Ask Proactive – Our facility would like to start a process for assessing post-COVID patients to determine if they would benefit from restorative nursing program(s). This will be for those patients who are not appropriate for skilled therapy services. I know our licensed nurse can complete the assessment and implement the program, but how do you suggest we go about developing specific programs without therapy recommendations?

Our facility would like to start a process for assessing post-COVID patients to determine if they would benefit from restorative nursing program(s). This will be for those patients who are not appropriate for skilled therapy services. I know our licensed nurse can complete the assessment and implement the program, but how do you suggest we go about developing specific programs without therapy recommendations?

A:

COVID-19 residual deficits may include fatigue, dyspnea, cough, arthralgia, cognitive impairment, myalgia, depression, and/or swallowing issues. The licensed nurse Individual assessment will benefit from including interviews with any of the following: nurse assistants, nurses, activity personnel, resident, family, and therapy. Patient assessments may also benefit from review of Incident/Event reports, MDS Assessments (declines in Mobility, ADL/ROM, continence, swallowing disorders, language/communication problems, falls) Quality Measure reports, and other reports available within your EHR. Depending on the individual clinical needs of the patient, intervention focus areas could be appropriate in any of the following: mobility and strengthening exercises, ADL enhancement, energy conservation strategies, endurance training, balance strategies, dysphagia techniques, communication/voice impairments strategies, memory aid, attention skills, visual-spatial ability techniques, executive function skills, and/or breathing exercises.

For more information on restorative nursing programs, resource pages O-42 – O-49 of the MDS 3.0 RAI Manual.