosis tools to help support diagnosis CMS and state regulations