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A home health assessment of the post-operative status of a patient with hip replacement surgery focuses on the following five elements: 1. surgical wound healing, including assessing for signs of site infection View Hip Replacement Recovery: 2020 PDGM Utilization Guidelines. 1. Surgical Wound Assessment M1342Assessing any wound includes evaluating for tissue loss, clinical appearance of the wound bed and stage of healing, wound dimensions, condition of the wound edge, presence of drainage or exudate, presence of a fever. M1342 is an 'outcome measure', the HHA's statistics on improvement published by Medicare on Home Health COMPARE. The purpose of the OASIS question "(M1342) Status of Most Problematic (Observable) Surgical Wound" is to identify, track, and quantify the level of healing for any observable surgical wound. the available answers are: 0 Newly epithelialized KEEP IN MIND...one common mistake made with this particular question is that a fresh wound without any observable complications (e.g., a very recent knee replacement wound) is considered to be in a healing stage, however, since we are determining a baseline at the start of care to track the wound, “3 Not healing” is actually the
correct response. We want to establish a baseline at the start of care and then track its progress from that point forward throughout that patient’s care period. 2. Pain Assessment M1242M1242 is another 'outcome measure'. The available answers for M1242: Frequency of Pain Interfering with patient's activity or movement are
0 Patient has no pain KEEP IN MIND...assess the patient's pain level - using the above metrics - when the patient IS COMPLIANT WITH CURRENT PAIN INTERVENTION (medications and non-medical pain management techniques). The clinician's pain assessment must include ability to perform ADLs and IADLs can provide additional information about such pain. 3. TransferringM1850 Transferring is another 'outcome measure'. Physical therapy typically assesses all different manners of transfer: wheelchair, bed-chair, slide-board, pivot, chair-commode, scoot. KEEP IN MIND...To the home health agency, most important, however, the ability to perform a SAFE transfer from bed to chair, or if bedbound, the ability to position self in bed. Available OASIS answers: 0 Able to independently transfer. From the OASIS Guidance Manual: • In order for the assistance to be considered minimal, it would mean the individual assisting the patient is contributing less than 25% of the total
effort required to perform the transfer. 4. Toilet TransferringM1840 is the next functional assessment with treatment addressed by the physical therapist. 0 Able to get to and from the toilet and transfer independently with or without a device. 5. M1860 Ambulation/LocomotionM1860 is another outcome measure. Physical therapy typically assesses the patient's gait on level and non-level surfaces, stairs and steps. This assessment coincides with the OASIS M1860 question. Available answers are: 0 Able to independently walk on even and uneven surfaces and negotiate stairs with or without railings (specifically: needs no human assistance or assistive device). 6 Ways to Improve Home Health Face to Face COVID-19: Daily Management Plan for Home Health Agencies Can Your Governing Body Answer These 10 Questions? Tags: DX Hip Replacement What are nursing interventions Post op hip replacement?Nursing Interventions. Maintain affected joint in prescribed position and body in alignment when in bed. ... . Medicate before procedures and activities. ... . Turn on unoperated side using adequate number of personnel and maintaining operated extremity in prescribed alignment.. Which nursing interventions would the nurse include in the plan of care for a client after a hip replacement?A. Nursing interventions that are required in postoperative care include prompt pain control, assessment of the surgical site and drainage tubes, monitoring the rate and patency of IV fluids and IV access, and assessing the patient's level of sensation, circulation, and safety.
What care measures are needed after hip replacement?Activity. You will need to be careful to not dislocate your new hip when you are walking, sitting, lying down, dressing, taking a bath or shower, and doing other activities. Avoid sitting in a low chair or soft sofa. Keep moving and walking once you get home.
What special precautions need to be in place when caring for a postoperative hip replacement patient?Hip Replacement (Posterior) Precautions: Don't bend your hip too far. Don't lean forward while you sit down or stand up, and don't bend past 90 degrees (like the angle in a letter "L"). ... . Don't lift your knee higher than your hip.. Don't sit on low chairs, beds, or toilets.. |