Restorative Nursing is a Viable Solution

Restorative Nursing is a Viable SolutionRestorative nursing programs have long been an important part of long-term care, even before it was thought of as a program. This concept has been used by health care organizations to appease families who believed their loved one was not receiving enough exercise; to enhance the lower Resource Utilization Group scores in case-mix states; to add to the marketing brochure; to maintain the capabilities learned in therapy; or give a busy therapy department an in-facility referral outlet.

Now, the Center for Medicare and Medicaid (CMS) is urging all levels of health care to transition patients/residents to the lowest level of care they can reach as efficiently and cost effectively as possible, and restorative nursing can help. Health care organizations have recognized that the central purpose of the restorative nursing program is to promote the resident’s ability to adapt and adjust to living as independently and safely as possible. The concept actively focuses on the resident achieving and maintaining the optimal physical, functional, mental, and psychosocial capability that they can.

Restorative nursing modalities meet the basic objectives of the CMS Nursing Home Action Plan: improve the individual experience of care; improve the health of the population; and reduce the per capita cost of care for populations.

Restorative nursing is:

  • Nursing driven
  • Goal oriented
  • Focused on what the resident can do
  • Assists in improving the quality of life
  • Is individual-centered
  • A regulatory requirement of CMS

Restorative nursing is not:

  • Therapy driven
  • Provided only for reimbursement purposes
  • An optional service in LTC
  • For alert residents only
  • Required to have specialized equipment
  • The same for all residents

CMS has encouraged long-term care staff to examine and update their practices to ensure resident choice, and promote resident centered care. A restorative nursing program is an excellent place to start, since restorative is closely connected to positive resident outcomes; the federal quality indicator program; CMS’s Five Star Rating system; reimbursement; and the outcome of the state survey process.

Restorative nursing program principles do require additional training beyond the state tested nursing assistant class for the staff. Staff is trained to recognize that the decline in the resident’s capabilities is avoidable when the assessment or interventions are adequate, and that reassessment and revision of the interventions must be completed on a continuous revolving cycle. A functional restorative nursing program benefits include:

  • Aiding the resident in slowing decline and, if other discharge areas line up, has been able to move the resident through the transition process.
  • Improvement in the quality indicators, the 5 Star program, and the regulatory process. The program or lack thereof can affect eleven individual F tags from F 310 ADL’s to F 498 Nurse Aides.
  • Resident/family satisfaction is improved when a program to restore the resident is in place

You can create a restorative nursing program by developing a quality assurance action plan. When creating your plan, ask yourself if your quality indications for ADL or incontinence show decline, are you meeting your quality measures at a benchmark that represent quality, and are your resident/family satisfaction surveys responding positively or are they full of negatives?

A quality restorative nursing program is very beneficial for facility quality improvement. If you’re interested in developing or implementing a restorative nursing program at your health care facility, the RMS can help. To learn more, or to contact RMS, visit: AssuredPartners NL Clinical Risk Management.

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