NURSING TASKS BASED ON ACUITY SCORE

Re-Hospitalization Intervention Program (RHIP) Nursing Tasks

High Risk for CHF

  • Respiratory to assess patient bi-weekly & prn
  • Secure physician orders for 30 days: daily weights
  • Confirm with physician about patients home diuretics and if a change is warranted
  • Start Incentive spirometery (IS) on any patient with high risk for CHF and instruct patient to use IS Q4 while awake 10 times. IS physician orders can be to patient bedside
  • Secure physician orders for +2 Pitting Edema to elevate legs & recommend support stockings
  • Vital signs should be checked every 8 hours for 30 days (include Borg scale & breath sounds)
  • Notify MD of 3lb weight gain in 2 days and 5lb weight gain in 5 days

Low Risk for CHF

  • Respiratory to assess weekly & prn
  • Secure physician orders for weights for 30 days: 3 times a week
  • Vital signs should be checked every day & prn for 30 days
  • Notify MD of 3lb weight gain in 2 days and 5lb weight gain in 5 days
  • Secure physician orders for +2 Pitting Edema to elevate legs & recommend support stockings

High Risk for Pneumonia

  • Respiratory to assess bi-weekly & prn
  • Initiate oral hygiene & hand washing protocol for patient
  • Start incentive spirometery on any patient with high risk for pneumonia and instruct patient to use IS Q4 while awake 10 times. IS physician orders can be to patient bedside
  • Vital signs should be checked every 8 hours for 30 days (include Borg scale & breath sounds)

Low Risk for Pneumonia

  • Respiratory to assess weekly & prn
  • Initiate oral hygiene & hand washing protocol for patient
  • Vital signs should be checked every day & prn for 30 days
  • Start incentive spirometery on any patient with high risk for pneumonia and instruct patient to use IS Q4 while awake 10 times. IS physician orders can be to patient bedside

High Risk for COPD

  • Respiratory to assess bi-weekly & prn
  • Initiate oral hygiene & hand washing protocol for patient
  • Start incentive spirometery on any patient with high risk for COPD and instruct patient to use IS Q4 while awake 10 times. IS physician orders can be to patient bedside
  • Vital signs should be checked every 8 hours for 30 days (include Borg scale & breath sounds)
  • Secure physician orders for Spirometery Testing to determine COPD severity index

Low Risk for COPD

  • Respiratory to assess weekly & prn
  • Initiate oral hygiene & hand washing protocol for patient
  • Vital signs should be checked every day & prn for 30 days (include Borg scale & breath sounds)
  • Start incentive spirometery on any patient with high risk for pneumonia and instruct patient to use IS Q4 while awake 10 times. IS physician orders can be to patient bedside