VUH: HED ASSESSMENT AND PRIORITY PROBLEMS INTEGRATED
Nursing Assessments will reflect a complete problem list
9.3.13/da
Assessments (Cardiac, GI, etc.) will be replaced as follows:
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Standard met will be replaced by WNL or Baseline
o Within normal limits (WNL) indicates absence of significant problems in the drop-down list.
Problems are significant when they may affect the plan for care or should be communicated to
the next caregiver. Baseline reflects chronic problems which are not the reason for admission.
Standard met except will be replaced by the Priority Problem List
This will allow staff to better visualize the complete assessment and then identify priority problems.
Example:
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(OLD) GI Assmnt: Standard Met, stand met except
(NEW) GI Assmnt (problems): WNL, Nausea, Bowel Incontinen, Constipation, ….
Note: Nurses will continue to chart as usual – this will require no additional documentation
Auto-created general
problem list from basic
assessments.
Example: After reviewing all the problems – identify 2-4 Priorities…