Admit to Reliant at Home Hospice. Dx: ????????
MD: Dr. George
Code Status: ?????
Diet as tolerated. (specify diet)
Activity as tolerated.
Initiate skin/wound protocol for skin breakdown and/or minor wound care as per
Hospice policy.
May initiate bowel protocol for constipation as indicated.
Sodium phosphate (Fleets) or SS enema prn.
May manually check for impaction and manually dis-impact as prn.
May insert indwelling catheter for relief of urinary retention or incontinence. Irrigate
and/or change catheter prn.
Continue current medications.
May change route of administration prn.
May use generic drug equivalents.
Medications may be administered by patient, nurse, and/or primary caregiver.
Oxygen at 2-4 lpm for dyspnea / comfort prn.
SN to perform O2 saturation using pulse oximeter as needed. SN to report O2 sat <80%
to MD.
Monitor and control pain level.
No lab work or diagnostics to be done by the nursing home pertaining to the Hospice
Diagnosis: XXXXXXXXX.
Order home medical equipment as needed.
Hospice MD or RN will pronounce death.
Each discipline (SN, CNA, SW, Chaplain, Homemaker, Volunteer, Physician) may visit
as frequently as needed to meet the patient's and/or family's needs and as approved by
the Hospice Interdisciplinary team.
Frequency and Assigned staff:
RN: 1 time weekly and 2 prn every 7 days.
CNA: 3 times weekly
SW: 1 time monthly and 1 prn every 30 days.
SC: 1 time monthly and 1 prn every 30 days.
Volunteer: NONE.